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

Standard XV: Immunizations, Pregnancy, Drugs & Transportation
CONTRACT
SECTION
Factor-related
Drugs
CC-V.H.16.i
26. CAPITATED
PLANS:
Transportation
Services
CC-V.H. 20.a–20.c
27. NON-REFORM
PLANS not
Covering
Transportation:
CTD Providers
Exhibit 5
28. CMSSP ONLY:
Insurance,
Safety
Requirements
and Standards
AGENCY FOR HEALTHCARE ADMINISTRATION
MANAGED CARE ORGANIZATIONS
Compliance Monitoring Tool with Specific Contract Standards
CONTRACT REQUIREMENT COMPLIANT SCORING
with hemophilia and will not be responsible for the
distribution of hemophilia factor-related drugs.
Transportation services
• Transportation services include the
arrangement and provision of an appropriate
mode of transportation for enrollees to receive
medical services.
• If the health plan provides transportation, it
may do so through its own network of
transportation providers or through a
contractual relationship, which may include
the Commission for the Transportation
Disadvantaged.
• If the health plan does not provide
transportation services, it must assist enrollees
in arranging transportation to and from
medical appointments for Medicaid-covered
services.
The health plan refers enrollees needing transportation
to the Agency’s contracted Commission for the
Transportation Disadvantaged (CTD) provider in
order to assist them to keep and travel to medical
appointments.
Instead of the minimal liability insurance
requirements specified for Reform health plans in this
exhibit, the health plan, as a unit of state government
operated by the Department of Health, Children’s
Medical Services, is insured under the state’s
Comprehensive Risk Management Program as set
DOCUMENTS
REVIEWED
FINDINGS
State of Florida Compliance Monitoring_Standard_XV_F2_07_11
Yes
No
N/A
Yes
No
N/A
Yes
No
N/A
Met
Partially Met
Not Met
Met
Partially Met
Not Met
Met
Partially Met
Not Met
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