Marketing Requirements. The Contractor is required to submit to EOHHS for review and written approval all materials, in any media, and any other materials associated with marketing for open enrollment periods that will be distributed to members or potential members (referred to as member and marketing materials) before they are distributed. Plan materials developed or distributed by subcontractors or providers also require review and approval before being distributed. Member materials include, but are not limited to member handbooks, provider directories, member newsletters, identification cards, fact sheets, notices, brochures, form letters, mass mailings, system generated letters, newspaper, TV and radio advertisements, call scripts, surveys and other materials as identified by EOHHS. The Contractor agrees to submit marketing strategy and plans if requested. The Contractor is required to use RI EOHHS Model Member Handbook and Appeals/Grievances Notification Model Documents. Contractors are required to add Plan specific language to Model Documents. EOHHS requires the review of and prior approval of all materials related to or containing information that is intended to be used for education, outreach or marketing purposes for Plan enrollees or prospective enrollees. Plans are required to comply with the information requirements and marketing guidelines under 42 § C.F.R. 438.10 and 42 C.F.R. 438.104; RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program as set forth in the CMS Medicaid and CHIP Final Rule. The Contractor may conduct marketing campaigns for members subject to the restrictions noted in RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program, Rite Smiles, Non-Emergency Medical Transportation and Medicare-Medicaid Program (ad hoc materials). The Contractor agrees not to display or distribute marketing materials, nor solicit members in any other manner, within fifty (50) feet of eligibility and enrollment offices unless it has received permission to do so from EOHHS. The Contractor agrees to develop member materials that comply with 42 § C.F.R. 438.104 and RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program, Rite Smiles, Non-Emergency Medical Transportation and Medicare-Medicaid Program (ad hoc materials). Written material must use easily understood language and format and satisfy all the requirements provided for in 42 § C.F.R. 438.10 (c)(1). In accordance with 42 CFR 438.104(b)(2)(i), the Contractors may not communicate, either in writing or orally, any statements that enrollees must enroll in their Health/dental plan to obtain benefits or to not lose benefits. The Contractor may not communicate, either in writing or orally to enrollees that CMS, the Federal or State government or similar entity endorse the Contractor. All written material must be written at no higher than a sixth-grade level. Written material must be available, upon request, in alternative formats (e.g. audio and large print) and in an appropriate manner that takes into consideration the special needs of those who, for example, are visually limited or have limited reading proficiency. All written materials for members and potential enrollees must be written in a font no smaller than twelve (12) point and include a large print tagline and taglines in the prevalent non-English languages in the State which include: (1) Spanish, (2) Portuguese, (3) Chinese, (4) French Creole (Haitian Creole), (5) Mon-Khmer/Cambodian, (6) French, (7) Italian, (8) Laotian, (9) Arabic, (10) Russian, (11) Vietnamese, (12) Kru (Bassa), (13) Ibo, (14) Yoruba*, and (15) Polish. Taglines must be written in large print which is defined as conspicuously visible, that explains the availability of written translations or oral interpretation to understand the information provided and the toll-free telephone number of the entity providing choice counseling services as required by 42 § CFR 438.71(a). The Contractor must inform and make available interpretation services, including oral interpretations and auxiliary aids such as TTY/TDY and American Sign Language, to members and potential enrollees at no cost as required by 42 § C.F.R. 438.10(d)(4). Materials will be available in alternate languages for those members with limited or no English proficiency. The State will determine whether the Contractor’s marketing plans, procedures, and materials are accurate, and do not mislead, confuse, or defraud either recipients or the State, pursuant to 42 § C.F.R. 438.104. The Contractor, through members of its outreach staff and provider network, is encouraged to identify uninsured patients who may be Medicaid eligible and to make appropriate referrals to the appropriate contacts such as navigators, DHS and Healthsource RI to assist in determining eligibility for Medicaid programs.
