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

Standard XIII: Community Outreach
CONTRACT
SECTION
28. Permitted:
Attending
Health Fairs/
Public Events
CC-IV.B.3.a
29. Permitted:
Leaving
Outreach
Materials at
Health Fairs/
Public Events
CC-IV.B.3.b
30. Permitted:
Providing
Community
Outreach
Materials
CC-IV.B.3.c
AGENCY FOR HEALTHCARE ADMINISTRATION
MANAGED CARE ORGANIZATIONS
Compliance Monitoring Tool with Specific Contract Standards
CONTRACT REQUIREMENT COMPLIANT SCORING
The health plan may engage in the following
activities upon prior written notice to BMHC:
The health plan may attend health fairs/public
events upon request by the sponsor and after
written notification to BMHC.
The health plan may engage in the following
activities upon prior written notice to BMHC:
The health plan may leave community outreach
materials at health fairs/public events at which
the health plan participates.
The health plan may engage in the following
activities upon prior written notice to BMHC:
The health plan can provide BMHC-approved
community outreath materials. Such materials
may include Medicaid enrollment and eligibility
information and information related to other
health care projects and health, welfare, and
social services provided by the State of Florida
or local communities.
The health plan staff, including community
outreach representatives, refers all health plan
inquiries to the member services section of the
health plan or the Agency’s choice
counselor/enrollment broker. BMHC approval of
the script used by the health plan’s member
services section must be obtained before usage.
No
Yes
No
Yes
No
Yes
No
Met
Partially Met
Not Met
Met
Partially Met
Not Met
Met
Partially Met
Not Met
DOCUMENTS
REVIEWED
FINDINGS
State of Florida Compliance Monitoring_Standard_XIII_F2_07_11
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