Common use of Member Information, Outreach and Education Clause in Contracts

Member Information, Outreach and Education. The Contractor shall provide the information listed under this section within a reasonable timeframe, following the notification from the State fiscal agent of the member’s enrollment in the Contractor. This information shall be included in the member handbook. The Contractor shall notify all members of their right to request and obtain information in accordance with 42 CFR 438.10. In addition to providing the specific information required at 42 CFR 438.10(f) upon enrollment in the Welcome Packet as described in Section 4.2.1, the Contractor shall notify members at least once a year of their right to request and obtain this information. Written notice shall be given to each member of any significant change in this information at least thirty (30) days before the intended effective date of the change. Significant change is defined as any change that may impact member accessibility to the Contractor’s services and benefits. The Contractor shall make written information available in English and Spanish and other prevalent non-English languages identified by OMPP, upon OMPP’s or the member’s request. At the time of enrollment with the Contractor, the State shall provide the primary language of each member. The Contractor shall utilize this information to ensure communication materials are distributed in the appropriate language. In addition, the Contractor shall identify additional languages that are prevalent among the Contractor’s membership. For purposes of this requirement, prevalent language is defined as any language spoken by at least three percent (3%) of the general population in the Contractor’s service area. Written information shall be provided in any such prevalent languages identified by the Contractor. Per Section 1557 of the Affordable Care Act / 45 CFR 92.1, Contractor shall ensure that for significant publications and communications taglines (short statements written in non-English languages to alert individuals with limited English proficiency to the availability of language assistance services, free of charge, and how the services can be obtained) must be included in the State’s top 15 languages spoken by limited English proficient populations, and for small-size significant publications and significant communications a tagline must be included in the State’s top two languages spoken by limited English proficient populations. The Contractor shall inform members that information is available upon request in alternative formats and how to obtain them. OMPP defines alternative formats as Braille, large font letters, audiotape, prevalent languages and verbal explanation of written materials. To the extent possible, written materials shall not exceed a fifth grade reading level. The Contractor shall provide notification to OMPP, to the Enrollment Broker and to its members of any covered services that the Contractor or any of its sub-contractors or networks do not cover on the basis of moral or religious grounds and guidelines for how and where to obtain those services, in accordance with 42 CFR 438.102, which relates to provider-enrollee communications. This information shall be relayed to the member before and during enrollment and within ninety (90) calendar days after adopting the policy with respect to any particular service. Refer to Section 6.3.3 for additional information. The Contractor shall inform the members that, upon the member’s request, the Contractor will provide information on the structure and operation of the Contractor and, in accordance with 42 CFR 438.10(f)(3), will provide information on the Contractor’s provider incentive plans. Grievance, appeal and fair hearing procedures and timeframes shall be provided to members in accordance with 42 CFR 438.10(g)(2)(xi), which requires specific information be provided to enrollees. Please see Section 4.9 for further information about grievance, appeal and fair hearing procedures, as well as the kind of information that the Contractor shall provide to members. The Contractor shall be responsible for developing and maintaining member education programs designed to provide the members with clear, concise and accurate information about the Contractor’s program, the Contractor’s network and the Hoosier Healthwise program. The State encourages the Contractor to incorporate community advocates, support agencies, health departments, other governmental agencies and public health associations in its outreach and member education programs. The State encourages the Contractor to develop community partnerships with these types of organizations, in particular with school based health centers, community mental health centers, WIC clinics, county health departments and prenatal clinics to promote health and wellness within its membership. The Contractor shall develop communication strategies that meet the requirements of this section, and provide innovative approaches to ensure member understanding of the Hoosier Healthwise program. The Contactor shall, at minimum, provide program information to the member through required notices and other communications prescribed by the State. The Contractor's educational activities and services shall also address the special needs of specific Hoosier Healthwise subpopulations (e.g., pregnant women, newborns, early childhood, at-risk members, children with special needs) as well as its general membership. The Contractor shall demonstrate how these educational interventions reduce barriers to health care and improve health outcomes for members. The Contractor shall have in place policies and procedures to ensure that materials are accurate in content, accurate in translation relevant to language or alternate formats and do not defraud, mislead or confuse the member. The Contractor shall provide information requested by the State, or the State’s designee, for use in member education and enrollment, upon request.

