Delegated Functions

Priority Health may delegate activities to another party ("delegate").  Priority Health maintains a process by which delegation of certain functions may occur.

Prior to contractual agreement, Priority Health will determine if the delegate's operational processes and performance of these activities meets NCQA standards, OFIR regulations, CMS regulations and Priority Health's own standards for these programs and present the findings to the Quality Integration Committee for approval of the delegation. 

On-going oversight of delegated activities will be performed at least annually and will include a review of established policies and procedures and the delegate's performance against agreed upon outcomes via, performance goals and benchmarks through objective and measurable indicators.  Based on the findings of the on-going or at least annual review, follow-up corrective actions plans will be initiated as required by the Plan.