Common use of Enrollee Communications Clause in Contracts

Enrollee Communications. CMS and the Commonwealth agree that Enrollee and prospective Enrollee materials, in all forms, shall require prior approval by CMS and the Commonwealth unless CMS and the Commonwealth agree that one or the other entity is authorized to review and approve such documents on behalf of CMS and the Commonwealth. CMS and the Commonwealth will also work to develop pre-approved documents that may be used, under certain circumstances, without additional CMS or Commonwealth approval. All materials shall be integrated and include, but not be limited to: outreach and education materials; enrollment and disenrollment materials; benefit coverage information; and operational letters for enrollment, disenrollment, claims or service denials, complaints, internal appeals, external appeals, and provider terminations. Such uniform/integrated materials will be required to be accessible and understandable to the beneficiaries that will be enrolled in the Participating Plans, and their caregivers. This includes individuals with disabilities, including, but not limited to, those with cognitive and functional limitations, and those with limited English proficiency, in accordance with current Federal guidelines for Medicare and Medicaid. Where Medicare and Medicaid standards differ, the standard providing the greatest access to individuals with disabilities or limited English proficiency will apply.

Enrollee Communications. CMS and the Commonwealth DMAS agree that Enrollee and prospective Enrollee materials, in all forms, shall require prior approval by CMS and the Commonwealth DMAS in accordance with all existing rules and regulation, unless CMS and the Commonwealth DMAS agree that one or the other entity is authorized to review and approve such documents on behalf of CMS and the CommonwealthDMAS. CMS and the Commonwealth DMAS will also work to develop pre-approved documents that may be used, under certain circumstances, without additional CMS or Commonwealth DMAS approval. All CMS and DMAS will develop integrated materials shall be integrated and that include, but not be limited to: outreach and education materials; enrollment and disenrollment materials; benefit coverage information; and operational letters for enrollment, disenrollment, claims or service denials, complaints, internal appeals, external appeals, and provider terminations. Such uniform/integrated materials will be required to be accessible and understandable to the beneficiaries that will be enrolled Enrollees and prospective Enrollees in the Participating Plans, and their caregivers. This includes individuals with disabilities, including, but not limited to, those with cognitive and functional limitations, and those with limited English proficiency, in accordance with current Federal guidelines for Medicare and Medicaid. Where Medicare and Medicaid standards differ, the standard providing the greatest access to individuals with disabilities or limited English proficiency will apply.

Enrollee Communications. CMS and the Commonwealth State agree that Enrollee and prospective Enrollee materials, in all forms, shall require prior approval by CMS and the Commonwealth State in accordance with all existing rules and regulation, unless CMS and the Commonwealth State agree that one or the other entity is authorized to review and approve such documents on behalf of CMS and the CommonwealthState. CMS and the Commonwealth State will also work to develop pre-approved documents that may be used, under certain circumstances, without additional CMS or Commonwealth State approval. All CMS and the State will develop integrated materials shall be integrated and that include, but are not be limited to: outreach and education materials; enrollment and disenrollment materials; benefit coverage information; and operational letters for enrollment, disenrollment, claims or service denials, complaints, internal appeals, external appeals, and provider terminations. Such uniform/integrated materials will be required to be accessible and understandable to the beneficiaries that will be enrolled in the Participating PlansEnrollees, prospective Enrollees, and their caregivers. This includes Materials must be accessible to individuals with disabilities, including, including but not limited to, those with to cognitive and functional limitations, and those with limited English proficiency, in accordance with current Federal federal guidelines for Medicare and Medicaid. Where Medicare and Medicaid standards differ, the standard providing that provides the greatest level of understanding and comprehension access to individuals with disabilities or limited English proficiency will apply.