Common use of Corrective Action Requests Clause in Contracts

Corrective Action Requests. The MCO will notify the STATE and provide copies of any CMS corrective action requests and subsequent corrective plans submitted to CMS related to compliance with SNP Medicare Advantage or Part D requirements within thirty (30) days of submission to CMS. Dual Demonstration. The MCO agrees to participate in the CMS Demonstration to Align Administrative Functions for Improvements in Beneficiary Experience (Demonstration) as a Fully Integrated Medicare Advantage Dual Eligible Special Needs Plan (FIDE SNP, as defined in 42 CFR § 422.2 and further defined by CMS in the 2014 SNP Application) for MSHO enrollees as outlined in the Memorandum of Understanding between CMS and the STATE. The demonstration’s goals will be to improve the integration of Medicare and Medicaid through increased participation of integrated provider health care delivery systems, improve enrollee health outcomes as measured through risk adjusted quality metrics appropriate to the enrolled population, and to align administrative systems to improve efficiency and beneficiary experience. The STATE will include the MCO in calls between CMS and the STATE to work out details of any provisions of the demonstration affecting the MCO’s Medicare SNP and Medicaid operations, provider networks, provider contracting and policies. The STATE will establish a work group for consultation with the MCOs on work plan development and implementation of the demonstration. Topics shall include: