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

More documents

Recommendations

Info

VARIATIONS BY HEALTH PLAN TYPE: No variations. REPORT TEMPLATE: The Agency supplied quarterly and annual MLR template can be found on the Bureau of Managed Health Care’s Medical Health Plan information web page at: http://ahca.myflorida.com/MCHQ/Managed_Health_Care/MHMO/docs/Templates/2009-2012- Templates/ANNUAL_MLR_REPORT.xls REMAINDER OF PAGE INTENTIONALLY LEFT BLANK Page 2 of 2
Attachment V Special Term and Condition #14d Health Plan Transition Process Provider Termination Policy
Page 3 and 4:
Attachment I Special Term and Condi
Page 5 and 6:
Attachment II Special Term and Cond
Page 7 and 8:
RICK SCOTT GOVERNOR 272 7 Mah an Dr
Page 9 and 10:
• Encounter data • Systems issu
Page 11 and 12:
Appendix A How to Become a Florida
Page 13 and 14:
How to Become a Florida Medicaid He
Page 15 and 16:
Appendix B MCO Application Checklis
Page 17 and 18:
4 5 6 7 8 9 10 Service Level(s) are
Page 19 and 20:
19 b. Total number of employees; AP
Page 21 and 22:
APPLICATION ITEM 25 3. In the past
Page 23 and 24:
32 33 34 35 36 APPLICATION ITEM 10.
Page 25 and 26:
APPLICATION ITEM C. Criminal Backgr
Page 27 and 28:
APPLICATION ITEM 43 13. For medical
Page 29 and 30:
46 47 APPLICATION ITEM 16. Indicate
Page 31 and 32:
49 APPLICATION ITEM 19. Describe in
Page 33 and 34:
51 52 53 54 55 56 APPLICATION ITEM
Page 35 and 36:
Attachment III Special Term and Con
Page 37 and 38:
RICK SCOTT GOVERNOR Regulatory Auth
Page 39 and 40:
e. Complete a credentialing review
Page 41 and 42:
RICK SCOTT GOVERNOR Regulatory Auth
Page 43 and 44:
Compliance Monitoring Tool with Spe
Page 45 and 46:
Standard I: Care Management/Continu
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Results for Standard I Care Managem
Page 53 and 54:
Standarrd II: Utilizatio on Managem
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Standard III: Eligibility, Enrollme
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Standard IV: Enrollee Services & En
Page 79 and 80:
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Results for Standard IV Enrollee Se
Page 105 and 106:
Standard V: Provider Credentialing
Page 107 and 108:
Standard VI: Provider Services CONT
Page 109 and 110:
Standard VI: Provider Services CC-
Page 111 and 112:
Standard VI: Provider Services CONT
Page 113 and 114:
Standard VII: Provider Contracting
Page 115 and 116:
AGENCY FOR HEALTHCARE ADMINISTRATIO
Page 117 and 118:
Standard VIII: Quality Improvement
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Results for Standard IX Medical Rec
Page 131 and 132:
Standard X: Access and Availability
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Results for Standard X Access and A
Page 147 and 148:
Standard XI: Grievances and Appeals
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Standard XII: Administration and Ma
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Results for Standard XII Administra
Page 191 and 192:
Standard XIII: Community Outreach C
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Results for Standard XIII Community
Page 205 and 206:
Standard XIV: Covered Services AGEN
Page 207 and 208:
Page 209 and 210:
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Page 219 and 220:
Page 221 and 222:
Page 223 and 224:
Page 225 and 226:
Page 227 and 228:
Page 229 and 230:
Page 231 and 232:
Page 233 and 234:
Standard XV: Immunizations, Pregnan
Page 235 and 236:
Page 237 and 238:
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
Vendor Name: Review Period: Date of
Page 251 and 252:
Page 253 and 254:
Agency For Health Care Administrati
Page 255 and 256:
File # Case ID # Agency For Health
Page 257 and 258:
File # Case ID # 1 2 3 4 5 6 7 8 9
Page 259 and 260:
Page 261 and 262:
13 14 15 Agency For Health Care Adm
Page 263 and 264:
Page 265 and 266:
f. Posting of the Agency Summary of
Page 267 and 268:
Name: Review Period: Date of Review
Page 269 and 270:
Page 271 and 272:
Page 273 and 274:
Page 275 and 276:
Page 277 and 278:
Page 279 and 280:
Page 281 and 282:
Page 283 and 284:
5. 6. 7. 8. 9. local WIC office to
Page 285 and 286:
Page 287 and 288:
Page 289 and 290: 14 Agency For Health Care Administr
Page 291 and 292: Agency For Health Care Administrati
Page 293 and 294: Vendor Name: Review Period: Date of
Page 295 and 296: 8 providers Agency For Health Care
Page 329 and 330: Medical Loss Ratio The following dr
Page 331 and 332: RICK SCOTT GOVERNOR Better Health C
Page 333 and 334: Plan Name: AGENCY FOR HEALTH CARE A
Page 335 and 336: DRAFT ATTESTATION OF 201_ QUARTER E
Page 337 and 338: Draft MLR Reporting Schedule Health
Page 339: RICK SCOTT GOVERNOR PLAN TYPES: Bet
Page 343 and 344: RICK SCOTT GOVERNOR Mission to Ensu
Page 345 and 346: • Obtaining data from the health
Page 347 and 348: RICK SCOTT GOVERNOR Mission to Ensu
Page 349 and 350: Attachment VI Special Term and Cond
Page 351 and 352: RICK SCOTT GOVERNOR Better Health C
show all

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

Create successful ePaper yourself

Delete template?

Save as template?