Common use of Contract with CMS for Special Needs Plan Clause in Contracts

Contract with CMS for Special Needs Plan. The MCO agrees to participate in Medicare Advantage as a Dual Eligible Special Needs Plan (SNP). The MCO shall notify the STATE, consistent with section 3.6.14, of any material changes in its contract with CMS as a Special Needs Plan, including but not limited to, termination of the contract by either party. The MCO shall inform the STATE regarding significant changes in its Medicare Program or the administration of Medicare Programs, in order to facilitate operating MSHO in as fully integrated a manner as possible. The MCO will notify the STATE of changes, including but not limited to terminations of SNP plans, changes in type of SNPs approved or applied for, denial of a SNP application, failure to meet the CMS Low Income Subsidy (LIS) requirements, Part D issues that may materially affect the SNP, or a decision to conduct a Federal investigative audit that may lead to termination of the SNP, within thirty (30) days of such actions. For any SNP that may enroll Dual Eligible persons, the MCO also agrees to inform the STATE of any requests to CMS for Service Area changes in its SNP Service Area(s) within Minnesota, and of final approval, denial or withdrawal of such requests to CMS within fifteen (15) days of submission of such requests to CMS or within fifteen

Contract with CMS for Special Needs Plan. ‌ The MCO agrees to participate in Medicare Advantage as a Dual Eligible Special Needs Plan (SNP). . 3.19.1.1 The MCO shall notify the STATE, consistent with section 3.6.143.13, of any material changes in its contract with CMS as a Special Needs Plan, including but not limited to, termination of the contract by either party. party.‌‌ 3.19.1.2 The MCO shall inform the STATE regarding significant changes in its Medicare Program or the administration of Medicare Programs, in order to facilitate operating MSHO in as fully integrated a manner as possible. Significant changes include, for this section, a change in the SNP service area. MCOs must send a copy of the proposed service area to the STATE within ten (10) days of the time a Notice of Intent to Apply is submitted to CMS. 3.19.1.3 The MCO will notify the STATE of changes, including but not limited to terminations of SNP plans, changes in type of SNPs approved or applied for, denial of a SNP application, failure to meet the CMS Low Income Subsidy (LIS) requirements, Part D issues that may materially affect the SNP, or a decision to conduct a Federal investigative audit that may lead to termination of the SNP, within thirty (30) days of such actions. For any SNP that may enroll Dual Eligible persons, the MCO also agrees to inform the STATE of any requests to CMS for Service Area changes in its SNP Service Area(s) within Minnesota, and of final approval, denial or withdrawal of such requests to CMS within fifteen (15) days of submission of such requests to CMS or within fifteenfifteen (15) days of receipt of notice from CMS, whichever is applicable.

Contract with CMS for Special Needs Plan. The MCO agrees to participate in Medicare Advantage as a Dual Eligible Special Needs Plan (SNP). . (A) The MCO shall notify the STATE, consistent with section 3.6.14, of any material changes in its contract with CMS as a Special Needs Plan, including but not limited to, termination of the contract by either party. . (B) The MCO shall inform the STATE regarding significant changes in its Medicare Program or the administration of Medicare Programs, in order to facilitate operating MSHO in as fully integrated a manner as possible. . (C) The MCO will notify the STATE of changes, including but not limited to terminations of SNP plans, changes in type of SNPs approved or applied for, denial of a SNP application, failure to meet the CMS Low Income Subsidy (LIS) requirements, Part D issues that may materially affect the SNP, or a decision to conduct a Federal investigative audit that may lead to termination of the SNP, within thirty (30) days of such actions. For any SNP that may enroll Dual Eligible persons, the MCO also agrees to inform the STATE of any requests to CMS for Service Area changes in its SNP Service Area(s) within Minnesota, and of final approval, denial or withdrawal of such requests to CMS within fifteen (15) days of submission of such requests to CMS or within fifteen

Contract with CMS for Special Needs Plan. The MCO agrees to participate in Medicare Advantage as a Dual Eligible Special Needs Plan (SNP). . (A) The MCO shall notify the STATE, consistent with section 3.6.14, of any material changes in its contract with CMS as a Special Needs Plan, including but not limited to, termination of the contract by either party. . (B) The MCO shall inform the STATE regarding significant changes in its Medicare Program or the administration of Medicare Programs, in order to facilitate operating MSHO in as fully integrated a manner as possible. . (C) The MCO will notify the STATE of changes, including but not limited to terminations of SNP plans, changes in type of SNPs approved or applied for, denial of a SNP application, failure to meet the CMS Low Income Subsidy (LIS) requirements, Part D issues that may materially affect the SNP, or a decision to conduct a Federal investigative audit that may lead to termination of the SNP, within thirty (30) days of such actions. For any SNP that may enroll Dual Eligible personsEligibles, the MCO also agrees to inform the STATE of any requests to CMS for Service Area changes in its SNP Service Area(s) within Minnesota, and of final approval, denial or withdrawal of such requests to CMS within fifteen (15) days of submission of such requests to CMS or within fifteenfifteen (15) days of receipt of notice from CMS, whichever is applicable.