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

Standard IV: Enrollee Services & Enrollee Rights
CONTRACT
SECTION
15. Reading Level
CC-IV.A.2.d
16. New Enrollee
Materials
CC-IV.A.3.a
AGENCY FOR HEALTHCARE ADMINISTRATION
MANAGED CARE ORGANIZATIONS
Compliance Monitoring Tool with Specific Contract Standards
CONTRACT REQUIREMENT COMPLIANT SCORING
All written materials are at or near the
fourth (4 th ) grade comprehension level.
Suggested reference materials to
determine whether the written materials
meet this requirement include:
a. Fry Readability Index.
b. PROSE The Readability Analyst.
c. Gunning FOG Index.
d. McLaughlin SMOG Index.
e. The Flesch-Kincaid Index.
f. Other Agency approved software.
The health plan mails to the new enrollee
(not later than 5 calendar days following
receipt of the enrollment file from
Medicaid or its agent, whichever is
later):
a. Enrollee handbook.
b. Provider directory.
c. Enrollee identification card.
a. Yes
No
b. Yes
No
c. Yes
No
d. Yes
No
e. Yes
No
f. Yes
No
a. Yes
No
b. Yes
No
c. Yes
No
Met
Partially Met
Not Met
Met
Partially Met
Not Met
DOCUMENTS
REVIEWED
FINDINGS
State of Florida Compliance Monitoring_Standard_IV_F2_07_11
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