Additional Information Available Upon Request. The Contractor shall have written policies guaranteeing to provide all other information to members as required by CMS, including but not limited to the following information to any enrollee who requests it. The Contractor shall inform members that information is available upon request in alternative formats and how to obtain them at no cost. OMPP defines alternative formats as braille, large font letters, audio recordings, languages other than English and verbal explanation of written materials. When a member has requested materials in a preferred alternative format, this shall be documented in the member’s record. The Contractor shall supply future materials in the requested and preferred format to the member. The Contractor may review with the member and document the specific material type the member wishes to receive in a specific format versus other formats. For example, a member may wish to receive certain materials in braille and other materials in audio recordings. As required by 42 CFR 438.10(c)(6)(i)-(v), if the Contractor chooses to provide any required information electronically to members: ▪ The information must be in a format that is readily accessible. ▪ The information must be placed in a location on the Contractor’s website that is prominent and readily accessible. ▪ The information must be provided in an electronic form which can be electronically retained and printed. ▪ The information must be consistent with content and language requirements. ▪ The Contractor must notify the member that the information is available in paper form without charge upon request. ▪ The Contractor must provide, upon request, information in paper form within five (5) business days. Unless a member specifically states their alternative format request is a one-time request, the Contractor shall consider the request an ongoing request and supply all future materials in the preferred format to the member. For first-time or one-time requests from a member, the Contractor shall mail the alternative version of the document in no more than seven (7) business days from the date of the request. If, for example, the member received a wellness visit reminder flyer and called the Contractor to ask for the flyer to be sent in braille, the Contractor shall take no more than seven (7) business days to mail the braille version from the date of the member request call. For first-time or one-time requests from a member, when the mailing is governed by NCQA or statutory requiremen...
Additional Information Available Upon Request. The CONTRACTOR shall provide all other information to Members as required by CMS, including but not limited to, the following information to any Member who requests such information: Information regarding the structure and operation of the CONTRACTOR’s MCO; and Physician incentive plans, if applicable. Each Member shall be provided an identification card identifying the Member as a participant in the Turquoise Care program within twenty (20) Calendar Days of notification of enrollment into the CONTRACTOR’s MCO. The CONTRACTOR shall re-issue a Member ID card within ten (10) Calendar Days of notice if a Member reports a lost card or if information on the Member ID card needs to be changed. The Member ID card shall be durable (e.g., plastic or other durable paper stock but not regular paper stock), shall comply with all State and federal requirements and, at a minimum, shall include: The CONTRACTOR’s name and issuer identifier, with the company logo; The phone number for information and/or authorizations for all Covered Services, including for Physical Health, Behavioral Health, and LTC services; Descriptions of procedures to be followed for emergency or special services; The Member’s identification number; The Member’s name (first and last name and middle initial); The Member’s date of birth; The Member’s enrollment effective date; The Member’s PCP; Whether the Member is enrolled in the ABP, indicated on the card as “ABP,” or is ABP Exempt, indicated on the card as “State Plan”; The Member’s State-issued Medicaid identification number, which shall be identified on the card as the “Medicaid ID”; and All applicable copayment amounts.
Additional Information Available Upon Request. The Contractor shall have written policies guaranteeing to provide all other information to members as required by CMS, including but not limited to the following information to any enrollee who requests it.
Additional Information Available Upon Request. The CONTRACTOR shall provide all other information to members as required by CMS, including but not limited to the following information to any enrollee who requests it:
2.17.8.1 Information regarding the structure and operation of the CONTRACTOR’s MCO; and
2.17.8.2 Information regarding physician incentive plans, including but not limited to:
2.17.8.2.1 Whether the CONTRACTOR uses a physician incentive plan that affects the use of referral services;
2.17.8.2.2 The type of incentive arrangement;
2.17.8.2.3 Whether stop-loss protection is provided; and
2.17.8.2.4 If the CONTRACTOR was required to conduct a survey, a summary of the survey results.
Additional Information Available Upon Request. The CONTRACTOR shall provide all other information to members as required by CMS, including but not limited to the following information to any enrollee who requests it:
2.17.9.1 Information regarding the structure and operation of the CONTRACTOR’s MCO; and
2.17.9.2 Information regarding physician incentive plans, including but not limited to:
2.17.9.2.1 Whether the CONTRACTOR uses a physician incentive plan that affects the use of referral services;
2.17.9.2.2 The type of incentive arrangement; and
2.17.9.2.3 Whether stop-loss protection is provided.
Additional Information Available Upon Request. The Contractor shall have written policies guaranteeing to provide all other information to members as required by CMS, including but not limited to the following information to any enrollee who requests it. The Contractor shall inform members that information is available upon request in alternative formats and how to obtain them. OMPP defines alternative formats as braille, large font letters, audio recordings, languages other than English and verbal explanation of written materials. When a member has requested materials in preferred alternative format, this shall be documented in the member’s record. The Contractor shall supply future materials in the requested and preferred format to the member. The Contractor may review with the member and document the specific type the member wishes to receive in a specific format versus other formats. For example, a member may wish to receive certain materials in braille and other materials in audio recordings. Unless a member specifically states their alternative format request is a one-time request, the Contractor shall consider the request an ongoing request and supply all future materials in the preferred format to the member.
Additional Information Available Upon Request. To the extent the Trustee has been provided information that Participants and eligible employees have the right to request under Section 404a-5(d)(4) of the Regulation, it will make such information available on the website and/or mail paper copies to Participants and eligible employees upon their request.
