Common use of Child Health Check-Up Program (CHCUP Clause in Contracts

Child Health Check-Up Program (CHCUP. a. The Health Plan shall provide a health screening evaluation that shall consist of: comprehensive health and developmental history (including assessment of past medical history, developmental history and behavioral health status); comprehensive unclothed physical examination; developmental assessment; nutritional assessment; appropriate immunizations according to the appropriate Recommended Childhood Immunization Schedule for the United States; laboratory testing (including blood lead testing); health education (including anticipatory guidance); dental screening (including a direct referral to a dentist for enrollees beginning at age three or earlier as indicated); vision screening, including objective testing as required; hearing screening, including objective testing as required; diagnosis and treatment; and referral and follow-up as appropriate. b. For children/adolescents whom the Health Plan identifies through blood lead screenings as having abnormal levels of lead, the Health Plan shall provide case management follow-up services as required in Chapter Two of the Child Health Check-Up Services Coverage and Limitations Handbook. Screening for lead poisoning is a required component of this Contract. The Health Plan shall require all providers to screen all enrolled children for lead poisoning at ages 12 months and 24 months. In addition, children between the ages of 12 months and 72 months must receive a screening blood lead test if there is no record of a previous test. The Health Plan shall provide additional diagnostic and treatment services determined to be medically necessary to a child/adolescent diagnosed with an elevated blood lead level. The Health Plan shall recommend, but shall not require, the use of paper filter tests as part of the lead screening requirement. c. The Health Plan shall inform enrollees of all testing/screenings due in accordance with the periodicity schedule specified in the Medicaid Child Health Check-Up WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract Services Coverage and Limitations Handbook. The Health Plan shall contact enrollees to encourage them to obtain health assessment and preventive care. d. The Health Plan shall authorize enrollee referrals to appropriate providers within four (4) weeks of these examinations for further assessment and treatment of conditions found during the examination. The Health Plan shall ensure that the referral appointment is scheduled for a date within six (6) months of the initial examination, or within the time periods set forth in Attachment II, Section VII, Provider Network, Item F., Appointment Waiting Times and Geographic Access Standards, as applicable. e. The Health Plan shall cover fluoride treatment by a physician or a dentist for children/adolescents even if the Health Plan does not provide dental coverage. Fluoride varnish application in a physician’s office is limited to children up to three and one half (3 ½) years (42 months) of age. f. If the Health Plan Contract covers transportation, the Health Plan shall offer transportation to enrollees in order to assist them to keep, and travel to, medical appointments. If the Contract does not cover transportation services, the Health Plan shall offer to help enrollees schedule transportation. g. The CHCUP program includes the maintenance of a coordinated system to follow the enrollee through the entire range of screening and treatment, as well as supplying CHCUP training to medical care providers. h. The Health Plan shall achieve a CHCUP screening rate of at least sixty percent (60%) for those enrollees who are continuously enrolled for at least eight (8) months during the federal fiscal year (October 1 – September 30) in accordance with s. 409.912(27), F.S. This screening compliance rate shall be based on the CHCUP data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report and due to the Agency by January 15 following the end of each federal fiscal year as specified in Attachment II, Section XII, Reporting Requirements. The data shall be monitored by the Agency for accuracy, and, if the Health Plan does not achieve the sixty percent (60%) screening rate for the federal fiscal year reported, the Health Plan shall file a corrective action plan (CAP) with the Agency no later than February 15, following the fiscal year reported. Failure to meet the sixty percent (60%) screening requirement may result in sanctions. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See Attachment II, Section XIV, Sanctions) i. The Health Plan shall achieve at least an eighty percent (80%) CHCUP participation rate, as required by the Centers for Medicare & Medicaid Services. This participation compliance rate shall be based on the CHCUP data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report (see sub-item H.2.h. above) and/or supporting encounter data. Upon implementation and notice by the Agency, the Health Plan shall submit additional data, as required by the Agency for its submission of the CMS-416, to the Centers for Medicare & Medicaid Services, within the schedule determined by the Agency. For each federal fiscal year that the Health Plan does not meet the eighty percent (80%) participation rate, it must file a CAP with the Agency no later than February 15 following the federal fiscal year being WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract reported. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See s. 1902(a)(43)(D)(iv) of the Social Security Act.)

