Common use of Information Required for MCOP Websites Clause in Contracts

Information Required for MCOP Websites. a. On-line Provider Directory. The MCOP shall have an internet-based provider directory in the same format as its ODM-approved provider directory, that allows members to electronically search for the MCOP panel providers based on name, provider type, and geographic proximity (as specified in Appendix H and the Three-Way Contract). MCOP provider directories shall include all MCOP-contracted providers (except as specified by ODM) as well as all federally qualified health centers, rural health centers, qualified family planning providers, and free- standing birth centers (FBCs) as defined in OAC 5160-18-01 located in the MCOP’s service regions. If the MCOP does not have contracted certified nurse midwives (CNMs) or certified nurse practitioners (CNPs) in a service region, then the MCOP shall specify that CNM and CNP services are available and members can contact the MCOP for information on accessing those services. The provider directory shall be the same for both Medicaid-only and dual eligible members. b. On-line Member Website. The MCOP shall have a secure internet-based website which provides members the ability to submit questions, comments, grievances, and appeals, and receive a response. Members shall be given the option of a response by return email or phone call. The MCOP’s responses to questions or comments shall be made within one business day of receipt. The MCOP’s responses to grievances and appeals shall adhere to the timeframes specified in OAC rule 5160-58-08. 4. The member website shall be regularly updated to include the most current ODM-approved materials, although this website shall not be the only means for notifying members of new and/or revised MCOP information (e.g., change in holiday closures, changes in additional benefits, and revisions to approved member materials). The MCOP shall make a copy of its Authorized Representative request form available to members through its online member portal located on the MCOP’s website.

Information Required for MCOP Websites. a. On-line Provider Directory. The MCOP shall have an internet-based provider directory in the same format as its ODM-approved provider directory, that allows members to electronically search for the MCOP panel providers based on name, provider type, and geographic proximity (as specified in Appendix H and the Three-Way Contract). MCOP provider directories shall include all MCOP-contracted providers (except as specified by ODM) as well as all federally qualified health centers, rural health centers, qualified family planning providers, and free- standing birth centers (FBCs) as defined in OAC 5160-18-01 located in the MCOP’s service regions. If the MCOP does not have contracted certified nurse midwives (CNMs) or certified nurse practitioners (CNPs) in a service region, then the MCOP shall specify that CNM and CNP services are available and members can contact the MCOP for information on accessing those services. The provider directory shall be the same for both Medicaid-only and dual eligible members. b. On-line Member Website. The MCOP shall have a secure internet-based website which provides members the ability to submit questions, comments, grievances, and appeals, and receive a response. Members shall be given the option of a response by return email or phone call. The MCOP’s responses to questions or comments shall be made within one business day of receipt. The MCOP’s responses to grievances and appeals shall adhere to the timeframes specified in OAC rule 5160-58-08. 4. The member website shall be regularly updated to include the most current ODM-approved materials, although this website shall not be the only means for notifying members of new and/or revised MCOP information (e.g., change in holiday closures, changes in additional benefits, and revisions to approved member materials). The MCOP shall make a copy of its Authorized Representative request form available to members through its online member portal located on the MCOP’s website.

Information Required for MCOP Websites. a. On-line Provider Directory. Directory – The MCOP shall must have an internet-based provider directory in the same format as its ODM-approved provider directory, that allows members to electronically search for the MCOP panel providers based on name, provider type, type and geographic proximity (as specified in Appendix H and the Three-Three- Way Contract). MCOP provider directories shall must include all MCOP-contracted providers (except as specified by ODM) as well as all federally qualified health centers, rural health centers, qualified family planning providers, and free- free-standing birth centers (FBCs) as defined in OAC 5160-18-01 located in the MCOP’s service regions. If the an MCOP does not have contracted certified nurse midwives ([CNMs) ] or certified nurse practitioners ([CNPs) ] in a service region, then the MCOP shall must specify that CNM and CNP services are available and that members can contact the MCOP for information on accessing those services. The provider directory shall must be the same for both Medicaid-only and dual eligible members. b. On-line Member Website. Website – The MCOP shall must have a secure internet-based website which provides members the ability to submit questions, comments, grievances, and appeals, and receive a response. Members shall must be given the option of a response by return email e-mail or phone call. The MCOP’s responses to questions or comments shall must be made within one business working day of receipt. The MCOP’s responses to grievances and appeals shall must adhere to the timeframes specified in OAC rule 5160-58-08. 408.4. The member website shall must be regularly updated to include the most current ODM-ODM- approved materials, although this website shall must not be the only means for notifying members of new and/or revised MCOP information (e.g., change in holiday closures, changes in additional benefits, and revisions to approved member materials). The MCOP shall must make a copy of its Authorized Representative request form available to members through its online member portal located on the MCOP’s website. The MCOP member website must also include, at a minimum, the following information which must be accessible to members and the general public without any log-in restriction: (1) MCOP contact information, including the MCOP’s toll-free member services phone number, service hours, and closure dates; (2) a listing of the counties the MCOP serves unless the MCOP serves the entire state in which case the MCOP may indicate it services the entire states; (3) the ODM-approved MCOP member handbook, recent newsletters and announcements; (4) the MCOP’s on-line provider directory as referenced in section 49.a. of this Appendix; (5) a list of services requiring prior authorization (PA); (6) the MCOP’s preferred drug list (PDL), including an explanation of the list and identification of any preferred drugs that require PA, the MCOP’s list of drugs that require PA, including an explanation of the list, identification of first line drugs for drugs that require PA for step therapy, how to initiate a PA, and the MCOP’s policy for coverage of generic versus brand name drugs : (7) the toll-free telephone numbers for the 24/7 medical advice, behavioral health crisis and care management support services call-in systems specified in section 28 of this Appendix; and (8) contact information to schedule non- emergency transportation assistance, including an explanation of the available services and to contact member services for transportation services complaints. The toll-free member services, 24/7 call-in systems and transportation scheduling telephone numbers must be easily identified on either the MCOP’s website home page or a page that is direct link from a contact button on the home page. ODM may require the MCOP to include additional information on the member website as needed. Provide all Healthchek information as specified in 26.a.i. of this Appendix.

