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

8
providers
Agency For Health Care Administration
Managed Care Organizations
Child Health Check-Up Policy Checklist
REQUIREMENTS FOR CHILD HEALTH CHECK-UP
Required Components File #1 File #2 File #3 File #4 File #5
The health plan achieved a CHCUP screening rate of at least sixty
percent (60%) for those enrollees who were continuously enrolled for
at least eight months during the federal fiscal years (October 1–
September 30).
a. This screening compliance rate is based on the CHCUP
screening data reported by the health plan and due to the
Agency by January 15 following the end of each federal
fiscal years as specified in Attachment II, Section XII,
Reporting Requirements.
b. The data is monitored by the Agency for accuracy, and if the
health plan does not achieve the 60% screening rate for the
federal fiscal year reported, the health plan will file a
corrective action plan (CAP) with the Agency no later than
February 15, following the fiscal year report.
c. The health plan adopted annual screening and participation
goals to achieve at least an 80% CHCUP screening and
participation rates, as required by the Centers for Medicare
and Medicaid Services. For each federal fiscal year that the
health plan does not meet the 80% screening and
participation rates, it must file a CAP with the Agency no
later than February 15 following the federal fiscal year being
reported. Any data reported by the health plan that is found
to be inaccurate will be disallowed by the Agency, and the
Agency will considers such findings as being in violation of
the Contract and may sanction the health plan accordingly.
(See s. 1902(a)(43)(D)(iv) of the Social Security Act)
Total # Applicable Elements
Total # Compliant Elements
Total Percent Compliant
Y N Y N Y N Y N Y N
Managed Care Organizations Page 3
Child Health Check-Up Policy Checklist F1_04_11
Florida Medicaid