Child Health Check-Up Program (CHCUP. a. The Health Plan shall provide a health screening evaluation that shall consist of: comprehensive health and developmental history (including assessment of past medical history, developmental history and behavioral health status); comprehensive unclothed physical examination; developmental assessment; nutritional assessment; appropriate immunizations according to the appropriate Recommended Childhood Immunization Schedule for the United States; laboratory testing (including blood lead testing); health education (including anticipatory guidance); dental screening (including a direct referral to a dentist for enrollees Enrollees beginning at three (3) years of age three or earlier as indicated); vision screening, including objective testing as required; hearing screening, including objective testing as required; diagnosis and treatment; and referral and follow-up as appropriate. b. For childrenChildren/adolescents whom Adolescents who the Health Plan identifies through blood lead screenings as having abnormal levels of lead, the Health Plan shall provide case management Case Management follow-up services as required in Chapter Two of the Child Health Check-Up Services Coverage and Limitations Handbook. Screening for lead poisoning is a required component of this Contract. The Health Plan shall require all providers Providers to screen all enrolled children Enrolled Children/Adolescents for lead poisoning at ages 12 twelve (12) and twenty-four (24) months and 24 monthsof age. In addition, children Children/Adolescents between the ages of 12 twenty-four (24) months and 72 seventy-two (72) months of age must receive a screening blood lead test if there is no record of a previous test. The Health Plan shall provide additional diagnostic and treatment services determined to be medically necessary Medically Necessary to a childChild/adolescent Adolescent diagnosed with an elevated blood lead level. The Health Plan shall recommend, but shall not require, the use of paper filter tests as part of the lead screening requirement. c. The Health Plan shall inform enrollees Enrollees of all testing/screenings due in accordance with the periodicity schedule specified in the Medicaid Child Health Check-Up WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract Services Coverage and Limitations Handbook. The Health Plan shall contact enrollees Enrollees to encourage them to obtain health assessment and preventive preventative care. d. The Health Plan shall authorize enrollee Enrollee referrals to appropriate providers Providers within four (4) weeks of these examinations for further assessment and treatment of conditions found during the examination. The Health Plan shall ensure that the referral appointment is scheduled for a date within six (6) months of the initial examination, or within the time periods set forth in Attachment II, Section VII, Provider Network, Item F., Appointment Waiting Times and Geographic Access StandardsVII.D., as applicable. e. The Health Plan shall cover fluoride treatment by a physician or a dentist for children/adolescents even if the Health Plan does not provide dental coverage. Fluoride varnish application in a physician’s office is limited offer scheduling assistance and Transportation to children up to three and one half (3 ½) years (42 months) of age. f. If the Health Plan Contract covers transportation, the Health Plan shall offer transportation to enrollees Enrollees in order to assist them to keep, and travel to, medical appointments. If the Contract does not cover transportation services, the Health Plan shall offer to help enrollees schedule transportation. g. f. The CHCUP program includes the maintenance of a coordinated system to follow the enrollee Enrollee through the entire range of screening and treatment, as well as supplying CHCUP training to medical care providersProviders. h. g. The Health Plan shall achieve a CHCUP screening rate of at least sixty percent (60%) for those enrollees Enrollees who are continuously enrolled for at least eight (8) months during the federal fiscal year Federal Fiscal Year (October 1 – - September 30) in accordance with s. 409.912(27)Section 409.912, F.S. This screening compliance rate shall be based on the CHCUP screening data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report and due to the Agency by January 15 following the end of each federal fiscal year Federal Fiscal Year as specified in Attachment II, Section XII, Reporting RequirementsReporting, of this Contract. The data shall be monitored by the Agency for accuracy, accuracy and, if the Health Plan does not achieve the sixty percent (60%) screening rate for the federal fiscal year Federal Fiscal Year reported, the Health Plan shall file a corrective action plan (CAP) with the Agency no later than February 15, following the fiscal year reported. Failure to meet the sixty percent (60%) screening requirement may result in sanctions. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, Agency and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See Attachment II, Section XIV, Sanctions). i. h. The Health Plan shall adopt annual screening and participation goals to achieve at least an eighty percent (80%) CHCUP screening and participation rate, as required by the Centers for Medicare & Medicaid Services. This participation compliance rate shall be based on the CHCUP data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report (see sub-item H.2.h. above) and/or supporting encounter data. Upon implementation and notice by the Agency, the Health Plan shall submit additional data, as required by the Agency for its submission of the CMS-416, to the Centers for Medicare & Medicaid Services, within the schedule determined by the Agency. For each federal fiscal year Federal Fiscal Year that the Health Plan does not meet the eighty percent (80%) screening and participation rate, it must file a CAP with the Agency no later than February 15 following the federal fiscal year Federal Fiscal Year being WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract reported. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See s. 1902(a)(43)(D)(iv) of the Social Security Act.)

Child Health Check-Up Program (CHCUP. a. The Health Plan shall provide a health screening evaluation that shall consist of: comprehensive health and developmental history (history, including assessment of past medical history, developmental history and behavioral health status); comprehensive unclothed physical examination; developmental assessment; nutritional assessment; appropriate immunizations according to the appropriate Recommended Childhood Immunization Schedule for the United States; laboratory testing (including blood lead testing); health education (including anticipatory guidance); dental screening (including a direct referral to a dentist for enrollees Enrollees beginning at three (3) years of age three or earlier as indicated); vision screening, including objective testing as required; hearing screening, including objective testing as required; diagnosis and treatment; and referral and follow-up as appropriate. b. For childrenChildren/adolescents whom Adolescents who the Health Plan identifies through blood lead screenings as having abnormal levels of lead, the Health Plan shall provide case management Case Management follow-up services as required in Chapter Two (2) of the Child Health Check-Up Services Coverage and Limitations Handbook. Screening for lead poisoning is a required component of this Contract. The Health Plan shall require all providers Providers to screen all enrolled children Enrolled Children for lead poisoning at ages 12 twelve (12) and twenty-four (24) months and 24 monthsof age. In addition, children Children/Adolescents between the ages of 12 twenty-four (24) months and 72 seventy-two (72) months of age must receive a screening blood lead test if there is no record of a previous test. The Health Plan shall provide additional diagnostic and treatment services determined to be medically necessary Medically Necessary to a childChild/adolescent Adolescent diagnosed with an elevated blood lead level. The Health Plan shall recommend, but shall not require, the use of paper filter tests as part of the lead screening requirement. c. The Health Plan shall inform enrollees Enrollees of all testing/screenings due in accordance with the periodicity schedule specified in the Medicaid Child Health Check-Up WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract Services Coverage and Limitations Handbook. The Health Plan shall contact enrollees Enrollees to encourage them to obtain health assessment and preventive preventative care. d. The Health Plan shall authorize enrollee referrals refer Enrollees to appropriate providers service Providers within four six (46) weeks months of these examinations the examination for further assessment and treatment of conditions found during the examination. The Health Plan shall ensure that the referral appointment is scheduled for a date within six (6) months of the initial examination, or