Member Information, Outreach and Education. The Contractor shall provide the information listed under this section within a reasonable timeframe, following the notification from the State fiscal agent of the member’s enrollment in the Contractor. This information shall be included in the member handbook. The Contractor shall notify all members of their right to request and obtain information in accordance with 42 CFR 438.10. In addition to providing the specific information required at 42 CFR 438.10(f) upon enrollment in the Welcome Packet as described in Section 4.2.1, the Contractor shall notify members at least once a year of their right to request and obtain this information. Written notice shall be given to each member of any significant change in this information at least thirty (30) days before the intended effective date of the change. Significant change is defined as any change that may impact member accessibility to the Contractor’s services and benefits. The Contractor shall make written information available in English and Spanish and other prevalent non-English languages identified by OMPP, upon OMPP’s or the member’s request. At the time of enrollment with the Contractor, the State shall provide the primary language of each member. The Contractor shall utilize this information to ensure communication materials are distributed in the appropriate language. In addition, the Contractor shall identify additional languages that are prevalent among the Contractor’s membership. For purposes of this requirement, prevalent language is defined as any language spoken by at least three percent (3%) of the general population in the Contractor’s service area. Written information shall be provided in any such prevalent languages identified by the Contractor. Per Section 1557 of the Affordable Care Act / 45 CFR 92.1, Contractor shall ensure that for significant publications and communications taglines (short statements written in non-English languages to alert individuals with limited English proficiency to the availability of language assistance services, free of charge, and how the services can be obtained) must be included in the State’s top 15 languages spoken by limited English proficient populations, and for small-size significant publications and significant communications a tagline must be included in the State’s top two languages spoken by limited English proficient populations. To the extent possible, written materials shall not exceed a fifth grade reading level. The Contractor shall inform members that information is available upon request in alternative formats and how to obtain them. OMPP defines alternative formats as Braillebraille, large font letters, audiotape, prevalent languages and verbal explanation of written materials. To the extent possibleAs of May 1, written materials shall not exceed a fifth grade reading level. The Contractor shall provide notification to OMPP, to the Enrollment Broker and to its members of any covered services that the Contractor or any of its sub-contractors or networks do not cover on the basis of moral or religious grounds and guidelines for how and where to obtain those services, in accordance with 42 CFR 438.102, which relates to provider-enrollee communications. This information shall be relayed to the member before and during enrollment and within ninety (90) calendar days after adopting the policy with respect to any particular service. Refer to Section 6.3.3 for additional information. The Contractor shall inform the members that, upon the member’s request2020, the Contractor will provide information on the structure and operation of the Contractor andshall offer braille as an alternative format for receiving member materials. When a member has requested materials in braille, in accordance with 42 CFR 438.10(f)(3), will provide information on the Contractor’s provider incentive plans. Grievance, appeal and fair hearing procedures and timeframes shall be provided to members in accordance with 42 CFR 438.10(g)(2)(xi), which requires specific information be provided to enrollees. Please see Section 4.9 for further information about grievance, appeal and fair hearing procedures, as well as the kind of information that the Contractor shall provide supply future materials in braille to members. The Contractor shall be responsible for developing and maintaining member education programs designed to provide the members with clear, concise and accurate information about the Contractor’s program, the Contractor’s network and the Hoosier Healthwise program. The State encourages the Contractor to incorporate community advocates, support agencies, health departments, other governmental agencies and public health associations in its outreach and member education programs. The State encourages the Contractor to develop community partnerships with these types of organizations, in particular with school based health centers, community mental health centers, WIC clinics, county health departments and prenatal clinics to promote health and wellness within its membership. The Contractor shall develop communication strategies that meet the requirements of this section, and provide innovative approaches to ensure member understanding of the Hoosier Healthwise program. The Contactor shall, at minimum, provide program information to the member through required notices and other communications prescribed by the State. The Contractor's educational activities and services shall also address the special needs of specific Hoosier Healthwise subpopulations (e.g., pregnant women, newborns, early childhood, at-risk members, children with special needs) as well as its general membership. The Contractor shall demonstrate how these educational interventions reduce barriers to health care and improve health outcomes for members. The Contractor shall have in place policies and procedures to ensure that materials are accurate in content, accurate in translation relevant to language or alternate formats and do not defraud, mislead or confuse the member. The Contractor shall provide information requested by may review with the State, or member the State’s designee, for use specific document types the member wishes to receive in member education and enrollment, upon requestbraille versus other formats. The Contractor may outreach to members to inquire if braille documents are still the desired format.