Appears in 2 contracts
Samples: Medicaid Program Agreement, Medicaid Rite Smiles Program Agreement
Marketing Requirements. The Contractor is required to submit to EOHHS for review and written approval all materials, in any media, and any other materials associated with marketing for open enrollment periods that will be distributed to members or potential members (referred to as member and marketing materials) before they are distributed. Plan materials developed or distributed by subcontractors or providers also require review and approval before being distributed. Member materials include, but are not limited to member handbooks, provider directories, member newsletters, identification cards, fact sheets, notices, brochures, form letters, mass mailings, system generated letters, newspaper, TV and radio advertisements, call scripts, surveys and other materials as identified by EOHHS. The Contractor agrees to submit marketing strategy and plans if requested. The Contractor is required to use RI EOHHS Model Member Handbook and Appeals/Grievances Notification Model Documents. Contractors are required to add Plan specific language to Model Documents. EOHHS requires the review of and prior approval of all materials related to or containing information that is intended to be used for education, outreach or marketing purposes for Plan enrollees or prospective enrollees. Plans are required to comply with the information requirements and marketing guidelines under 42 § C.F.R. 438.10 and 42 C.F.R. 438.104; RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program as set forth in the CMS Medicaid and CHIP Final Rule. The Contractor may conduct marketing campaigns for members subject to the restrictions noted in RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program, Rite Smiles, Non-Emergency Medical Transportation and Medicare-Medicaid Program (ad hoc materials). The Contractor agrees not to display or distribute marketing materials, nor solicit members in any other manner, within fifty (50) feet of eligibility and enrollment offices unless it has received permission to do so from EOHHS. The Contractor agrees to develop member materials that comply with 42 § C.F.R. 438.104 and RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program, Rite Smiles, Non-Emergency Medical Transportation and Medicare-Medicaid Program (ad hoc materials). Written material must use easily understood language and format and satisfy all the requirements provided for in 42 § C.F.R. 438.10 (c)(1). In accordance with 42 CFR 438.104(b)(2)(i), the Contractors may not communicate, either in writing or orally, any statements that enrollees must enroll in their Health/dental plan to obtain benefits or to not lose benefits. The Contractor may not communicate, either in writing or orally to enrollees that CMS, the Federal or State government or similar entity endorse the Contractor. All written material must be written at no higher than a sixth-grade level. Written material must be available, upon request, in alternative formats (e.g. audio and large print) and in an appropriate manner that takes into consideration the special needs of those who, for example, are visually limited or have limited reading proficiency. All written materials for members and potential enrollees must be written in a font no smaller than twelve (12) point and include a large print tagline and taglines in the prevalent non-English languages in the State which include: (1) Spanish, (2) Portuguese, (3) Chinese, (4) French Creole (Haitian Creole), (5) Mon-Khmer/Cambodian, (6) French, (7) Italian, (8) Laotian, (9) Arabic, (10) Russian, (11) Vietnamese, (12) Kru (Bassa), (13) Ibo, (14) Yoruba*, and (15) Polish. Taglines must be written in large print which is defined as conspicuously visible, that explains the availability of written translations or oral interpretation to understand the information provided and the toll-free telephone number of the entity providing choice counseling services as required by 42 § CFR 438.71(a). The Contractor must inform and make available interpretation services, including oral interpretations and auxiliary aids such as TTY/TDY and American Sign Language, to members and potential enrollees at no cost as required by 42 § C.F.R. 438.10(d)(4). Materials will be available in alternate languages for those members with limited or no English proficiency. The State will determine whether the Contractor’s marketing plans, procedures, and materials are accurate, and do not mislead, confuse, or defraud either recipients or the State, pursuant to 42 § C.F.R. 438.104. The Contractor, through members of its outreach staff and provider network, is encouraged to identify uninsured patients who may be Medicaid eligible and to make appropriate referrals to the appropriate contacts such as navigators, DHS and Healthsource RI to assist in determining eligibility for Medicaid programs.fifty
Appears in 1 contract