within the time periods set forth in Attachment II, Section VII, Provider Network, Item F., Appointment Waiting Times and Geographic Access Standards, as applicable. e. The Health Plan shall cover fluoride treatment by a physician or a dentist for children/adolescents even if the Health Plan does not provide dental coverage. Fluoride varnish application in a physician’s office is limited offer scheduling assistance and Transportation to children up to three and one half (3 ½) years (42 months) of age. f. If the Health Plan Contract covers transportation, the Health Plan shall offer transportation to enrollees Enrollees in order to assist them to keep, and travel to, medical appointments. If the Contract does not cover transportation services, the Health Plan shall offer to help enrollees schedule transportation. g. f. The CHCUP program includes the maintenance of a coordinated system to follow the enrollee Enrollee through the entire range of screening and treatment, as well as supplying CHCUP training to medical care providersProviders. h. g. The Health Plan shall achieve a CHCUP screening rate of at least sixty percent (60%) for those enrollees Enrollees who are continuously enrolled for at least eight (8) months during the federal fiscal year Federal Fiscal Year (October 1 – - September 30) in accordance with s. 409.912(27)section 409.912, F.S. This screening compliance rate shall be based on the CHCUP screening data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report and due to the Agency by January 15 following the end of each federal fiscal year Federal Fiscal Year as specified in Attachment II, Section XII, Reporting RequirementsReporting, of this Contract. The data shall be monitored by the Agency for accuracy, accuracy and, if the Health Plan does not achieve the sixty 60 percent (60%) screening rate for the federal fiscal year Federal Fiscal Year reported, the Health Plan shall file a corrective action plan (CAP) with the Agency no later than February 15, following the fiscal year reported. Failure to meet the sixty percent (60%) screening requirement may result in sanctions. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, Agency and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See Attachment II, Section XIV, Sanctions). i. h. The Health Plan shall adopt annual screening and participation goals to achieve at least an eighty percent (80%) CHCUP screening and participation rate, as required by the Centers for Medicare & Medicaid Services. This participation compliance rate shall be based on the CHCUP data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report (see sub-item H.2.h. above) and/or supporting encounter data. Upon implementation and notice by the Agency, the Health Plan shall submit additional data, as required by the Agency for its submission of the CMS-416, to the Centers for Medicare & Medicaid Services, within the schedule determined by the Agency. For each federal fiscal year Federal Fiscal Year that the Health Plan does not meet the eighty percent (80%) screening and participation rate, it must file a CAP with the Agency no later than February 15 following the federal fiscal year Federal Fiscal Year being WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract reported. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See s. 1902(a)(43)(D)(iv) of the Social Security Act.)

Child Health Check-Up Program (CHCUP. a. The Health Plan shall provide a health screening evaluation that shall consist of: comprehensive health and developmental history (including assessment of past medical history, developmental history and behavioral health status); comprehensive unclothed physical examination; developmental assessment; nutritional assessment; appropriate immunizations according to the appropriate Recommended Childhood Immunization Schedule for the United States; laboratory testing (including blood lead testing); health education (including anticipatory guidance); dental screening (including a direct referral to a dentist for enrollees beginning at age three or earlier as indicated); vision screening, including objective testing as required; hearing screening, including objective testing as required; diagnosis and treatment; and referral and follow-up as appropriate. b. For children/adolescents whom the Health Plan identifies through blood lead screenings as having abnormal levels of lead, the Health Plan shall provide case management follow-up services as required in Chapter Two of the Child Health Check-Up Services Coverage and Limitations Handbook. Screening for lead poisoning is a required component of this Contract. The Health Plan shall require all providers to screen all enrolled children for lead poisoning at ages 12 months and 24 months. In addition, children between the ages of 12 months and 72 months must receive a screening blood lead test if there is no record of a previous test. The Health Plan shall provide additional diagnostic and treatment services determined to be medically necessary to a child/adolescent diagnosed with an elevated blood lead level. The Health Plan shall recommend, but shall not require, the use of paper filter tests as part of the lead screening requirement. c. The Health Plan shall inform enrollees of all testing/screenings due in accordance with the periodicity schedule specified in the Medicaid Child Health Check-Up WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract Services Coverage and Limitations Handbook. The Health Plan shall contact enrollees to encourage them to obtain health assessment and preventive care. d. The Health Plan Ran shall authorize enrollee referrals to appropriate providers within four (4) weeks of these examinations for further assessment and treatment of conditions found during the examination. The Health Plan shall ensure that the referral appointment is scheduled for a date within six (6) months of the initial examination, AMERIGROUP Florida, Inc. d/b/a Medicaid Non-Reform and Reform AMERIGROUP Community Care HMO Contract or within the time periods set forth in Attachment II, Section VII, Provider Network, Item F., Appointment Waiting Times and Geographic Access Standards, as applicable. e. The Health Plan shall cover fluoride treatment by a physician or a dentist for children/adolescents even if the Health Plan does not provide dental coverage. Fluoride varnish application in a physician’s office is limited to children up to three and one half (3 ½) years (42 months) of age. f. If the Health Plan Contract covers transportation, the Health Plan shall offer transportation to enrollees in order to assist them to keep, and travel to, medical appointments. If the Contract does not cover transportation services, the Health Plan shall offer to help enrollees schedule transportation. g. The CHCUP program includes the maintenance of a coordinated system to follow the enrollee through the entire range of screening and treatment, as well as supplying CHCUP training to medical care providers. h. The Health Plan shall achieve a CHCUP screening rate of at least sixty percent (60%) for those enrollees who are continuously enrolled for at least eight (8) months during the federal fiscal year (October 1 – — September 30) in accordance with s. 409.912(27)409.912, F.S. This screening compliance rate shall be based on the CHCUP screening data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report and due to the Agency by January 15 following the end of each federal fiscal year as specified in Attachment II, Section XII, Reporting Requirements. The data shall be monitored by the Agency for accuracy, and, if the Health Plan does not achieve the sixty percent (60%) screening rate for the federal fiscal year reported, the Health Plan shall file a corrective action plan (CAP) with the Agency no later than February 15, following the fiscal year reported. Failure to meet the sixty percent (60%) screening requirement may result in sanctions. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See Attachment II, Section XIV, Sanctions) i. The Health Plan shall adopt annual screening and participation goals to achieve at least an eighty percent (80%) CHCUP screening and participation raterates, as required by the Centers for Medicare & and Medicaid Services. This participation compliance rate shall be based on the CHCUP data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report (see sub-item H.2.h. above) and/or supporting encounter data. Upon implementation and notice by the Agency, the Health Plan shall submit additional data, as required by the Agency for its submission of the CMS-416, to the Centers for Medicare & Medicaid Services, within the schedule determined by the Agency. For each federal fiscal year that the Health Plan does not meet the eighty percent (80%) screening and participation raterates, it must file a CAP with the Agency no later than February 15 following the federal fiscal year being WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract reported. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See s. 1902(a)(43)(D)(iv) of the Social Security Act.)