Member Information, Outreach and Education. The Contractor shall provide the information listed under this section within a reasonable timeframe, following the notification from the State fiscal agent of the member’s enrollment in the Contractor. This information shall be included in the member handbook. The Contractor shall notify all members of their right to request and obtain information in accordance with 42 CFR 438.10. In addition to providing the specific information required at 42 CFR 438.10(f) upon enrollment in the Welcome Packet as described in Section 4.2.1, the Contractor shall notify members at least once a year of their right to request and obtain this information. Written notice shall be given to each member of any significant change in this information at least thirty (30) days before the intended effective date of the change. Significant change is defined as any change that may impact member accessibility to the Contractor’s services and benefits. The Contractor shall make written information available in English and Spanish and other prevalent non-English languages identified by OMPP, upon OMPP’s or the member’s request. At the time of enrollment with the Contractor, the State shall provide the primary language of each member. The Contractor shall utilize this information to ensure communication materials are distributed in the appropriate language. In addition, the Contractor shall identify additional languages that are prevalent among the Contractor’s membership. For purposes of this requirement, prevalent language is defined as any language spoken by at least three percent (3%) of the general population in the Contractor’s service area. Written information shall be provided in any such prevalent languages identified by the Contractor. Per Section 1557 of the Affordable Care Act / 45 CFR 92.1, Contractor shall ensure that for significant publications and communications taglines (short statements written in non-English languages to alert individuals with limited English proficiency to the availability of language assistance services, free of charge, and how the services can be obtained) must be included in the State’s top 15 languages spoken by limited English proficient populations, and for small-size significant publications and significant communications a tagline must be included in the State’s top two languages spoken by limited English proficient populations. The Contractor shall inform members that information is available upon request in alternative formats and how to obtain them. OMPP defines alternative formats as Braillebraille, large font letters, audiotape, prevalent languages and verbal explanation of written materials. As of May 1, 2020, the Contractor shall offer braille as an alternative format for receiving member materials. When a member has requested materials in braille, the Contractor shall supply future materials in braille to the member. The Contractor may review with the member the specific documents types the member wishes to receive in braille versus other formats. The Contractor may outreach to members to inquire if braille documents are still the desired format. To the extent possible, written materials shall not exceed a fifth grade reading level. The Contractor shall provide notification to OMPP, to the Enrollment Broker and to its members of any covered services that the Contractor or any of its sub-contractors or networks do not cover on the basis of moral or religious grounds and guidelines for how and where to obtain those services, in accordance with 42 CFR 438.102, which relates to provider-enrollee communications. This information shall be relayed to the member before and during enrollment and within ninety (90) calendar days after adopting the policy with respect to any particular service. Refer to Section 6.3.3 for additional information. The Contractor shall inform the members that, upon the member’s request, the Contractor will provide information on the structure and operation of the Contractor and, in accordance with 42 CFR 438.10(f)(3), will provide information on the Contractor’s provider incentive plans. Grievance, appeal and fair hearing procedures and timeframes shall be provided to members in accordance with 42 CFR 438.10(g)(2)(xi), which requires specific information be provided to enrollees. Please see Section 4.9 for further information about grievance, appeal and fair hearing procedures, as well as the kind of information that the Contractor shall provide to members. The Contractor shall be responsible for developing and maintaining member education programs designed to provide the members with clear, concise and accurate information about the Contractor’s program, the Contractor’s network and the Hoosier Healthwise program. The State encourages the Contractor to incorporate community advocates, support agencies, health departments, other governmental agencies and public health associations in its outreach and member education programs. The State encourages the Contractor to develop community partnerships with these types of organizations, in particular with school based health centers, community mental health centers, WIC clinics, county health departments and prenatal clinics to promote health and wellness within its membership. The Contractor shall develop communication strategies that meet the requirements of this section, and provide innovative approaches to ensure member understanding of the Hoosier Healthwise program. The Contactor shall, at minimum, provide program information to the member through required notices and other communications prescribed by the State. The Contractor's educational activities and services shall also address the special needs of specific Hoosier Healthwise subpopulations (e.g., pregnant women, newborns, early childhood, at-risk members, children with special needs) as well as its general membership. The Contractor shall demonstrate how these educational interventions reduce barriers to health care and improve health outcomes for members. The Contractor shall have in place policies and procedures to ensure that materials are accurate in content, accurate in translation relevant to language or alternate formats and do not defraud, mislead or confuse the member. The Contractor shall provide information requested by the State, or the State’s designee, for use in member education and enrollment, upon request.

