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Family Care, Family Care Partnership, and PACE: External Quality Review Activities

The 42 Code of Federal Regulations, §438, requires states that manage certain types of programs to have an external quality review. We contract with a company called MetaStar. They are not part of Wisconsin Department of Health Services (DHS). They help check the quality of our programs:

Federal regulations and Centers for Medicare & Medicaid Services protocols define external quality review activities. On a routine basis, MetaStar:

  • Looks at the quality of services provided to program members. They review the contract DHS has with managed care organizations.
  • Confirms whether each managed care organization is in line with federal and state rules. These rules ensure that programs meet members’ needs.

External quality review reports

MetaStar submits a technical report each year based on their findings:


Last revised December 4, 2023