Common use of Barriers to Health Access Clause in Contracts

Barriers to Health Access. The goal of this initiative is to better understand access issues experienced by ICO Enrollees. The Contractor shall identify a random sample of a minimum of 20 members each year. An independent quality assurance entity shall conduct interviews with each Enrollee in the sample, using a semi-structured interview tool provided by EOHHS, to determine if the Enrollees experienced any barriers to health care and, if so, to understand the nature of those barriers. Examples of barriers include, but are not limited to, the following: inaccessible medical equipment in provider offices, inaccessible signage in provider offices (i.e. no Braille writing on signs), inaccessible communication from the Contractor or providers (i.e. no access to ASL interpreters, no written communication in large print or plain language, or no access to someone who can explain information), inadequate access to appropriate physicians for intellectually disabled Enrollees, and incomplete or poor care due to negative attitudes about disability and/or recovery from providers. The Contractor shall analyze results of its survey in order to understand the underlying causes of these barriers to health care access. The Contractor shall identify issues within its system of care that require improvement to promote access and ADA compliance and shall implement such improvements. The Contractor will report results to EOHHS and to CMS. Other topic areas to be identified through annual guidance by CMS and EOHHS in accordance with 42 C.F.R. § 422.152(c) and 422.152(d). APPENDIX F ADDENDUM TO CAPITATED FINANCIAL ALIGNMENT CONTRACT PURSUANT TO SECTIONS 1860D-1 THROUGH 1860D-43 OF THE SOCIAL SECURITY ACT FOR THE OPERATION OF A VOLUNTARY MEDICARE PRESCRIPTION DRUG PLAN The Centers for Medicare & Medicaid Services (hereinafter referred to as “CMS”) and <<CONTRACT_NAME>>, the Commonwealth of Massachusetts, acting by and through the Executive Office of Health and Human Services (EOHHS), and a Medicare-Medicaid managed care organization (hereinafter referred to as Contractor) agree to amend the contract <<CONTRACT_ID>> governing Contractor’s operation of a Medicare-Medicaid plan described in § 1851(a)(2)(A) of the Social Security Act (hereinafter referred to as “the Act”) to include this addendum under which Contractor shall operate a Voluntary Medicare Prescription Drug Plan pursuant to §§1860D-1 through 1860D-43 (with the exception of §§1860D-22(a) and 1860D-31) of the Act.

Barriers to Health Access. The goal of this initiative is to better understand access issues experienced by ICO Enrollees. The Contractor shall identify a random sample of a minimum of 20 members each year. An independent quality assurance entity shall conduct interviews with each Enrollee in the sample, using a semi-structured interview tool provided by EOHHS, to determine if the Enrollees experienced any barriers to health care and, if so, to understand the nature of those barriers. Examples of barriers include, but are not limited to, the following: inaccessible medical equipment in provider offices, inaccessible signage in provider offices (i.e. no Braille writing on signs), inaccessible communication from the Contractor or providers (i.e. no access to ASL interpreters, no written communication in large print or plain language, or no access to someone who can explain information), inadequate access to appropriate physicians for intellectually disabled Enrollees, and incomplete or poor care due to negative attitudes about disability and/or recovery from providers. The Contractor shall analyze results of its survey in order to understand the underlying causes of these barriers to health care access. The Contractor shall identify issues within its system of care that require improvement to promote access and ADA compliance and shall implement such improvements. The Contractor will report results to EOHHS and to CMS. Other topic areas to be identified through annual guidance by CMS and EOHHS in accordance with 42 C.F.R. § 422.152(c) and 422.152(d). APPENDIX F - ADDENDUM TO CAPITATED FINANCIAL ALIGNMENT CONTRACT PURSUANT TO SECTIONS 1860D-1 THROUGH 1860D-43 OF THE SOCIAL SECURITY ACT FOR THE OPERATION OF A VOLUNTARY MEDICARE PRESCRIPTION DRUG PLAN The Centers for Medicare & Medicaid Services (hereinafter referred to as “CMS”) and <<CONTRACT_NAME>>, [CONTRACT NAME] the Commonwealth of Massachusetts, acting by and through the Executive Office of Health and Human Services (EOHHS), and a Medicare-Medicaid managed care organization (hereinafter referred to as Contractor) agree to amend the contract <<CONTRACT_ID>> [CONTRACT ID] governing Contractor’s operation of a Medicare-Medicaid plan described in § 1851(a)(2)(A) of the Social Security Act (hereinafter referred to as “the Act”) to include this addendum under which Contractor shall operate a Voluntary Medicare Prescription Drug Plan pursuant to §§1860D-1 through 1860D-43 (with the exception of §§1860D-22(a) and 1860D-31) of the Act.

Barriers to Health Access. The goal of this initiative is to better understand access issues experienced by ICO One Care Plan Enrollees. The Contractor shall identify a random sample of a minimum of 20 members each year. An independent quality assurance entity shall conduct interviews with each Enrollee in the sample, using a semi-structured interview tool provided by EOHHS, to determine if the Enrollees experienced any barriers to health care and, if so, to understand the nature of those barriers. Examples of barriers include, but are not limited to, the following: inaccessible medical equipment in provider offices, inaccessible signage in provider offices (i.e. no Braille writing on signs), inaccessible communication from the Contractor or providers (i.e. no access to ASL interpreters, no written communication in large print or plain language, or no access to someone who can explain information), inadequate access to appropriate physicians for intellectually disabled Enrollees, and incomplete or poor care due to negative attitudes about disability and/or recovery from providers. The Contractor shall analyze results of its survey in order to understand the underlying causes of these barriers to health care access. The Contractor shall identify issues within its system of care that require improvement to promote access and ADA compliance and shall implement such improvements. The Contractor will report results to EOHHS and to CMS. Other topic areas to be identified through annual guidance by CMS and EOHHS in accordance with 42 C.F.R. § 422.152(c) or proposed by the Contractor and 422.152(d)approved by CMS and EOHHS. APPENDIX F - ADDENDUM TO CAPITATED FINANCIAL ALIGNMENT CONTRACT PURSUANT TO SECTIONS 1860D-1 THROUGH 1860D-43 OF THE SOCIAL SECURITY ACT FOR THE OPERATION OF A VOLUNTARY MEDICARE PRESCRIPTION DRUG PLAN The Centers for Medicare & Medicaid Services (hereinafter referred to as “CMS”) and <<CONTRACT_NAME>>), the Commonwealth of Massachusetts, acting by and through the Executive Office of Health and Human Services (EOHHS), and [the Contractor], a Medicare-Medicaid managed care organization (hereinafter referred to as Contractor) agree to amend the contract <<CONTRACT_ID>> [Contract ID] governing Contractor’s operation of a Medicare-Medicaid plan described in § 1851(a)(2)(A) of the Social Security Act (hereinafter referred to as “the Act”) to include this addendum under which Contractor shall operate a Voluntary Medicare Prescription Drug Plan pursuant to §§1860D-1 through 1860D-43 (with the exception of §§1860D-22(a) and 1860D-31) of the Act.