Attachment I, Section. 20.5, Licensure of Staff, Florida Statutory Reference is changed to: 456.047(4) F.S. 37. Attachment I, Section 20.12.2 b. is amended to read:
Attachment I, Section. 30.7.1, Member Services Handbook, is amended to read: The member services handbook shall include the following information: terms and conditions of enrollment including the reinstatement process; a description of the open enrollment process; description of services provided, including limitations and general restrictions on provider access, exclusions and out-of-plan use; procedures for obtaining required services, including second opinions; the toll-free telephone number of the statewide Consumer Call Center; emergency services and procedures for obtaining services both in and out of the plan's service area; procedures for enrollment, including member rights and responsibilities; grievance procedures; and procedures for disenrollment; procedures for filing a "good cause change" request, including the agency's toll-free telephone number for the enrollment and disenrollment services contractor; information regarding newborn enrollment, including the mother's responsibility to notify the plan and the mother's DCF caseworker of the newborn's birth and assignment of pediatricians and other appropriate physicians; member rights and responsibilities; information on emergency transportation and non-emergency transportation available under the plan; and information regarding the health care advance directives pursuant to Chapter 765, F.S.
Attachment I, Section. 10.3, Ineligible Recipients, subsection f. is amended to read:
Attachment I, Section. 10.8.6, Hearing Services, is amended to read:
Attachment I, Section. 20.1, Availability/Accessibility of Services, is amended to include a third and fourth paragraph to read: If the plan is unable to provide medically necessary services covered under the contract to a particular beneficiary, the plan must adequately and timely cover these services outside of the network for the beneficiary for as long as the plan is unable to provide them. The plan must require out-of-network providers to coordinate with respect to payment and must ensure that cost to the beneficiary is no greater than it would be if the covered services were furnished within the network.
Attachment I, Section. 30.2.1, Prohibited Activities, subsection d. is amended to read:
Attachment I, Section. 30.12.1, Voluntary Disenrollments, is amended to include subsections f. and g. as follows:
Attachment I, Section. 30.1, Marketing and Pre-enrollment Materials. The title is changed to "Marketing, Pre-enrollment and Post-enrollment Materials."
Attachment I, Section. 30.2.1, Prohibited Activities, is amended to include a new subsection j. Subsequent subsections are renamed accordingly. Subsection j. becomes k. and is amended to read:
