CFR > Title 42 - Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS (parts 430 to 456) > PART 438—MANAGED CARE > SUBPART E—External Quality Review (§438.310 to §438.370) > 438.350—State responsibilities.

438.350—State responsibilities.

Each State that contracts with MCOs or PIHPs must ensure that—
(a) Except as provided in § 438.362, a qualified EQRO performs an annual EQR for each contracting MCO or PIHP;
(b) The EQRO has sufficient information to use in performing the review;
(c) The information used to carry out the review must be obtained from the EQR-related activities described in § 438.358.
(d) For each EQR-related activity, the information must include the elements described in § 438.364(a)(1)(i) through (a)(1)(iv);
(e) The information provided to the EQRO in accordance with paragraph (c) of this section is obtained through methods consistent with the protocols established under § 438.352; and
(f) The results of the reviews are made available as specified in § 438.364.