Common use of Healthchek and Pregnancy Related Services Clause in Contracts

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) and Pregnancy Related Services, are outlined in OAC rules 5160:1-2- 15, 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the MCOP shall: i. Inform each new member under the age of 21 about Healthchek services as prescribed by ODM and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment file. An MCOP may meet this requirement by including information with the new member materials specified in Appendix F. In addition, the MCOP may be required to communicate with the member’s local county department of job and family services agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOP’s member handbooks shall be provided to members within the time frames specified in this appendix and shall include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation that providers may request prior authorization for: a. Coverage of services that have limitations; and/or b. Services not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the above Healthchek information on the MCOP's member website specified in this appendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s members at the following intervals: 1. January of each calendar year; and 2. In July for members from age 18 to under 21. v. Use the mailing templates provided by ODM not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP shall populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, and age of member on the date of service). b. Informing members about Pregnancy Related Services (PRS), the MCOP shall: i. Upon the identification of a member as pregnant, the MCOP shall deliver to the member within 5 calendar days a PRS form as designated by ODM. ii. The MCOP may be required to communicate with the member’s local CDJFS agency any requests made by the member for county-coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP shall: i. Provide Healthchek education to all contracted providers on an annual basis which shall include, at a minimum: 1. The required components of a Healthchek exam as specified in OAC rule 5160-1- 14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOP’s provider website as specified in this appendix. d. An MCOP shall maintain documentation to verify members and providers were informed of Healthchek and PRS as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) and Pregnancy Related Services, are outlined in OAC rules 5160:1-2- 15, 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the MCOP shall: i. Inform each new member under the age of 21 about Healthchek services as prescribed by ODM XXX and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment file. An MCOP may meet this requirement by including information with the new member materials specified in Appendix F. In addition, the MCOP may be required to communicate with the member’s local county department of job and family services agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOP’s member handbooks shall be provided to members within the time frames specified in this appendix and shall include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation that providers may request prior authorization for: a. Coverage of services that have limitations; and/or b. Services not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the above Healthchek information on the MCOP's member website specified in this appendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s members at the following intervals: 1. January of each calendar year; and 2. In July for members from age 18 to under 21. v. Use the mailing templates provided by ODM not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP shall populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, and age of member on the date of service). b. Informing members about Pregnancy Related Services (PRS), the MCOP shall: i. Upon the identification of a member as pregnant, the MCOP shall deliver to the member within 5 calendar days a PRS form as designated by ODM. ii. The MCOP may be required to communicate with the member’s local CDJFS agency any requests made by the member for county-coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP shall: i. Provide Healthchek education to all contracted providers on an annual basis which shall include, at a minimum: 1. The required components of a Healthchek exam as specified in OAC rule 5160-1- 14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOP’s provider website as specified in this appendix. d. An MCOP shall maintain documentation to verify members and providers were informed of Healthchek and PRS as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, diagnostic and treatment (EPSDT) and Pregnancy Related Services, Services programs are outlined in OAC rules 5160:1-2- 2-15, 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the MCOP MCP shall: i. Inform each new member under the age of 21 about Healthchek services as prescribed by ODM XXX and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment file. An MCOP The MCP may meet this requirement by including information with the new member materials as specified in Appendix F. In addition, the MCOP MCP may be required to communicate with the member’s local county department of job and family services (CDJFS) agency any requests made by the member for County county-coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOPMCP’s member handbooks shall be provided to members within the time frames specified in this appendix and shall include verbatim the model language developed by ODM. The model language language, at a minimum minimum, will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation Information that providers may request prior authorization for: a. Coverage of services that have limitations; and/or b. Services not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the information included in the member handbook above regarding Healthchek information on the MCOPMCP's member website specified in this appendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s its members at the following intervals: 1. When the member is 9 months old; 2. When the member is 18 months old; 3. When the member is 30 months old; 4. January of each calendar yearyear to all members under the age of 21; and 25. In July for members from age 18 4 to under 21. 