Child Health Check-Up Program (CHCUP. a. The Health Plan shall provide a health screening evaluation that shall consist of: comprehensive health and developmental history (including assessment of past medical history, developmental history and behavioral health status); comprehensive unclothed physical examination; developmental assessment; nutritional assessment; appropriate immunizations according to the appropriate Recommended Childhood Immunization Schedule for the United States; laboratory testing (including blood lead testing); health education (including anticipatory guidance); dental screening (including a direct referral to a dentist for enrollees Enrollees beginning at three (3) years of age three or earlier as indicated); vision screening, including objective testing as required; hearing screening, including objective testing as required; diagnosis and treatment; and referral and follow-up as appropriate. b. For childrenChildren/adolescents whom Adolescents who the Health Plan identifies through blood lead screenings as having abnormal levels of lead, the Health Plan shall provide case management Case Management follow-up services as required in Chapter Two of the Child Health Check-Up Services Coverage and Limitations Handbook. Screening for lead poisoning is a required component of this Contract. The Health Plan shall require all providers Providers to screen all enrolled children Enrolled Children/Adolescents for lead poisoning at ages 12 twelve (12) and twenty-four (24) months and 24 monthsof age. In addition, children Children/Adolescents between the ages of 12 twenty-four (24) months and 72 seventy-two (72) months of age must receive a screening blood lead test if there is no record of a previous test. The Health Plan shall provide additional diagnostic and treatment services determined to be medically necessary Medically Necessary to a childChild/adolescent Adolescent diagnosed with an elevated blood lead level. The Health Plan shall recommend, but shall not require, the use of paper filter tests as part of the lead screening requirement. c. The Health Plan shall inform enrollees Enrollees of all testing/screenings due in accordance with the periodicity schedule specified in the Medicaid Child Health Check-Up WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract Services Coverage and Limitations Handbook. The Health Plan shall contact enrollees Enrollees to encourage them to obtain health assessment and preventive preventative care. d. The Health Plan shall authorize enrollee Enrollee referrals to appropriate providers Providers within four (4) weeks of these examinations for further assessment and treatment of conditions found during the examination. The Health Plan shall ensure that the referral appointment is scheduled for a date within six (6) months of the initial examination, or within the time periods set forth in Attachment II, Section VII, Provider Network, Item F., Appointment Waiting Times and Geographic Access StandardsVII.D., as applicable. e. The Health Plan shall cover fluoride treatment by a physician or a dentist for children/adolescents even if the Health Plan does not provide dental coverage. Fluoride varnish application in a physician’s office is limited offer scheduling assistance and Transportation to children up to three and one half (3 ½) years (42 months) of age. f. If the Health Plan Contract covers transportation, the Health Plan shall offer transportation to enrollees Enrollees in order to assist them to keep, and travel to, medical appointments. If the Contract does not cover transportation services, the Health Plan shall offer to help enrollees schedule transportation. g. f. The CHCUP program includes the maintenance of a coordinated system to follow the enrollee Enrollee through the entire range of screening and treatment, as well as supplying CHCUP training to medical care providersProviders. h. g. The Health Plan shall achieve a CHCUP screening rate of at least sixty percent (60%) for those enrollees Enrollees who are continuously enrolled for at least eight (8) months during the federal fiscal year Federal Fiscal Year (October 1 – September 30) in accordance with s. 409.912(27)Section 409.912, F.S. This screening compliance rate shall be based on the CHCUP screening data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report and due to the Agency by January 15 following the end of each federal fiscal year Federal Fiscal Year as specified in Attachment II, Section XII, Reporting RequirementsReporting, of this Contract. The data shall be monitored by the Agency for accuracy, accuracy and, if the Health Plan does not achieve the sixty percent (60%) screening rate for the federal fiscal year Federal Fiscal Year reported, the Health Plan shall file a corrective action plan (CAP) with the Agency no later than February 15, following the fiscal year reported. Failure to meet the sixty percent (60%) screening requirement may result in sanctions. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, Agency and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See Attachment II, Section XIV, Sanctions). i. h. The Health Plan shall adopt annual screening and participation goals to achieve at least an eighty percent (80%) CHCUP screening and participation rate, as required by the Centers for Medicare & Medicaid Services. This participation compliance rate shall be based on the CHCUP data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report (see sub-item H.2.h. above) and/or supporting encounter data. Upon implementation and notice by the Agency, the Health Plan shall submit additional data, as required by the Agency for its submission of the CMS-416, to the Centers for Medicare & Medicaid Services, within the schedule determined by the Agency. For each federal fiscal year Federal Fiscal Year that the Health Plan does not meet the eighty percent (80%) screening and participation rate, it must file a CAP with the Agency no later than February 15 following the federal fiscal year Federal Fiscal Year being WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract reported. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See s. 1902(a)(43)(D)(iv) of the Social Security Act.)