Member Information, Outreach and Education. ‌ The Contractor shall provide the information listed under this section within a reasonable timeframe, following the notification from the State fiscal agent of the member’s enrollment in the Contractor. This information shall be included in the member handbook. The Contractor shall notify all members of their right to request and obtain information in accordance with 42 CFR 438.10. In addition to providing the specific information required at 42 CFR 438.10(f) upon enrollment in the Welcome Packet as described in Section 4.2.1, the Contractor shall notify members at least once a year of their right to request and obtain this information. Written notice shall be given to each member of any significant change in this information at least thirty (30) days before the intended effective date of the change. Significant change is defined as any change that may impact member accessibility to the Contractor’s services and benefits. The Contractor shall make written information available in English and Spanish and other prevalent non-English languages identified by OMPP, upon OMPP’s or the member’s request. At the time of enrollment with the Contractor, the State shall provide the primary language of each member. The Contractor shall utilize this information to ensure communication materials are distributed in the appropriate language. In addition, the Contractor shall identify additional languages that are prevalent among the Contractor’s membership. For purposes of this requirement, prevalent language is defined as any language spoken by at least three percent (3%) of the general population in the Contractor’s service area. Written information shall be provided in any such prevalent languages identified by the Contractor. Per Section 1557 of the Affordable Care Act / 45 CFR 92.1, Contractor shall ensure that for significant publications and communications taglines (short statements written in non-English languages to alert individuals with limited English proficiency to the availability of language assistance services, free of charge, and how the services can be obtained) must be included in the State’s top 15 languages spoken by limited English proficient populations, and for small-size significant publications and significant communications a tagline must be included in the State’s top two languages spoken by limited English proficient populations. The Contractor shall inform members that information is available upon request in alternative formats and how to obtain them. OMPP defines alternative formats as Braille, large font letters, audiotape, prevalent languages and verbal explanation of written materials. To the extent possible, written materials shall not exceed a fifth grade reading level. The Contractor shall provide notification to OMPP, to the Enrollment Broker and to its members of any covered services that the Contractor or any of its sub-contractors or networks do not cover on the basis of moral or religious grounds and guidelines for how and where to obtain those services, in accordance with 42 CFR 438.102, which relates to provider-enrollee communications. This information shall be relayed to the member before and during enrollment and within ninety (90) calendar days after adopting the policy with respect to any particular service. Refer to Section 6.3.3 for additional information. The Contractor shall inform the members that, upon the member’s request, the Contractor will provide information on the structure and operation of the Contractor and, in accordance with 42 CFR 438.10(f)(3), will provide information on the Contractor’s provider incentive plans. Grievance, appeal and fair hearing procedures and timeframes shall be provided to members in accordance with 42 CFR 438.10(g)(2)(xi), which requires specific information be provided to enrollees. Please see Section 4.9 for further information about grievance, appeal and fair hearing procedures, as well as the kind of information that the Contractor shall provide to members. The Contractor shall be responsible for developing and maintaining member education programs designed to provide the members with clear, concise and accurate information about the Contractor’s program, the Contractor’s network and the Hoosier Healthwise program. The State encourages the Contractor to incorporate community advocates, support agencies, health departments, other governmental agencies and public health associations in its outreach and member education programs. The State encourages the Contractor to develop community partnerships with these types of organizations, in particular with school based health centers, community mental health centers, WIC clinics, county health departments and prenatal clinics to promote health and wellness within its membership. The Contractor shall develop communication strategies that meet the requirements of this section, and provide innovative approaches to ensure member understanding of the Hoosier Healthwise program. The Contactor shall, at minimum, provide program information to the member through required notices and other communications prescribed by the State. The Contractor's educational activities and services shall also address the special needs of specific Hoosier Healthwise subpopulations (e.g., pregnant women, newborns, early childhood, at-risk members, children with special needs) as well as its general membership. The Contractor shall demonstrate how these educational interventions reduce barriers to health care and improve health outcomes for members. The Contractor shall have in place policies and procedures to ensure that materials are accurate in content, accurate in translation relevant to language or alternate formats and do not defraud, mislead or confuse the member. The Contractor shall provide information requested by the State, or the State’s designee, for use in member education and enrollment, upon request.