6. When the member is identified as pregnant. v. Use the mailing templates provided by ODM not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP MCP shall populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, and age of member on the date of service). b. Informing members Members about Pregnancy Related Services (PRS), the MCOP shall:): i. Upon the identification of a member as pregnant, the MCOP MCP shall deliver to the member within 5 calendar days a PRS form as designated by ODM. ii. The MCOP MCP may be required to communicate with the member’s local CDJFS agency any requests made by the member for county-coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP MCP shall: i. Provide Healthchek education to all contracted providers on an annual basis which shall include, at a minimum: 1. The required components of a Healthchek exam as specified in OAC rule 51605160- 01-1- 14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, diagnostic and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOPMCP’s provider website as specified in this appendix. d. An MCOP The MCP shall maintain documentation to verify members and providers were informed of Healthchek and PRS as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, diagnostic and treatment (EPSDT) and Pregnancy Related Services, Services programs are outlined in OAC rules 5160:1-2- 2-15, 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the MCOP MCP shall: i. Inform each new member under the age of 21 about Healthchek services as prescribed by ODM and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment file. An MCOP The MCP may meet this requirement by including information with the new member materials as specified in Appendix F. In addition, the MCOP MCP may be required to communicate with the member’s local county department of job and family services (CDJFS) agency any requests made by the member for County county-coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOPMCP’s member handbooks shall be provided to members within the time frames specified in this appendix and shall include verbatim the model language developed by ODM. The model language language, at a minimum minimum, will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation Information that providers may request prior authorization for: a. Coverage of services that have limitations; and/or b. Services not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the information included in the member handbook above regarding Healthchek information on the MCOPMCP's member website specified in this appendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s its members at the following intervals: 1. When the member is 9 months old; 2. When the member is 18 months old; 3. When the member is 30 months old; 4. January of each calendar yearyear to all members under the age of 21; and 25. In July for members from age 18 4 to under 21. 6. When the member is identified as pregnant. v. Use the mailing templates provided by ODM not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP MCP shall populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, and age of member on the date of service). b. Informing members Members about Pregnancy Related Services (PRS), the MCOP shall:): i. Upon the identification of a member as pregnant, the MCOP MCP shall deliver to the member within 5 calendar days a PRS form as designated by ODM. ii. The MCOP MCP may be required to communicate with the member’s local CDJFS agency any requests made by the member for county-coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP MCP shall: i. Provide Healthchek education to all contracted providers on an annual basis which shall include, at a minimum: 1. The required components of a Healthchek exam as specified in OAC rule 51605160- 01-1- 14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, diagnostic and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOPMCP’s provider website as specified in this appendix. d. An MCOP The MCP shall maintain documentation to verify members and providers were informed of Healthchek and PRS as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, diagnostic and treatment (EPSDT) and Pregnancy Related Services, Services programs are outlined in OAC rules 5160:1-2- 2-15, 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the MCOP MCP shall: i. Inform each new member under the age of 21 about Healthchek services as prescribed by ODM and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment file. An MCOP The MCP may meet this requirement by including information with the new member materials as specified in Appendix F. In addition, the MCOP MCP may be required to communicate with the member’s local county department County Department of job Job and family services Family Services (CDJFS) agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOPMCP’s member handbooks shall be provided to members within the time frames specified in this appendix appendix, and shall include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation Information that providers may request prior authorization for: a. Coverage of services that have limitations; and/or b. Services not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the information included in the member handbook above regarding Healthchek information on the MCOPMCP's member website specified in this appendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s its members at the following intervals: 1. When the member is 9 months old; 2. When the member is 18 months old; 3. When the member is 30 months old; 4. January of each calendar yearyear to all members under the age of 21; and 25. In At the beginning of each school year in the month of July for members from age 18 4 to under 21. 6. When the member is identified as pregnant. v. Use the mailing templates provided by ODM not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP MCP shall populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, service and age of member on the date of service). b. Informing members Members about Pregnancy Related Services (PRS), the MCOP shall:): i. Upon the identification of a member as pregnant, the MCOP MCP shall deliver to the member within 5 calendar days a PRS form as designated by ODM. ii. The MCOP MCP may be required to communicate with the member’s local CDJFS agency any requests made by the member for county-County coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP MCP shall: i. Provide Healthchek education to all contracted providers on an annual basis which shall include, at a minimum: 1. The required components of a Healthchek exam as specified in OAC rule 51605160- 01-1- 14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, diagnostic and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOPMCP’s