Child Health Check-Up Program (CHCUP. a. The Health Plan shall provide a health screening evaluation that shall consist of: comprehensive health and developmental history (including assessment of past medical history, developmental history and behavioral health status); comprehensive unclothed physical examination; developmental assessment; nutritional assessment; appropriate immunizations according to the appropriate Recommended Childhood Immunization Schedule for the United States; laboratory testing (including blood lead testing); health education (including anticipatory guidance); dental screening (including a direct referral to a dentist for enrollees beginning at age three or earlier as indicated); vision screening, including objective testing as required; hearing screening, including objective testing as required; diagnosis and treatment; and referral and follow-up as appropriate. b. For children/adolescents whom the Health Plan identifies through blood lead screenings as having abnormal levels of lead, the Health Plan shall provide case management follow-up services as required in Chapter Two of the Child Health Check-Up Services Coverage and Limitations Handbook. Screening for lead poisoning is a required component of this Contract. The Health Plan shall require all providers to screen all enrolled children for lead poisoning at ages 12 months and 24 months. In addition, children between the ages of 12 months and 72 months must receive a screening blood lead test if there is no record of a previous test. The Health Plan shall provide additional diagnostic and treatment services determined to be medically necessary to a child/adolescent diagnosed with an elevated blood lead level. The Health Plan shall recommend, but shall not require, the use of paper filter tests as part of the lead screening requirement. c. The Health Plan shall inform enrollees of all testing/screenings due in accordance with the periodicity schedule specified in the Medicaid Child Health Check-Up WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract Services Coverage and Limitations Handbook. The Health Plan shall contact enrollees to encourage them to obtain health assessment and preventive care. d. The Health Plan shall authorize enrollee referrals to appropriate providers within four (4) weeks of these examinations for further assessment and treatment of conditions found during the examination. The Health Plan shall ensure that the referral appointment is scheduled for a date within six (6) months of the initial examination, WellCare of Florida, Inc. d/b/a Staywell Health Plan of Florida Medicaid HMO Non-Reform Contract or within the time periods set forth in Attachment II, Section VII, Provider Network, Item F., Appointment Waiting Times and Geographic Access Standards, as applicable. e. The Health Plan shall cover fluoride treatment by a physician or a dentist for children/adolescents even if the Health Plan does not provide dental coverage. Fluoride varnish application in a physician’s office is limited to children up to three and one half (3 ½) years (42 months) of age. f. If the Health Plan Contract covers transportation, the Health Plan shall offer transportation to enrollees in order to assist them to keep, and travel to, medical appointments. If the Contract does not cover transportation services, the Health Plan shall offer to help enrollees schedule transportation. g. The CHCUP program includes the maintenance of a coordinated system to follow the enrollee through the entire range of screening and treatment, as well as supplying CHCUP training to medical care providers. h. The Health Plan shall achieve a CHCUP screening rate of at least sixty percent (60%) for those enrollees who are continuously enrolled for at least eight (8) months during the federal fiscal year (October 1 – September 30) in accordance with s. 409.912(27)409.912, F.S. This screening compliance rate shall be based on the CHCUP screening data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report and due to the Agency by January 15 following the end of each federal fiscal year as specified in Attachment II, Section XII, Reporting Requirements. The data shall be monitored by the Agency for accuracy, and, if the Health Plan does not achieve the sixty percent (60%) screening rate for the federal fiscal year reported, the Health Plan shall file a corrective action plan (CAP) with the Agency no later than February 15, following the fiscal year reported. Failure to meet the sixty percent (60%) screening requirement may result in sanctions. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See Attachment II, Section XIV, Sanctions) i. The Health Plan shall adopt annual screening and participation goals to achieve at least an eighty percent (80%) CHCUP screening and participation raterates, as required by the Centers for Medicare & and Medicaid Services. This participation compliance rate shall be based on the CHCUP data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report (see sub-item H.2.h. above) and/or supporting encounter data. Upon implementation and notice by the Agency, the Health Plan shall submit additional data, as required by the Agency for its submission of the CMS-416, to the Centers for Medicare & Medicaid Services, within the schedule determined by the Agency. For each federal fiscal year that the Health Plan does not meet the eighty percent (80%) screening and participation raterates, it must file a CAP with the Agency no later than February 15 following the federal fiscal year being WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract reported. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See s. 1902(a)(43)(D)(iv) of the Social Security Act.)

Child Health Check-Up Program (CHCUP. a. The Health Plan shall provide a health screening evaluation that shall consist of: comprehensive health and developmental history (including assessment of past medical history, developmental history and behavioral health status); comprehensive unclothed physical examination; developmental assessment; nutritional assessment; appropriate immunizations according to the appropriate Recommended Childhood Immunization Schedule for the United States; laboratory testing (including blood lead testing); health education (including anticipatory guidance); dental screening (including a direct referral to a dentist for enrollees beginning at age three or earlier as indicated); vision screening, including objective testing as required; hearing screening, including objective testing as required; diagnosis and treatment; and referral and follow-up as appropriate. b. For children/adolescents whom the Health Plan identifies through blood lead screenings as having abnormal levels of lead, the Health Plan shall provide case management follow-up services as required in Chapter Two of the Child Health Check-Up Services Coverage and Limitations Handbook. Screening for lead poisoning is a required component of this Contract. The Health Plan shall require all providers to screen all enrolled children for lead poisoning at ages 12 months and 24 months. In addition, children between the ages of 12 months and 72 months must receive a screening blood lead test if there is no record of a previous test. The Health Plan shall provide additional diagnostic and treatment services determined to be medically necessary to a child/adolescent diagnosed with an elevated blood lead level. The Health Plan shall recommend, but shall not require, the use of paper filter tests as part of the lead screening requirement. c. The Health Plan shall inform enrollees of all testing/screenings due in accordance with the periodicity schedule specified in the Medicaid Child Health Check-Up WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract Services Coverage and Limitations Handbook. The Health Plan shall contact enrollees to encourage them to obtain health assessment and preventive care. d. The Health Plan shall authorize enrollee referrals to appropriate providers within four (4) weeks of these examinations for further assessment and treatment of conditions found during the examination. The Health Plan shall ensure that the referral appointment is scheduled for a date within six (6) months of the initial examination, HealthEase of Florida, Inc. Medicaid HMO Non-Reform Contract or within the time periods set forth in Attachment II, Section VII, Provider Network, Item F., Appointment Waiting Times and Geographic Access Standards, as applicable. e. The Health Plan shall cover fluoride treatment by a physician or a dentist for children/adolescents even if the Health Plan does not provide dental coverage. Fluoride varnish application in a physician’s office is limited to children up to three and one half (3 ½) years (42 months) of age. f. If the Health Plan Contract covers transportation, the Health Plan shall offer transportation