Member Information, Outreach and Education. The Contractor shall provide the information listed under this section within a reasonable timeframe, following the notification from the State fiscal agent of the member’s enrollment in the Contractor. This information shall be included in the member handbook. All correspondence between the Contractor and either pending HIP applicants or conditionally eligible HIP members shall provide notice that the individual has the right to select another MCE before the first payment is made or enrollment is otherwise finalized in accordance with Section 4.6. The notice shall be prominently displayed on the first page and include contact information for the Enrollment Broker available to assist with MCE selection and transfer. The Contractor shall notify all members of their right to request and obtain information in accordance with 42 CFR 438.10. In addition to providing the specific information required at 42 CFR 438.10(f) upon enrollment in the Welcome Packet as described in Section 4.2.17.2.1, the Contractor shall notify members at least once a year of their right to request and obtain this information. Written notice shall be given to each member of any significant change in this information at least thirty (30) days before the intended effective date of the change. Significant change is defined as any change that may impact member accessibility to the Contractor’s services and benefits. The Contractor shall make written information available in English and Spanish and other prevalent non-English languages identified by OMPP, upon OMPP’s or the member’s request. At the time of enrollment with the Contractor, the State shall provide the primary language of each member. The Contractor shall utilize this information to ensure communication materials are distributed in the appropriate language. In addition, the Contractor shall identify additional languages that are prevalent among the Contractor’s membership. For purposes of this requirement, prevalent language is defined as any language spoken by at least three percent (3%) of the general population in the Contractor’s service area. Written information shall be provided in any such prevalent languages identified by the Contractor. Per Section 1557 of the Affordable Care Act / 45 CFR 92.1, Contractor shall ensure that for significant publications and communications taglines (short statements written in non-English languages to alert individuals with limited English proficiency to the availability of language assistance services, free of charge, and how the services can be obtained) must be included in the State’s top 15 languages spoken by limited English proficient populations, and for small-size significant publications and significant communications a tagline must be included in the State’s top two languages spoken by limited English proficient populations. The Contractor shall inform members that information is available upon request in alternative formats and how to obtain them. OMPP defines alternative formats as Braille, large font letters, audiotape, prevalent languages and verbal explanation of written materials. To the extent possible, written materials shall not exceed a fifth grade reading level. The Contractor shall provide notification to OMPP, to the Enrollment Broker and to its members of any covered services that the Contractor or any of its sub-contractors or networks do not cover on the basis of moral or religious grounds and guidelines for how and where to obtain those services, in accordance with 42 CFR 438.102, which relates to provider-enrollee communications. This information shall be relayed to the member before and during enrollment and within ninety (90) calendar days after adopting the policy with respect to any particular service. Refer to Section 6.3.3 9.3.3 for additional information. The Contractor shall inform the members that, upon the member’s request, the Contractor will provide information on the structure and operation of the Contractor and, in accordance with 42 CFR 438.10(f)(3), will provide information on the Contractor’s provider incentive plans. Grievance, appeal and fair hearing procedures and timeframes shall be provided to members in accordance with 42 CFR 438.10(g)(2)(xi), which requires specific information be provided to enrollees. Please see Section 4.9 7.9 for further information about grievance, appeal and fair hearing procedures, as well as the kind of information that the Contractor shall provide to members. The Contractor shall be responsible for developing and maintaining member education programs designed to provide the members with clear, concise and accurate information about the Contractor’s program, the Contractor’s network and the Hoosier Healthwise HIP program. The State encourages the Contractor to incorporate community advocates, support agencies, health departments, other governmental agencies and public health associations in its outreach and member education programs. The State encourages the Contractor to develop community partnerships with these types of organizations, in particular with school based health centers, community mental health centers, WIC clinics, county health departments and prenatal clinics to promote health and wellness within its membership. The Contractor shall develop communication strategies that meet the requirements of this section, and provide innovative approaches to ensure member understanding of the Hoosier Healthwise HIP program. The Contactor shall, at minimum, provide program information to the member through required notices and other communications prescribed by the State. The Contractor's educational activities and services shall also address the special needs of specific Hoosier Healthwise HIP subpopulations (e.g., medically frail, pregnant women, newborns, early childhood, at-risk members, children with special needs) as well as its general membership. The Contractor shall demonstrate how these educational interventions reduce barriers to health care and improve health outcomes for members. The Contractor shall have in place policies and procedures to ensure that materials are accurate in content, accurate in translation relevant to language or alternate formats and do not defraud, mislead or confuse the member. The Contractor shall provide information requested by the State, or the State’s designee, for use in member education and enrollment, upon request.