provider website as specified in this appendix. d. An MCOP The MCP shall maintain documentation to verify members and providers were informed of Healthchek and PRS as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, diagnostic and treatment (EPSDT) and Pregnancy Related Services, Services programs are outlined in OAC rules 5160:1-2- 2-15, 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the MCOP MCP shall: i. Inform each new member under the age of 21 about Healthchek services as prescribed by ODM and as specified by 42 CFR CFR. Section 441.56 within 5 7 calendar days of receipt their effective date of enrollment in the 834C enrollment fileMCP. An MCOP The MCP may meet this requirement by including information with the new member materials as specified in Appendix F. In addition, the MCOP MCP may be required to communicate with the member’s local county department County Department of job Job and family services Family Services (CDJFS) agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOPMCP’s member handbooks shall be provided to members within the time frames specified in this appendix appendix, and shall include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation Information that providers may request prior authorization for: a. Coverage of services that have limitations; and/or b. Services not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the above Healthchek information in 25.a.ii on the MCOPMCP's member website specified in this appendixAppendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s its members at the following intervals: 1. When the member is 9 months old; 2. When the member is 18 months old; 3. When the member is 30 months old; 4. January of each calendar yearyear to all members under the age of 21; and 25. In At the beginning of each school year in the month of July for members from age 18 4 to under 21. 6. When the member is identified as pregnant. v. Use the mailing templates provided by ODM not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP MCP shall populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, and age of member on the date of service). b. Informing members about Pregnancy Related Services (PRS), the MCOP shall: i. Upon the identification of a member as pregnant, the MCOP shall deliver to the member within 5 calendar days a PRS form as designated by ODM. ii. The MCOP may be required to communicate with the member’s local CDJFS agency any requests made by the member for county-coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP shall: i. Provide Healthchek education to all contracted providers on an annual basis which shall include, at a minimum: 1. The required components of a Healthchek exam as specified in OAC rule 5160-1- 14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOP’s provider website as specified in this appendix. d. An MCOP shall maintain documentation to verify members and providers were informed of Healthchek and PRS as specified by ODM.e.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) and Pregnancy Related Services, are outlined in OAC rules 5160:1-2- 155160:1‐2‐15, 5160:1-2-165160:1‐2‐16, and 5160-1-145160‐1‐14. a. Informing members about Healthchek, the MCOP shall: i. Inform each new member under the age of 21 within 7 calendar days of their effective date of enrollment in the MCOP about Healthchek services as prescribed by ODM and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment fileCFR. Section 441.56. An MCOP may meet this requirement by including information with the new member materials specified in Appendix F. In addition, the MCOP may be required to communicate with the member’s local county department County Department of job Job and family services Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOP’s member handbooks shall be provided to members within the time frames specified in section 25 of this appendix Appendix, and shall include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation that providers may request prior authorization for: a. Coverage of services that have limitations; and/or b. Services not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the above Healthchek information on the MCOP's member website specified in section 48 of this appendixAppendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s members at the following intervals: 1. January of each calendar year; and 2. In July for members from age 18 to under 21At the beginning of each school year in the month of July. v. Use the mailing templates provided by ODM not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP shall populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, service and age of member on the date of service). b. Informing members about Pregnancy Related Services (PRS), the MCOP shall: i. Upon the identification of a member as pregnant, the MCOP shall deliver to the member within 5 7 calendar days a PRS form as designated by ODM. ii. The MCOP may be required to communicate with the member’s local CDJFS County Department of Job and Family Services agency any requests made by the member for county-County coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP shall: i. Provide Healthchek education to all contracted providers on an annual basis which shall include, at a minimum: 1. The required components of a Healthchek exam as specified in OAC rule 5160-1- 145160‐1‐14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, diagnostic and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOP’s provider website as specified in section 48 of this appendixAppendix. d. An MCOP shall maintain documentation to verify members and providers were informed of Healthchek and PRS as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) and Pregnancy Related Services, are outlined in OAC rules 5160:1-2- 15, 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the MCOP shall: i. Inform each new member under the age of 21 about Healthchek services as prescribed by ODM XXX and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment file. An MCOP may meet this requirement by including information with the new member materials specified in Appendix F. In addition, the MCOP may be required to communicate with the member’s local county department County Department of job Job and family services Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOP’s member handbooks shall be provided to members within the time frames specified in this appendix and shall include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation that providers may request prior authorization for: a. Coverage of