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

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Vendor Name:<br />

Review Period:<br />

Date of Review:<br />

Reviewer:<br />

Participating Vendor Staff Member:<br />

<strong>Agency</strong> For Health <strong>Care</strong> Administration<br />

<strong>Managed</strong> <strong>Care</strong> Organizations<br />

Cultural Competency Plan Review Tool<br />

CULTURAL COMPETENCY PLAN<br />

File # Title Yes or No Reference Comments<br />

1<br />

2<br />

3<br />

4<br />

5<br />

6<br />

The Cultural Competency Plan (CCP) is updated annually and submitted <strong>to</strong><br />

BMHC by Oc<strong>to</strong>ber 1.<br />

The CCP includes a mission statement which defines the purpose and<br />

rationale <strong>for</strong> implementing a CCP (statement <strong>to</strong> include the Plan’s values<br />

and principles).<br />

The CCP describes how providers will effectively provide services <strong>to</strong> people<br />

of all cultures, races, ethnic backgrounds and religions in a manner that<br />

recognizes, values, affirms and respects the worth of individual enrollees<br />

and protects and preserves the dignity of each.<br />

The CCP describes how health plan employees effectively provide services<br />

<strong>to</strong> people of all cultures, races, ethnic backgrounds and religions in a<br />

manner that recognizes, values, affirms and respects the worth of individual<br />

enrollees and protects and preserves the dignity of each.<br />

The CCP describes how health plan systems effectively provide services <strong>to</strong><br />

people of all cultures, races, ethnic backgrounds and religions in a manner<br />

that recognizes, values, affirms and respects the worth of individual<br />

enrollees and protects and preserves the dignity of each.<br />

If the health plan distributes a summary of the CCP <strong>to</strong> network providers, the<br />

summary includes in<strong>for</strong>mation on how the provider may access the full CCP<br />

on the website. The summary also details how the provider can request a<br />

hard copy of the CCP from the health plan at no charge <strong>to</strong> the provider.<br />

<strong>Managed</strong> <strong>Care</strong> Organizations Page 1<br />

Cultural Competency Plan Review Tool F2_05_10<br />

Florida <strong>Medicaid</strong><br />

Y N<br />

Y N<br />

42 CFR 438.206<br />

CC-VIII.A.4.a.<br />

Y N CC-VIII.A.4.a.<br />

Y N CC-VIII.A.4.a.<br />

Y N CC-VIII.A.4.a.<br />

Y N N/A<br />

42 CFR 438.206<br />

CC-VIII.A.4.b.

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