Marketing Requirements. The Contractor is required to submit to EOHHS for review and written approval all materials, in any media, and any other materials associated with marketing for open enrollment periods that will be distributed to members or potential members (referred to as member and marketing materials) before they are distributed. Plan materials developed or distributed by subcontractors or providers also require review and approval before being distributed. Member materials include, but are not limited to member handbooks, provider directories, member newsletters, identification cards, fact sheets, notices, brochures, form letters, mass mailings, system generated letters, newspaper, TV and radio advertisements, call scripts, surveys and other materials as identified by EOHHS. The Contractor agrees to submit marketing strategy and plans if requested. The Contractor is required to use RI EOHHS Model Member Handbook and Appeals/Grievances Notification Model Documents. Contractors are required to add Plan specific language to Model Documents. EOHHS requires the review of and prior approval of all materials related to or containing information that is intended to be used for education, outreach or marketing purposes for Plan enrollees or prospective enrollees. Plans are required to comply with the information requirements and marketing guidelines under 42 § C.F.R. 438.10 and 42 C.F.R. 438.104; RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program as set forth in the CMS Medicaid and CHIP Final Rule. The Contractor may conduct marketing campaigns for members subject to the restrictions noted in RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program, Rite Smiles, Non-Emergency Medical Transportation and Medicare-Medicaid Program (ad hoc materials). The Contractor agrees not to display or distribute marketing materials, nor solicit members in any other manner, within fifty (50) feet of eligibility and enrollment offices unless it has received permission to do so from EOHHS. The Contractor agrees to develop member materials that comply with 42 § C.F.R. 438.104 and RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program, Rite Smiles, Non-Emergency Medical Transportation and Medicare-Medicaid Program (ad hoc materials). Written material must use easily understood language and format and satisfy all the requirements provided for in 42 § C.F.R. 438.10 (c)(1). In accordance with 42 CFR 438.104(b)(2)(i), the Contractors may not communicate, either in writing or orally, any statements that enrollees must enroll in their Health/dental plan to obtain benefits or to not lose benefits. The Contractor may not communicate, either in writing or orally to enrollees that CMS, the Federal or State government or similar entity endorse the Contractor. All written material must be written at no higher than a sixth-grade level. Written material must be available, upon request, in alternative formats (e.g. audio and large print) and in an appropriate manner that takes into consideration the special needs of those who, for example, are visually limited or have limited reading proficiency. All written materials for members and potential enrollees must be written in a font no smaller than twelve (12) point and include a large print tagline and taglines in the prevalent non-English languages in the State which include: (1) Spanish, (2) Portuguese, (3) Chinese, (4) French Creole (Haitian Creole), (5) Mon-Khmer/Cambodian, (6) French, (7) Italian, (8) Laotian, (9) Arabic, (10) Russian, (11) Vietnamese, (12) Kru (Bassa), (13) Ibo, (14) Yoruba*, and (15) Polish. Taglines must be written in large print which is defined as conspicuously visible, that explains the availability of written translations or oral interpretation to understand the information provided and the toll-free telephone number of the entity providing choice counseling services as required by 42 § CFR 438.71(a). The Contractor must inform and make available interpretation services, including oral interpretations and auxiliary aids such as TTY/TDY and American Sign Language, to members and potential enrollees at no cost as required by 42 § C.F.R. 438.10(d)(4). Materials will be available in alternate languages for those members with limited or no English proficiency. The State will determine whether the Contractor’s marketing plans, procedures, and materials are accurate, and do not mislead, confuse, or defraud either recipients or the State, pursuant to 42 § C.F.R. 438.104. The Contractor, through members of its outreach staff and provider network, is encouraged to identify uninsured patients who may be Medicaid eligible and to make appropriate referrals to the appropriate contacts such as navigators, DHS and Healthsource RI to assist in determining eligibility for Medicaid programs.. When engaged in marketing its programs or in marketing targeted to potential or current members, the Contractor: (1) will not distribute marketing materials to less than the entire service area; (2) will not distribute marketing materials without the approval of EOHHS