services that have limitations; and/or : b. Services not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the above Healthchek information on the MCOP's member website specified in this appendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s members at the following intervals: 1. January of each calendar year; and 2. In July for members from age 18 to under 21At the beginning of each school year in the month of July. v. Use the mailing templates provided by ODM not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP shall populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, and age of member on the date of service). b. Informing members about Pregnancy Related Services (PRS), the MCOP shall: i. Upon the identification of a member as pregnant, the MCOP shall deliver to the member within 5 calendar days a PRS form as designated by ODM. ii. The MCOP may be required to communicate with the member’s local CDJFS County Department of Job and Family Services agency any requests made by the member for county-county coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP shall: i. Provide Healthchek education to all contracted providers on an annual basis which shall include, at a minimum: 1. The required components of a Healthchek exam as specified in OAC rule 5160-1- 14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOP’s provider website as specified in this appendix. d. An MCOP shall maintain documentation to verify members and providers were informed of Healthchek and PRS as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) and Pregnancy Related ServicesServices programs, are outlined in OAC rules 5160:1-2- 15, 5160:1-2-16, 5160:1‐2‐15 and 5160-1-145160:1‐2‐16. a. Informing members about Healthchek, the . The MCOP shallmust: i. Inform each new member under the age of 21 within 7 calendar days of their effective date of enrollment in the MCOP about the Healthchek services program as prescribed by ODM and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment fileCFR. Section 441.56. An MCOP may meet this requirement by including information with the new member materials specified in Appendix F. section 25 of this Appendix. In addition, the MCOP may be required to communicate with the member’s local county department County Department of job Job and family services Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOP’s member handbooks shall must be provided to members within the time frames specified in section 25 of this appendix Appendix, and shall must include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation Information that providers may request prior authorization for: a. Coverage for coverage of services that have limitations; and/or b. Services limitations and/or are not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the above Healthchek information on the MCOP's member website specified in section 48 of this appendixAppendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s members at the following intervals: 1. January of each calendar year; and 2. In July for members from age 18 to under 21At the beginning of each school year in the month of July. v. Use the mailing templates provided by ODM that will not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP shall must populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, service and age of member on the date of service). b. Informing members about Pregnancy Related Services (PRS), the MCOP shallmust: i. Upon the identification of a member as pregnant, the MCOP shall must deliver to the member within 5 14 calendar days a PRS form as designated by ODM. ii. The MCOP may be required to communicate with the member’s local CDJFS County Department of Job and Family Services agency any requests made by the member for county-County coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP shallmust: i. Provide Healthchek education to all contracted providers on an annual basis which shall must include, at a minimum, the following: 1. The required components of a Healthchek exam as specified in OAC rule 5160-1- 145160‐14‐03 or 5160‐1‐14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, diagnosis and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOP’s provider website as specified in section 48 of this appendixAppendix. d. An MCOP shall must maintain documentation to verify that it informed members and providers were informed of Healthchek and PRS Pregnancy Related Services as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, diagnostic and treatment (EPSDT) and Pregnancy Related Services, Services programs are outlined in OAC rules 5160:1-2- 2-15, 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the MCOP MCP shall: i. Inform each new member under the age of 21 about Healthchek services as prescribed by ODM XXX and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment file. An MCOP The MCP may meet this requirement by including information with the new member materials as specified in Appendix F. In addition, the MCOP MCP may be required to communicate with the member’s local county department County Department of job Job and family services Family Services (CDJFS) agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOPMCP’s member handbooks shall be provided to members within the time frames specified in this appendix appendix, and shall include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation Information that providers may request prior authorization for: a. Coverage of services that have limitations; and/or b. Services not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the information included in the member handbook above regarding Healthchek information on the MCOPMCP's member website specified in this appendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s its members at the following intervals: 1. When the member is 9 months old; 2. When the member is 18 months old; 3. When the member is 30 months old; 4. January of each calendar yearyear to all members under the age of 21; and 25. In At the beginning of each school year in the month of July for members from age 18 4 to under 21. 