to enrollees in order to assist them to keep, and travel to, medical appointments. If the Contract does not cover transportation services, the Health Plan shall offer to help enrollees schedule transportation. g. The CHCUP program includes the maintenance of a coordinated system to follow the enrollee through the entire range of screening and treatment, as well as supplying CHCUP training to medical care providers. h. The Health Plan shall achieve a CHCUP screening rate of at least sixty percent (60%) for those enrollees who are continuously enrolled for at least eight (8) months during the federal fiscal year (October 1 – September 30) in accordance with s. 409.912(27)409.912, F.S. This screening compliance rate shall be based on the CHCUP screening data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report and due to the Agency by January 15 following the end of each federal fiscal year as specified in Attachment II, Section XII, Reporting Requirements. The data shall be monitored by the Agency for accuracy, and, if the Health Plan does not achieve the sixty percent (60%) screening rate for the federal fiscal year reported, the Health Plan shall file a corrective action plan (CAP) with the Agency no later than February 15, following the fiscal year reported. Failure to meet the sixty percent (60%) screening requirement may result in sanctions. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See Attachment II, Section XIV, Sanctions) i. The Health Plan shall adopt annual screening and participation goals to achieve at least an eighty percent (80%) CHCUP screening and participation raterates, as required by the Centers for Medicare & and Medicaid Services. This participation compliance rate shall be based on the CHCUP data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report (see sub-item H.2.h. above) and/or supporting encounter data. Upon implementation and notice by the Agency, the Health Plan shall submit additional data, as required by the Agency for its submission of the CMS-416, to the Centers for Medicare & Medicaid Services, within the schedule determined by the Agency. For each federal fiscal year that the Health Plan does not meet the eighty percent (80%) screening and participation raterates, it must file a CAP with the Agency no later than February 15 following the federal fiscal year being WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract reported. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See s. 1902(a)(43)(D)(iv) of the Social Security Act.)

Child Health Check-Up Program (CHCUP. a. The Health Plan PSN shall provide a health screening evaluation that shall consist of: comprehensive health and developmental history (history, including assessment of past medical history, developmental history and behavioral health status); comprehensive unclothed physical examination; developmental assessment; nutritional assessment; appropriate immunizations according to the appropriate Recommended Childhood Immunization Schedule for the United States; laboratory testing (including blood lead testing); health education (including anticipatory guidance); dental screening (including a direct referral to a dentist for enrollees Enrollees beginning at three (3) years of age three or earlier as indicated); vision screening, including objective testing as required; hearing screening, including objective testing as required; diagnosis and treatment; and referral and follow-up as appropriate. b. For childrenChildren/adolescents whom Adolescents who the Health Plan PSN identifies through blood lead screenings as having abnormal levels of lead, the Health Plan PSN shall provide case management Case Management follow-up services as required in Chapter Two (2) of the Child Health Check-Up Services Coverage and Limitations Handbook. Screening for lead poisoning is a required component of this Contract. The Health Plan PSN shall require all providers Providers to screen all enrolled children Enrolled Children for lead poisoning at ages 12 twelve (12) and twenty-four (24) months and 24 monthsof age. In addition, children Children/Adolescents between the ages of 12 twenty-four (24) months and 72 seventy-two (72) months of age must receive a screening blood lead test if there is no record of a previous test. The Health Plan PSN shall provide additional diagnostic and treatment services determined to be medically necessary Medically Necessary to a childChild/adolescent Adolescent diagnosed with an elevated blood lead level. The Health Plan PSN shall recommend, but shall not require, the use of paper filter tests as part of the lead screening requirement. c. The Health Plan PSN shall inform enrollees Enrollees of all testing/screenings due in accordance with the periodicity schedule specified in the Medicaid Child Health Check-Up WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract Services Coverage and Limitations Handbook. The Health Plan PSN shall contact enrollees Enrollees to encourage them to obtain health assessment and preventive preventative care. d. The Health Plan PSN shall authorize enrollee Enrollee referrals to appropriate providers Providers within four (4) weeks of these examinations for further assessment and treatment of conditions found during the examination. The Health Plan PSN shall ensure that the referral appointment is scheduled for a date within six (6) months of the initial examination, or within the time periods set forth in Attachment II, Section VII, Provider Network, Item F., Appointment Waiting Times and Geographic Access StandardsVII.D., as applicable. e. The Health Plan shall cover fluoride treatment by a physician or a dentist for children/adolescents even if the Health Plan does not provide dental coverage. Fluoride varnish application in a physician’s office is limited to children up to three and one half (3 ½) years (42 months) of age. f. If the Health Plan Contract covers transportation, the Health Plan PSN shall offer transportation scheduling assistance and Transportation to enrollees Enrollees in order to assist them to keep, and travel to, medical appointments. If the Contract does not cover transportation services, the Health Plan shall offer to help enrollees schedule transportation. g. f. The CHCUP program includes the maintenance of a coordinated system to follow the enrollee Enrollee through the entire range of screening and treatment, as well as supplying CHCUP training to medical care providersProviders. h. g. The Health Plan PSN shall achieve a CHCUP screening rate of at least sixty percent (60%) for those enrollees Enrollees who are continuously enrolled for at least eight (8) months during the federal fiscal year Federal Fiscal Year (October 1 – September 30) in accordance with s. 409.912(27)section 409.912, F.S. This screening compliance rate shall be based on the CHCUP screening data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report PSN and due to the Agency by January 15 following the end of each federal fiscal year Federal Fiscal Year as specified in Attachment II, Section XII, Reporting RequirementsReporting, of this Contract. The data shall be monitored by the Agency for accuracy, accuracy and, if the Health Plan PSN does not achieve the sixty 60 percent (60%) screening rate for the federal fiscal year Federal Fiscal Year reported, the Health Plan PSN shall file a corrective action plan (CAP) with the Agency no later than February 15, following the fiscal year reported. Failure to meet the sixty percent (60%) screening requirement may result in sanctions. Any data reported by the Health Plan PSN that is found to be inaccurate shall be disallowed by the Agency, Agency and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan PSN accordingly. (See Attachment II, Section XIV, Sanctions). i. h. The Health Plan PSN shall adopt annual screening and participation goals to achieve at least an eighty percent (80%) CHCUP screening and participation rate, as required by the Centers for Medicare & Medicaid Services. This participation compliance rate shall be based on the CHCUP data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report (see sub-item H.2.h. above) and/or supporting encounter data. Upon implementation and notice by the Agency, the Health Plan shall submit additional data, as required by the Agency for its submission of the CMS-416, to the Centers for Medicare & Medicaid Services, within the schedule determined by the Agency. For each federal fiscal year Federal Fiscal Year that the Health Plan PSN does not meet the eighty percent (80%) screening and participation rate, it must file a CAP with the Agency no later than February 15 following the federal fiscal year Federal Fiscal Year being WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract reported. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See s. 1902(a)(43)(D)(iv) of the Social Security Act.)