Appears in 1 contract
Marketing Requirements. The Contractor is required to submit to EOHHS for review and written approval all materials, in any media, and any other materials associated with marketing for open enrollment periods that will be distributed to members or potential members (referred to as member and marketing materials) before they are distributed. Plan materials developed or distributed by subcontractors or providers also require review and approval before being distributed. Member materials include, but are not limited to member handbooks, provider directories, member newsletters, identification cards, fact sheets, notices, brochures, form letters, mass mailings, system generated letters, newspaper, TV and radio advertisements, call scripts, surveys and other materials as identified by EOHHS. The Contractor agrees to submit marketing strategy and plans if requested. The Contractor is required to use RI EOHHS Model Member Handbook and Appeals/Grievances Notification Model Documents. Contractors are required to add Plan specific language to Model Documents. EOHHS requires the review of and prior approval of all materials related to or containing information that is intended to be used for education, outreach or marketing purposes for Plan enrollees or prospective enrollees. Plans are required to comply with the information requirements and marketing guidelines under 42 § C.F.R. 42CFR 438.10 and 42 C.F.R. 438.104; RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program as set forth in the CMS Medicaid and CHIP Final Rule. The Contractor may conduct marketing campaigns for members subject to the restrictions noted in RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program, Rite Smiles, Non-Emergency Medical Transportation and Medicare-Medicaid Program (ad hoc materials). The Contractor agrees not to display or distribute marketing materials, nor solicit members in any other manner, within fifty (50) feet of eligibility and enrollment offices unless it has received permission to do so from EOHHS. The Contractor agrees to develop member materials that comply with 42 § C.F.R. 438.104 and RI EOHHS Guidelines for Marketing and Member Communications for Medicaid Managed Care Program, Rite Smiles, Non-Emergency Medical Transportation and Medicare-Medicaid Program (ad hoc materials). Written material must use easily understood language and format and satisfy all the requirements provided for in 42 § C.F.R. 438.10 (c)(1). In accordance with 42 CFR 438.104(b)(2)(i), the Contractors may not communicate, either in writing or orally, any statements that enrollees must enroll in their Health/dental plan to obtain benefits or to not lose benefits. The Contractor may not communicate, either in writing or orally to enrollees that CMS, the Federal or State government or similar entity endorse the Contractor. All written material must be written at no higher than a sixth-grade level. Written material must be available, upon request, in alternative formats (e.g. audio and large print) and in an appropriate manner that takes into consideration the special needs of those who, for example, are visually limited or have limited reading proficiency. All written materials for members and potential enrollees must be written in a font no smaller than twelve (12) point and include a large print tagline and taglines in the prevalent non-English languages in the State which include: (1) Spanish, (2) Portuguese, (3) Chinese, (4) French Creole (Haitian Creole), (5) Mon-Khmer/Cambodian, (6) French, (7) Italian, (8) Laotian, (9) Arabic, (10) Russian, (11) Vietnamese, (12) Kru (Bassa), (13) Ibo, (14) Yoruba*, and (15) Polish. Taglines must be written in large print which is defined as conspicuously visible, that explains the availability of written translations or oral interpretation to understand the information provided and the toll-free telephone number of the entity providing choice counseling services as required by 42 § CFR 438.71(a). The Contractor must inform and make available interpretation services, including oral interpretations and auxiliary aids such as TTY/TDY and American Sign Language, to members and potential enrollees at no cost as required by 42 § C.F.R. 438.10(d)(4). Materials will be available in alternate languages for those members with limited or no English proficiency. The State will determine whether the Contractor’s marketing plans, procedures, and materials are accurate, and do not mislead, confuse, or defraud either recipients or the State, pursuant to 42 § C.F.R. 438.104. The Contractor, through members of its outreach staff and provider network, is encouraged to identify uninsured patients who may be Medicaid eligible and to make appropriate referrals to the appropriate contacts such as navigators, DHS and Healthsource RI to assist in determining eligibility for Medicaid programs.fifty
Appears in 1 contract
Samples: Medicaid Agreement