6. When the member is identified as pregnant. v. Use the mailing templates provided by ODM not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP MCP shall populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, service and age of member on the date of service). b. Informing members Members about Pregnancy Related Services (PRS), the MCOP shall:): i. Upon the identification of a member as pregnant, the MCOP MCP shall deliver to the member within 5 calendar days a PRS form as designated by ODM. ii. The MCOP MCP may be required to communicate with the member’s local CDJFS agency any requests made by the member for county-County coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP MCP shall: i. Provide Healthchek education to all contracted providers on an annual basis which shall include, at a minimum: 1. The required components of a Healthchek exam as specified in OAC rule 51605160- 01-1- 14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, diagnostic and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOPMCP’s provider website as specified in this appendix. d. An MCOP The MCP shall maintain documentation to verify members and providers were informed of Healthchek and PRS as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) and Pregnancy Related Services, are outlined in OAC rules 5160:1-2- 15, 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the MCOP shall: i. Inform each new member under the age of 21 about Healthchek services as prescribed by ODM and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment file. An MCOP may meet this requirement by including information with the new member materials specified in Appendix F. In addition, the MCOP may be required to communicate with the member’s local county department County Department of job Job and family services Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOP’s member handbooks shall be provided to members within the time frames specified in this appendix appendix, and shall include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation that providers may request prior authorization for: a. Coverage of services that have limitations; and/or : b. Services not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the above Healthchek information on the MCOP's member website specified in this appendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s members at the following intervals: 1. January of each calendar year; and 2. In July for members from age 18 to under 21At the beginning of each school year in the month of July. v. Use the mailing templates provided by ODM not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP shall populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, service and age of member on the date of service). b. Informing members about Pregnancy Related Services (PRS), the MCOP shall: i. Upon the identification of a member as pregnant, the MCOP shall deliver to the member within 5 calendar days a PRS form as designated by ODM. ii. The MCOP may be required to communicate with the member’s local CDJFS County Department of Job and Family Services agency any requests made by the member for county-coordinated services County e and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP shall: i. Provide Healthchek education to all contracted providers on an annual basis which shall include, at a minimum: 1. The required components of a Healthchek exam as specified in OAC rule 5160-1- 14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, diagnostic and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOP’s provider website as specified in this appendix. d. An MCOP shall maintain documentation to verify members and providers were informed of Healthchek and PRS as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) and Pregnancy Related ServicesServices programs, are outlined in OAC rules 5160:1-2- 15, 2-15 and 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the . The MCOP shallmust: i. Inform each new member under the age of 21 within 7 calendar days of their effective date of enrollment in the MCOP about the Healthchek services program as prescribed by ODM and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment fileCFR. Section 441.56. An MCOP may meet this requirement by including information with the new member materials specified in Appendix F. section 25 of this Appendix. In addition, the MCOP may be required to communicate with the member’s local county department County Department of job Job and family services Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOP’s member handbooks shall must be provided to members within the time frames specified in section 25 of this appendix Appendix, and shall must include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation Information that providers may request prior authorization for: a. Coverage for coverage of services that have limitations; and/or b. Services limitations and/or are not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the above Healthchek information on the MCOP's member website specified in section 48 of this appendixAppendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s members at the following intervals: 1. January of each calendar year; and 2. In July for members from age 18 to under 21At the beginning of each school year in the month of July. v. Use the mailing templates provided by ODM that will not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP shall must populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, service and age of member on the date of service). b. Informing members about Pregnancy Related Services (PRS), the MCOP shallmust: i. Upon the identification of a member as pregnant, the MCOP shall must deliver to the member within 5 14 calendar days a PRS form as designated by ODM. ii. The MCOP may be required to communicate with the member’s local CDJFS County Department of Job and Family Services agency any requests made by the member for county-County coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP shallmust: i. Provide Healthchek education to all contracted providers on an annual basis which shall must include, at a minimum, the following: 1. The required components of a Healthchek exam as specified in OAC rule 5160-1- 14-03; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, diagnosis and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOP’s provider website as specified in section 48 of this appendixAppendix. d. An MCOP shall must maintain documentation to verify that it informed members and providers were informed of Healthchek and PRS Pregnancy Related Services as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, diagnostic and treatment (EPSDT) and Pregnancy Related Services, Services programs are outlined in OAC rules 5160:1-2- 2-15, 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the MCOP MCP shall: i. Inform each new member under the age of 21 about Healthchek services as prescribed by ODM and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment file. An MCOP The MCP may meet this requirement by