Information Required for MCOP Websites. a. On-line Provider Directory. The MCOP shall have an internet-based provider directory in the same format as its ODM-approved provider directory, that allows members to electronically search for the MCOP panel providers based on name, provider type, and geographic proximity (as specified in Appendix H and the Three-Way Contract). MCOP provider directories shall include all MCOP-contracted providers (except as specified by ODM) as well as all federally qualified health centers, rural health centers, qualified family planning providers, and free- standing birth centers (FBCs) as defined in OAC 5160-18-01 located in the MCOP’s service regions. If the MCOP does not have contracted certified nurse midwives (CNMs) or certified nurse practitioners (CNPs) in a service region, then the MCOP shall specify that CNM and CNP services are available and members can contact the MCOP for information on accessing those services. The provider directory shall be the same for both Medicaid-only and dual eligible members. b. On-line Member Website. The MCOP shall have a secure internet-based website which provides members the ability to submit questions, comments, grievances, and appeals, and receive a response. Members shall be given the option of a response by return email e-mail or phone call. The MCOP’s responses to questions or comments shall be made within one business day of receipt. The MCOP’s responses to grievances and appeals shall adhere to the timeframes specified in OAC rule 5160-58-08. 4. The member website shall be regularly updated to include the most current ODM-approved materials, although this website shall not be the only means for notifying members of new and/or revised MCOP information (e.g., change in holiday closures, changes in additional benefits, and revisions to approved member materials). The MCOP shall make a copy of its Authorized Representative request form available to members through its online member portal located on the MCOP’s website.

Information Required for MCOP Websites. a. On-line Provider Directory. The MCOP’s website must have a link to ODM’s provider directory and provider network management (PNM) system. The MCOP shall have an internet-based provider directory in the same format as its ODM-approved provider directory, that allows members to electronically search for the MCOP panel providers based on name, provider type, and geographic proximity (as specified in Appendix H and the Three-Way Contract). MCOP provider directories shall include all MCOP-contracted providers (except as specified by ODM) as well as all federally qualified health centers, rural health centers, qualified family planning providers, and free- free-standing birth centers (FBCs) as defined in OAC 5160-18-01 located in the MCOP’s service regions. If the MCOP does not have contracted certified nurse midwives (CNMs) or certified nurse practitioners (CNPs) in a service region, then the MCOP shall specify that CNM and CNP services are available and members can contact the MCOP for information on accessing those services. The provider directory shall be the same for both Medicaid-only and dual eligible members. b. On-line Member Website. The MCOP shall have a secure internet-based website which provides members the ability to submit questions, comments, grievances, and appeals, and receive a response. Members shall be given the option of a response by return email or phone call. The MCOP’s responses to questions or comments shall be made within one business day of receipt. The MCOP’s responses to grievances and appeals shall adhere to the timeframes specified in OAC rule 5160-58-08.The 4. The member website shall be regularly updated to include the most current ODM-approved materials, although this website shall not be the only means for notifying members of new and/or revised MCOP information (e.g., change in holiday closures, changes in additional benefits, and revisions to approved member materials). The MCOP shall make a copy of its Authorized Representative request form available to members through its online member portal located on the MCOP’s website.