Member Information, Outreach and Education. The Contractor shall provide the information listed under this section within a reasonable timeframe, following the notification from the State fiscal agent of the member’s enrollment in the Contractor. This information shall be included in the member handbook. The Contractor shall notify all members of their right to request and obtain information in accordance with 42 CFR 438.10. In addition to providing the specific information required at 42 CFR 438.10(f) upon enrollment in the Welcome Packet as described in Section 4.2.1, the Contractor shall notify members at least once a year of their right to request and obtain this information. Written notice shall be given to each member of any significant change in this information at least thirty (30) days before the intended effective date of the change. Significant change is defined as any change that may impact member accessibility to the Contractor’s services and benefits. The Contractor shall make written information available in English and Spanish and other prevalent non-English languages identified by OMPP, upon OMPP’s or the member’s non- request. At the time of enrollment with the Contractor, the State shall provide the primary language of each member. The Contractor shall utilize this information to ensure communication materials are distributed in the appropriate language. In addition, the Contractor shall identify additional languages that are prevalent among the Contractor’s membership. For purposes of this requirement, prevalent language is defined as any language spoken by at least three percent (3%) of the general population in the Contractor’s t service area. Written information shall be provided in any such prevalent languages identified by the Contractor. Per Section 1557 of the Affordable Care Act / 45 CFR 92.1, Contractor shall ensure that for significant publications and communications taglines (short statements written in non-English languages to alert individuals with limited English proficiency to the availability of language assistance services, free of charge, and how the services can be obtained) must be included in the State’s top 15 languages spoken by limited English proficient populations, and for small-size significant publications and significant communications a tagline must be included in the State’s top two languages spoken by limited English proficient populations. The Contractor shall inform members that information is available upon request in alternative formats and how to obtain them. OMPP defines alternative formats as Braille, large font letters, audiotape, prevalent languages and verbal explanation of written materials. To the extent possible, written materials shall not exceed a fifth grade reading level. The Contractor shall provide notification to OMPP, to the Enrollment Broker and to its members of any covered services that the Contractor or any of its sub-contractors or networks do not cover on the basis of moral or religious grounds and guidelines for how and where to obtain those services, in accordance with 42 CFR 438.102, which relates to provider-enrollee communications. This information shall be relayed to the member before and during enrollment and within ninety (90) calendar days after adopting the policy with respect to any particular service. Refer to Section 6.3.3 for additional information. The Contractor shall inform the members that, upon the member’s request, the Contractor u will provide information on the structure and operation of the Contractor and, in accordance with 42 CFR 438.10(f)(3), will provide information on the Contractor’s provider incentive plans. Grievance, appeal and fair hearing procedures and timeframes shall be provided to members in accordance with 42 CFR 438.10(g)(2)(xi), which requires specific information be provided to enrollees. Please see Section 4.9 for further information about grievance, appeal and fair hearing procedures, as well as the kind of information that the Contractor shall provide to members. The Contractor shall be responsible for developing and maintaining member education programs designed to provide the members with clear, concise and accurate information about the Contractor’s program, the Contractor’s network and the Hoosier Healthwise program. The State encourages the Contractor to incorporate community advocates, support agencies, health departments, other governmental agencies and public health associations in its outreach and member education programs. The State encourages the Contractor to develop community partnerships with these types of organizations, in particular with school based health centers, community mental health centers, WIC clinics, county health departments and prenatal clinics to promote health and wellness within its membership. The Contractor shall develop communication strategies that meet the requirements of this section, and provide innovative approaches to ensure member understanding of the Hoosier Healthwise program. The Contactor shall, at minimum, provide program information to the member through required notices and other communications prescribed by the State. The Contractor's educational activities and services shall also address the special needs of specific Hoosier Healthwise subpopulations (e.g., pregnant women, newborns, early childhood, at-risk members, children with special needs) as well as its general membership. The Contractor shall demonstrate how these educational interventions reduce barriers to health care and improve health outcomes for members. The Contractor shall have in place policies and procedures to ensure that materials are accurate in content, accurate in translation relevant to language or alternate formats and do not defraud, mislead or confuse the member. The Contractor shall provide information requested by the State, or the State’s designee, for use in member education and enrollment, upon request.

