PUBLIC LAW 105-33 —AUG. 5, 1997 111 STAT. 499 data as the Secretary approves, in consultation with the State. "(iv) PERIODIC REVIEW. —Regular, periodic examinations of the scope and content of the strategy. "(B) STANDARDS. — The strategy developed under subparagraph (A) shall be consistent with standards that the Secretary first establishes within 1 year after the date of the enactment of this section. Such standards shall not preempt any State standards that are more stringent than such standards. Guidelines relating to quality assurance Applicability, that are applied under section 1915(b)(1) shall apply under this subsection until the effective date of standards for quality assurance established under this subparagraph. "(C) MONITORING.— The Secretary shall monitor the development and implementation of strategies under subparagraph (A). "(D) CONSULTATION. —The Secretary shall conduct activities under subparagraphs (B) and (C) in consultation with the States. "(2) EXTERNAL INDEPENDENT REVIEW OF MANAGED CARE ACTIVITIES. — "(A) REVIEW OF CONTRACTS. — "(i) IN GENERAL. —Each contract under section 1903(m) with a medicaid managed care organization shall provide for an annual (as appropriate) external independent review conducted by a qualified independent entity of the quality outcomes and timeliness of, and access to, the items and services for which the organization is responsible under the contract. The requirement for such a review shall not apply until after the date that the Secretary establishes the identification method described in clause (ii). "(ii) QUALIFICATIONS OF REVIEWER. — The Secretary, in consultation with the States, shall establish a method for the identification of entities that are qualified to conduct reviews under clause (i). "(iii) USE OF PROTOCOLS.The Secretary, in coordination with the National Governors' Association, shall contract with an independent quality review organization (such as the National Committee for Quality Assurance) to develop the protocols to be used in external independent reviews conducted under this paragraph on and after January 1, 1999. "(iv) AVAILABILITY OF RESULTS. —The results of each external independent review conducted under this subparagraph shall be available to participating health care providers, enrollees, and potential enrollees of the organization, except that the results may not be made available in a manner that discloses the identity of any individual patient. "(B) NONDUPLICATION OF ACCREDITATION.^A State may provide that, in the case of a medicaid managed care organization that is accredited by a private independent entity (such as those described in section 1852(e)(4)) or that has an external review conducted under section 1852(e)(3), the external review activities conducted under subparagraph (A) with respect to the organization shall
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