Child Health Check-Up Program (CHCUP. a. The Health Plan shall provide a health screening evaluation that shall consist of: comprehensive health and developmental history (including assessment of past medical history, developmental history and behavioral health status); comprehensive unclothed physical examination; developmental assessment; nutritional assessment; appropriate immunizations according to the appropriate Recommended Childhood Immunization Schedule for the United States; laboratory testing (including blood lead testing); health education (including anticipatory guidance); dental screening (including a direct referral to a dentist for enrollees Enrollees beginning at three (3) years of age three or earlier as indicated); vision screening, including objective testing as required; hearing screening, including objective testing as required; diagnosis and treatment; and referral and follow-up as appropriate. b. For childrenChildren/adolescents whom Adolescents who the Health Plan identifies through blood lead screenings as having abnormal levels of lead, the Health Plan shall provide case management Case Management follow-up services as required in Chapter Two of the Child Health Check-Up Services Coverage and Limitations Handbook. Screening for lead poisoning is a required component of this Contract. The Health Plan shall require all providers Providers to screen all enrolled children Enrolled Children/Adolescents for lead poisoning at ages 12 twelve (12) and twenty-four (24) months and 24 monthsof age. In addition, children Children/Adolescents between the ages of 12 twenty-four (24) months and 72 seventy- two (72) months of age must receive a screening blood lead test if there is no record of a previous test. The Health Plan shall provide additional diagnostic and treatment services determined to be medically necessary Medically Necessary to a childChild/adolescent Adolescent diagnosed with an elevated blood lead level. The Health Plan shall recommend, but shall not require, the use of paper filter tests as part of the lead screening requirement. c. The Health Plan shall inform enrollees Enrollees of all testing/screenings due in accordance with the periodicity schedule specified in the Medicaid Child Health Check-Up WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract Services Coverage and Limitations Handbook. The Health Plan shall contact enrollees Enrollees to encourage them to obtain health assessment and preventive preventative care. d. The Health Plan shall authorize enrollee Enrollee referrals to appropriate providers Providers within four (4) weeks of these examinations for further assessment and treatment of conditions found during the examination. The Health Plan shall ensure that the referral appointment is scheduled for a date within six (6) months of the initial examination, or within the time periods set forth in Attachment II, Section VII, Provider Network, Item F., Appointment Waiting Times and Geographic Access StandardsVII.D., as applicable. e. The Health Plan shall cover fluoride treatment by a physician or a dentist for children/adolescents even if the Health Plan does not provide dental coverage. Fluoride varnish application in a physician’s office is limited offer scheduling assistance and Transportation to children up to three and one half (3 ½) years (42 months) of age. f. If the Health Plan Contract covers transportation, the Health Plan shall offer transportation to enrollees Enrollees in order to assist them to keep, and travel to, medical appointments. If the Contract does not cover transportation services, the Health Plan shall offer to help enrollees schedule transportation. g. f. The CHCUP program includes the maintenance of a coordinated system to follow the enrollee Enrollee through the entire range of screening and treatment, as well as supplying CHCUP training to medical care providersProviders. h. g. The Health Plan shall achieve a CHCUP screening rate of at least sixty percent (60%) for those enrollees Enrollees who are continuously enrolled for at least eight (8) months during the federal fiscal year Federal Fiscal Year (October 1 – September 30) in accordance with s. 409.912(27)Section 409.912, F.S. This screening compliance rate shall be based on the CHCUP screening data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report and due to the Agency by January 15 following the end of each federal fiscal year Federal Fiscal Year as specified in Attachment II, Section XII, Reporting RequirementsReporting, of this Contract. The data shall be monitored by the Agency for accuracy, accuracy and, if the Health Plan does not achieve the sixty percent (60%) screening rate for the federal fiscal year Federal Fiscal Year reported, the Health Plan shall file a corrective action plan (CAP) with the Agency no later than February 15, following the fiscal year reported. Failure to meet the sixty percent (60%) screening requirement may result in sanctions. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, Agency and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See Attachment II, Section XIV, Sanctions). i. h. The Health Plan shall adopt annual screening and participation goals to achieve at least an eighty percent (80%) CHCUP screening and participation rate, as required by the Centers for Medicare & Medicaid Services. This participation compliance rate shall be based on the CHCUP data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report (see sub-item H.2.h. above) and/or supporting encounter data. Upon implementation and notice by the Agency, the Health Plan shall submit additional data, as required by the Agency for its submission of the CMS-416, to the Centers for Medicare & Medicaid Services, within the schedule determined by the Agency. For each federal fiscal year Federal Fiscal Year that the Health Plan does not meet the eighty percent (80%) screening and participation rate, it must file a CAP with the Agency no later than February 15 following the federal fiscal year Federal Fiscal Year being WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract reported. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See s. 1902(a)(43)(D)(iv) of the Social Security Act.)

