Specifications include, but are not limited to: Mandatory 1: Quality Review Process. The Vendor shall develop and maintain a Quality Review Process to address all quality issues identified and referred for assessment as well as identified patterns of unnecessary utilization of inpatient or outpatient services or patterns of incorrect diagnostic and procedural coding resulting in Diagnosis Related Group (DRG) changes. Mandatory 2: Assessment of Quality of Care Issues. The Vendor shall:D.2.3.1.Assess suspected quality of care issues in inpatient and outpatient settings, and for other types of care or settings as directed by the Department. The Vendor shall comply with 42 CFR Part 476 and determine completeness, adequacy and quality of hospital care provided.D.2.3.2.Include in its assessment a physician review of the medical record and notification to providers of potential quality of care issues;D.2.3.3.Determine, for each issue assessed, whether a lapse in quality occurred and if so, whether a single significant quality issue occurred or whether a provider exhibits a pattern of quality issues;D.2.3.4.Review Provider’s Quality Improvement Plan (QIP), provide guidance to the Provider necessary to achieve Vendor’s approval of the QIP, and conduct ongoing monitoring of the Provider’s implementation of the approved QIP. The Vendor may direct a provider to develop a QIP to correct a quality issue or serious pattern of concern that the Vendor has identified. D.2.3.4.1.Vendor may suggest corrective action steps to the provider without a formal QIP if quality concerns do not rise to the level of a single significant quality issue or a pattern of quality issues. D.2.3.4.2.Provide technical support to providers as needed to develop acceptable QIPs, and notify the provider when the QIP is acceptable and approved. A copy of the approved QIP will be provided to the Department. D.2.3.4.3.Monitor the provider’s implementation of the QIP, and notify the Department of any provider’s failure to fully implement a QIP.D.2.3.4.4.Submit a monthly Summary Report of QIPs and validated serious quality issues and/or patterns of quality concerns requiring further action which may include notification to the Department’s Office of Inspector General (OIG), as referenced in Section D.3.2.3.5. Mandatory 3: Web Portal. Vendor shall establish and maintain a secure web-based system for submission of data by multiple sources.D.2.4.1.1.The Vendor shall develop and provide training materials for users of the web-based system and provide support to user groups as needed. D.2.4.1.2.The web-based system shall provide and support the collection and analysis of data necessary to support review processes.D.2.4.1.3.The web-based system shall have the ability to give providers access to real-time review status and outcomes, direct project management, database administration, and technical and business analysis.D.2.4.1.4.The Vendor shall provide modifications to its web-based system as requested by the Department reasonably within the scope of services under this RFP.