including information with the new member materials as specified in Appendix F. In addition, the MCOP MCP may be required to communicate with the member’s local county department County Department of job Job and family services Family Services (CDJFS) agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOPMCP’s member handbooks shall be provided to members within the time frames specified in this appendix and shall include verbatim the model language developed by ODM. The model language language, at a minimum minimum, will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation Information that providers may request prior authorization for: a. Coverage of services that have limitations; and/or b. Services not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the information included in the member handbook above regarding Healthchek information on the MCOPMCP's member website specified in this appendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s its members at the following intervals: 1. When the member is 9 months old; 2. When the member is 18 months old; 3. When the member is 30 months old; 4. January of each calendar yearyear to all members under the age of 21; and 25. In At the beginning of each school year in the month of July for members from age 18 4 to under 21. 6. When the member is identified as pregnant. v. Use the mailing templates provided by ODM not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP MCP shall populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, and age of member on the date of service). b. Informing members Members about Pregnancy Related Services (PRS), the MCOP shall:): i. Upon the identification of a member as pregnant, the MCOP MCP shall deliver to the member within 5 calendar days a PRS form as designated by ODM. ii. The MCOP MCP may be required to communicate with the member’s local CDJFS agency any requests made by the member for county-County coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP MCP shall: i. Provide Healthchek education to all contracted providers on an annual basis which shall include, at a minimum: 1. The required components of a Healthchek exam as specified in OAC rule 51605160- 01-1- 14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, diagnostic and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOPMCP’s provider website as specified in this appendix. d. An MCOP The MCP shall maintain documentation to verify members and providers were informed of Healthchek and PRS as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, and treatment (EPSDT) and Pregnancy Related ServicesServices programs, are outlined in OAC rules 5160:1-2- 15, 2-15 and 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the . The MCOP shallmust: i. Inform each new member under the age of 21 within 7 calendar days of their effective date of enrollment in the MCOP about the Healthchek services program as prescribed by ODM and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment fileCFR. Section 441.56. An MCOP may meet this requirement by including information with the new member materials specified in Appendix F. section 25 of this Appendix. In addition, the MCOP may be required to communicate with the member’s local county department County Department of job Job and family services Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOP’s member handbooks shall must be provided to members within the time frames specified in section 25 of this appendix Appendix, and shall must include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation Information that providers may request prior authorization for: a. Coverage for coverage of services that have limitations; and/or b. Services limitations and/or are not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the above Healthchek information on the MCOP's member website specified in section 48 of this appendixAppendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s members at the following intervals: 1. January of each calendar year; and 2. In July for members from age 18 to under 21At the beginning of each school year in the month of July. v. Use the mailing templates provided by ODM that will not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP shall must populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, service and age of member on the date of service). b. Informing members about Pregnancy Related Services (PRS), the MCOP shallmust: i. Upon the identification of a member as pregnant, the MCOP shall must deliver to the member within 5 14 calendar days a PRS form as designated by ODM. ii. The MCOP may be required to communicate with the member’s local CDJFS County Department of Job and Family Services agency any requests made by the member for county-County coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP shallmust: i. Provide Healthchek education to all contracted providers on an annual basis which shall must include, at a minimum, the following: 1. The required components of a Healthchek exam as specified in OAC rule 5160-1- 14-03 or 5160-1-14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, diagnosis and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOP’s provider website as specified in section 48 of this appendixAppendix. d. An MCOP shall must maintain documentation to verify that it informed members and providers were informed of Healthchek and PRS Pregnancy Related Services as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, diagnostic and treatment (EPSDT) and Pregnancy Related Services, Services programs are outlined in OAC rules 5160:1-2- 15, 2-15 and 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the MCOP shall. The MCPs must: i. Inform each new member under the age of 21 within 7 calendar days of their effective date of enrollment in the MCP about the Healthchek services program as prescribed by ODM and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment fileCFR. Section 441.56. An MCOP MCP may meet this requirement by including information with the new member materials as specified in Appendix F. section 24.d of this Appendix. In addition, the MCOP MCP may be required to communicate with the member’s local county department County Department of job Job and family services Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOPMCP’s member handbooks shall must be provided to members within the time frames specified in section 24.d of this appendix Appendix, and shall must include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation Information that providers may request prior authorization for: a. Coverage for