Letter to CMS - Medicaid Managed Care Policies - Agency for ...

Standard IV: Enrollee Services & Enrollee Rights
CONTRACT
SECTION
CC- IV.A.17.d.3
83. Using
Redetermination
Date: Log of
Mailings
CC- IV.A.17.e.1
AGENCY FOR HEALTHCARE ADMINISTRATION
MANAGED CARE ORGANIZATIONS
Compliance Monitoring Tool with Specific Contract Standards
CONTRACT REQUIREMENT COMPLIANT SCORING
future time by the health plan. If the
health plan receives enrollee inquiries
about the notices, such inquiries are
referred to the DCF.
If the health plan chooses to participate
in using the redetermination date
information, it will keep the following
information about each mailing made
available for the Agency’s review within
5 business days after the Agency’s
request:
For each month of mailings, a dated hard
copy or pdf of the monthly template used
for that specific mailing:
a. A list of enrollees to whom a
mailing was sent. This list includes
each enrollee’s name and Medicaid
identification number, the address to
which the notice was mailed, and the
date of the Agency’s enrollment file
used to create the mailing list.
b. A log of returned, undeliverable mail
received for the notices, by month,
for each enrollee for whom a
returned notice was received.
a. Yes
No
N/A
b. Yes
No
N/A
Met
Partially Met
Not Met
DOCUMENTS
REVIEWED
FINDINGS
State of Florida Compliance Monitoring_Standard_IV_F2_07_11
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