Child Health Check-Up Program (CHCUP. a. The Health Plan PSN shall provide a health screening evaluation that shall consist of: comprehensive health and developmental history (history, including assessment of past medical history, developmental history and behavioral health status); comprehensive unclothed physical examination; developmental assessment; nutritional assessment; appropriate immunizations according to the appropriate Recommended Childhood Immunization Schedule for the United States; laboratory testing (including blood lead testing); health education (including anticipatory guidance); dental screening (including a direct referral to a dentist for enrollees Enrollees beginning at three (3) years of age three or earlier as indicated); vision screening, including objective testing as required; hearing screening, including objective testing as required; diagnosis and treatment; and referral and follow-up as appropriate. b. For childrenChildren/adolescents whom Adolescents who the Health Plan PSN identifies through blood lead screenings as having abnormal levels of lead, the Health Plan PSN shall provide case management Case Management follow-up services as required in Chapter Two (2) of the Child Health Check-Up Services Coverage and Limitations Handbook. Screening for lead poisoning is a required component of this Contract. The Health Plan PSN shall require all providers Providers to screen all enrolled children Enrolled Children for lead poisoning at ages 12 twelve (12) and twenty-four (24) months and 24 monthsof age. In addition, children Children/Adolescents between the ages of 12 twenty-four (24) months and 72 seventy-two (72) months of age must receive a screening blood lead test if there is no record of a previous test. The Health Plan PSN shall provide additional diagnostic and treatment services determined to be medically necessary Medically Necessary to a childChild/adolescent Adolescent diagnosed with an elevated blood lead level. The Health Plan PSN shall recommend, but shall not require, the use of paper filter tests as part of the lead screening requirement. c. The Health Plan PSN shall inform enrollees Enrollees of all testing/screenings due in accordance with the periodicity schedule specified in the Medicaid Child Health Check-Up WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract Services Coverage and Limitations Handbook. The Health Plan PSN shall contact enrollees Enrollees to encourage them to obtain health assessment and preventive preventative care. d. The Health Plan PSN shall authorize enrollee Enrollee referrals refer Enrollees to appropriate providers service Providers within four (4) weeks six (6) months of these examinations for further assessment and treatment of conditions found during the examination. The Health Plan PSN shall ensure that the referral appointment is scheduled for a date within six (6) months of the initial examination, or within the time periods set forth in Attachment II, Section VII, Provider Network, Item F., Appointment Waiting Times and Geographic Access StandardsVII.D., as applicable. e. The Health Plan shall cover fluoride treatment by a physician or a dentist for children/adolescents even if the Health Plan does not provide dental coverage. Fluoride varnish application in a physician’s office is limited to children up to three and one half (3 ½) years (42 months) of age. f. If the Health Plan Contract covers transportation, the Health Plan PSN shall offer transportation scheduling assistance and Transportation to enrollees Enrollees in order to assist them to keep, and travel to, medical appointments. If the Contract does not cover transportation services, the Health Plan shall offer to help enrollees schedule transportation. g. f. The CHCUP program includes the maintenance of a coordinated system to follow the enrollee Enrollee through the entire range of screening and treatment, as well as supplying CHCUP training to medical care providersProviders. h. g. The Health Plan PSN shall achieve a CHCUP screening rate of at least sixty percent (60%) for those enrollees Enrollees who are continuously enrolled for at least eight (8) months during the federal fiscal year Federal Fiscal Year (October 1 – September 30) in accordance with s. 409.912(27)section 409.912, F.S. This screening compliance rate shall be based on the CHCUP screening data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report PSN and due to the Agency by January 15 following the end of each federal fiscal year Federal Fiscal Year as specified in Attachment II, Section XII, Reporting RequirementsReporting, of this Contract. The data shall be monitored by the Agency for accuracy, accuracy and, if the Health Plan PSN does not achieve the sixty 60 percent (60%) screening rate for the federal fiscal year Federal Fiscal Year reported, the Health Plan PSN shall file a corrective action plan (CAP) with the Agency no later than February 15, following the fiscal year reported. Failure to meet the sixty percent (60%) screening requirement may result in sanctions. Any data reported by the Health Plan PSN that is found to be inaccurate shall be disallowed by the Agency, Agency and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan PSN accordingly. (See Attachment II, Section XIV, Sanctions). i. h. The Health Plan PSN shall adopt annual screening and participation goals to achieve at least an eighty percent (80%) CHCUP screening and participation rate, as required by the Centers for Medicare & Medicaid Services. This participation compliance rate shall be based on the CHCUP data reported by the Health Plan in its CHCUP (CMS-416) and FL 60% Screening Report (see sub-item H.2.h. above) and/or supporting encounter data. Upon implementation and notice by the Agency, the Health Plan shall submit additional data, as required by the Agency for its submission of the CMS-416, to the Centers for Medicare & Medicaid Services, within the schedule determined by the Agency. For each federal fiscal year Federal Fiscal Year that the Health Plan PSN does not meet the eighty percent (80%) screening and participation rate, it must file a CAP with the Agency no later than February 15 following the federal fiscal year Federal Fiscal Year being WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract reported. Any data reported by the Health Plan that is found to be inaccurate shall be disallowed by the Agency, and the Agency shall consider such findings as being in violation of the Contract and may sanction the Health Plan accordingly. (See s. 1902(a)(43)(D)(iv) of the Social Security Act.)