coverage of services that have limitations; and/or b. Services limitations and/or are not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the above Healthchek information in 25.a.ii on the MCOPMCP's member website specified in 41.b. of this appendixAppendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s its members at the following intervals: 1. When the member is 9 months old; 2. When the member is 18 months old; 3. When the member is 30 months old; 4. January of each calendar yearyear to all members under the age of 21; and 25. In At the beginning of each school year in the month of July for members from age 18 4 to under 21. v. Use the mailing templates provided by ODM that will not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP shall MCP must populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, service and age of member on the date of service). b. Informing members Members about Pregnancy Related Services (PRS), the MCOP shall: i. Upon the identification of a member as pregnant, the MCOP shall MCP must deliver to the member within 5 14 calendar days a PRS form as designated by ODM. ii. The MCOP MCP may be required to communicate with the member’s local CDJFS County Department of Job and Family Services agency any requests made by the member for county-County coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP shallMCP must: i. Provide Healthchek education to all contracted providers on an annual basis which shall must include, at a minimum, the following: 1. The required components of a Healthchek exam as specified in OAC rule 5160-1- 14-03; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, diagnosis and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOPMCP’s provider website as specified in section 41.c. of this appendixAppendix. d. An MCOP shall MCP must maintain documentation to verify that it informed members and providers were informed of Healthchek and PRS Pregnancy Related Services as specified by ODM.

Healthchek and Pregnancy Related Services. Healthchek, Ohio’s early and periodic screening, diagnostic, diagnostic and treatment (EPSDT) and Pregnancy Related Services, Services programs are outlined in OAC rules 5160:1-2- 15, 2-15 and 5160:1-2-16, and 5160-1-14. a. Informing members about Healthchek, the MCOP shall. The MCPs must: i. Inform each new member under the age of 21 within 7 calendar days of their effective date of enrollment in the MCP about the Healthchek services program as prescribed by ODM and as specified by 42 CFR 441.56 within 5 calendar days of receipt of the 834C enrollment fileCFR. Section 441.56. An MCOP MCP may meet this requirement by including information with the new member materials as specified in Appendix F. this appendix. In addition, the MCOP MCP may be required to communicate with the member’s local county department County Department of job Job and family services Family Services agency any requests made by the member for County coordinated services and/or supports (e.g. social services). ii. Provide members with accurate information in the member handbook regarding Healthchek. The MCOPMCP’s member handbooks shall must be provided to members within the time frames specified in this appendix appendix, and shall must include verbatim the model language developed by ODM. The model language at a minimum will include: 1. A description of the types of screening and treatment services covered by Healthchek; 2. A list of the intervals at which members individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document entitled “Recommendations for Preventive Pediatric Health Care,” published by Bright Futures/American Academy of Pediatrics; 3. Information that Healthchek services are provided at no additional cost to the member; and 4. An explanation Information that providers may request prior authorization for: a. Coverage for coverage of services that have limitations; and/or b. Services limitations and/or are not covered for members age 21 and older if the services are medically necessary EPSDT services. iii. Provide the above Healthchek information in 25.a.ii on the MCOPMCP's member website specified in 41.b. of this appendixAppendix. iv. Deliver Healthchek information as provided, or as approved, by ODM to the MCOP’s its members at the following intervals: 1. When the member is 9 months old; 2. When the member is 18 months old; 3. When the member is 30 months old; 4. January of each calendar yearyear to all members under the age of 21; and 25. In At the beginning of each school year in the month of July for members from age 18 4 to under 21. v. Use the mailing templates provided by ODM that will not to exceed two 8x11 pages for each mailing with most mailings being one page or less in length. The MCOP shall MCP must populate the materials with appropriate Healthchek information as required (e. g. type of service, rendering provider, date of service, service and age of member on the date of service). b. Informing members Members about Pregnancy Related Services (PRS), the MCOP shall: i. Upon the identification of a member as pregnant, the MCOP shall MCP must deliver to the member within 5 14 calendar days a PRS form as designated by ODM. ii. The MCOP MCP may be required to communicate with the member’s local CDJFS County Department of Job and Family Services agency any requests made by the member for county-County coordinated services and supports (e.g. social services). c. Informing providers about Healthchek, the MCOP shallMCP must: i. Provide Healthchek education to all contracted providers on an annual basis which shall must include, at a minimum, the following: 1. The required components of a Healthchek exam as specified in OAC rule 5160-1- 14-03 or 5160-01-14; 2. A list of the intervals at which individuals under age 21 should receive screening examinations, as indicated by the most recent version of the document “Recommendations for Preventive Pediatric Health Care” published by Bright Futures/American Academy of Pediatrics; 3. A statement that Healthchek includes a range of medically necessary screening, diagnostic, diagnosis and treatment services; and 4. A list of common billing codes and procedures related to the Healthchek services (e.g., immunizations, well child exams, laboratory tests, and screenings). ii. Provide the above information on the MCOPMCP’s provider website as specified in section 41.c. of this appendixAppendix. d. An MCOP shall MCP must maintain documentation to verify that it informed members and providers were informed of Healthchek and PRS Pregnancy Related Services as specified by ODM.