Maintenance and Distribution Sample Clauses

Maintenance and Distribution. The Contractor must: a. Maintain a combined Provider/Pharmacy Network directory that uses the model document developed by CMS and MassHealth; b. Provide either a copy or a separate notice on how to access the information online and how to request a hard copy, as specified in the Medicare Marketing Guidelines and the Medicare-Medicaid marketing guidance, to all new enrollees at the time of enrollment and annually thereafter; c. When there is a significant change to the network, the Contractor must send a special mailing, as specified in the Medicare Marketing Guidelines and the Medicare-Medicaid marketing guidance; d. Ensure an up-to-date copy is available on the Contractor’s website, consistent with the requirements at 42 C.F.R. § 422.111(h) and 42 C.F.R. § 423.128(d); Consistent with 42 C.F.R. § 422.111(e), make a good faith effort to provide written notice of termination of a contracted provider or pharmacy at least thirty calendar days before the termination effective date to all members who regularly use the provider or pharmacy’s services; if a contract termination involves a primary care professional, all members who are patients of that primary care professional must be notified; and

Maintenance and Distribution. The STAR+PLUS MMP’s Provider and Pharmacy Directory must; 439 2.15.5.1.1. Be approved by HHSC and/or CMS prior to publication and distribution, with the exception of PCP information changes or clerical corrections. The STAR+PLUS MMP is responsible for submitted draft Provider Directory updates to HHSC and/or CMS for prior review and approval. 439 2.15.5.1.2. Maintain a combined Provider and Pharmacy Network Directory that uses the model document developed by CMS and HHSC; 439 2.15.5.1.3. Provide either a print copy or a distinct and separate notice about how to access this information online or request a hard copy, as specified in Marketing Guidance for Texas Medicare-Medicaid Plans, to all new Enrollees at the time of Enrollment and annually thereafter; 439 2.15.5.1.4. When there is a significant change to the Network, the STAR+PLUS MMP must provide notice to impacted Enrollees, as specified in Chapter 4 of the Medicare Managed Care Manual; 440 2.15.5.1.5. Ensure an up-to-date version is available on the STAR+PLUS MMP’s website, consistent with the requirements at 42 C.F.R. §§ 422.111(h) and 423.128(d) and the Marketing Guidance for Texas Medicare-Medicaid Plans; 440 2.15.5.1.6. Provide written notice of termination of a contracted Provider or pharmacy consistent with the requirements under Section 2.7.5.4 of this Contract; 440 2.15.5.1.7. Include written and oral offers of such Provider and Pharmacy Directory in its outreach and orientation sessions for new Enrollees as well as at least annually for current Enrollees; and 440 2.15.5.1.8. Be updated aa frequently as indicated in the Marketing Guidance for Texas Medicare-Medicaid Plans. The STAR+PLUS MMP must make such updates available to existing Enrollees upon request. 440

Maintenance and Distribution. The Contractor must: a. Maintain a Provider Network directory that identifies the Contractor’s Provider Network, including at a minimum PCPs, behavioral health Providers, hospitals, specialty physicians, pharmacies, and ASAPs; b. Provide a copy to all new Enrollees and, upon request, to continuing Enrollees; and c. On an annual basis, provide Enrollees, CMS, and EOHHS with an updated copy of the Provider Network directory, or notice that the Provider Network directory has been updated and is available on the Contractor’s web site.