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:
- Family Care
- Family Care Partnership (Partnership)
- PACE (Program of All-Inclusive Care for the Elderly)
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: