Ohio Admin. Code 4123-6-70 - Evaluation of the QHP system by the bureau; reporting requirements by employers and QHPs

(A) To enhance the quality of the QHP system, and pursuant to division (G) of section 4121.44 of the Revised Code, divisions (D)(9) and (G) (A)(9) of section 4121.442 of the Revised Code, and division (D)(2)(d) of section 4121.125 of the Revised Code, the deputy administrator for the division of medical management and cost containment shall require employers and QHPs that participate in the workers workers' compensation QHP system to report data to be used by the administrator to: measure

(1) Measure and perform comparison analyses of costs, quality, appropriateness of medical care, and effectiveness of medical care delivered by all components of the workers compensation system. ; and

(2) Publish and report compiled data to the governor, the speaker of the house of representatives, and the president of the senate every six months to gauge the measures of outcomes and savings of the QHP system.

(B) The bureau shall evaluate the effectiveness of the QHP system based on standardized data and reporting requirements developed by the bureau.

(C) The bureau shall receive, define and publish data elements and data collection techniques that meet the thirteen standards set forth in divisions (D)(1) to (D)(13) (A)(1) to (A)(13) of section 4121.442 of the Revised Code and are necessary to evaluate the effectiveness of the QHP system. Performance indicators used by the bureau to evaluate the effectiveness of the QHP system may include, but shall not be limited to, the following: customer satisfaction; system cost drivers; improvements in quality, and cost reductions.

(D) QHPs shall submit to the bureau no more than twice per year, on standardized forms developed by the bureau, data that provide the bureau with information enabling the bureau to determine the effectiveness of the QHP system.

Notes

Ohio Admin. Code 4123-6-70

Five Year Review (FYR) Dates: 08/26/2015 and 08/25/2020
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.121, 4121.30, 4121.31, 4121.44, 4121.441, 4121.442, 4123.05
Rule Amplifies: 4121.12, 4121.121, 4121.44, 4121.441, 4121.442
Prior Effective Dates: 9/5/96, 2/1/10

Effective: 2/1/2010
R.C. 119.032 review dates: 11/17/2009 and 11/01/2014
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.30, 4121.31, 4123.05
Rule Amplifies: 4121.121, 4121.44, 4121.441, 4121.442, 4123.66
Prior Effective Dates: 9/5/96