Member Information, Outreach and Education. The Contractor shall provide the information listed under this section within a reasonable timeframe, following the notification from the State fiscal agent of the member’s enrollment in the Contractor. This information shall be included in the member handbook. All correspondence between the Contractor and either pending HIP applicants or conditionally eligible HIP members shall provide notice that the individual has the right to select another MCE before the first payment is made or enrollment is otherwise finalized in accordance with Section 4.6. The notice shall be prominently displayed on the first page and include contact information for the Enrollment Broker available to assist with MCE selection and transfer. The Contractor shall notify all members of their right to request and obtain information in accordance with 42 CFR 438.10. In addition to providing the specific information required at 42 CFR 438.10(f) upon enrollment in the Welcome Packet as described in Section 4.2.17.2.1, the Contractor shall notify members at least once a year of their right to request and obtain this information. Written notice shall be given to each member of any significant change in this information at least thirty (30) days before the intended effective date of the change. Significant change is defined as any change that may impact member accessibility to the Contractor’s services and benefits. The Contractor shall make written information available in English and Spanish and other prevalent non-English languages identified by OMPP, upon OMPP’s or the member’s request. At the time of enrollment with the Contractor, the State shall provide the primary language of each member. The Contractor shall utilize this information to ensure communication materials are distributed in the appropriate language. In addition, the Contractor shall identify additional languages that are prevalent among the Contractor’s membership. For purposes of this requirement, prevalent language is defined as any language spoken by at least three percent (3%) of the general population in the Contractor’s service area. Written information shall be provided in any such prevalent languages identified by the Contractor. Per Section 1557 of the Affordable Care Act / 45 CFR 92.1, Contractor shall ensure that for significant publications and communications taglines (short statements written in non-English languages to alert individuals with limited English proficiency to the availability of language assistance servicesservic es, free of charge, and how the services can be obtained) must be included in the State’s top 15 languages spoken by limited English proficient populations, and for small-size significant publications and significant communications a tagline must be included in the State’s top two languages spoken by limited English proficient populations. To the extent possible, written materials shall not exceed a fifth grade reading level. The Contractor shall inform members that information is available upon request in alternative formats and how to obtain them. OMPP defines alternative formats as Braillebraille, large font letters, audiotape, prevalent languages and verbal explanation of written materials. To the extent possibleAs of May 1, written materials shall not exceed a fifth grade reading level. The Contractor shall provide notification to OMPP, to the Enrollment Broker and to its members of any covered services that the Contractor or any of its sub-contractors or networks do not cover on the basis of moral or religious grounds and guidelines for how and where to obtain those services, in accordance with 42 CFR 438.102, which relates to provider-enrollee communications. This information shall be relayed to the member before and during enrollment and within ninety (90) calendar days after adopting the policy with respect to any particular service. Refer to Section 6.3.3 for additional information. The Contractor shall inform the members that, upon the member’s request2020, the Contractor will provide information on the structure and operation of the Contractor andshall offer braille as an alternative format for receiving member materials. When a member has requested materials in braille, in accordance with 42 CFR 438.10(f)(3), will provide information on the Contractor’s provider incentive plans. Grievance, appeal and fair hearing procedures and timeframes shall be provided to members in accordance with 42 CFR 438.10(g)(2)(xi), which requires specific information be provided to enrollees. Please see Section 4.9 for further information about grievance, appeal and fair hearing procedures, as well as the kind of information that the Contractor shall provide supply future materials in braille to members. The Contractor shall be responsible for developing and maintaining member education programs designed to provide the members with clear, concise and accurate information about the Contractor’s program, the Contractor’s network and the Hoosier Healthwise program. The State encourages the Contractor to incorporate community advocates, support agencies, health departments, other governmental agencies and public health associations in its outreach and member education programs. The State encourages the Contractor to develop community partnerships with these types of organizations, in particular with school based health centers, community mental health centers, WIC clinics, county health departments and prenatal clinics to promote health and wellness within its membership. The Contractor shall develop communication strategies that meet the requirements of this section, and provide innovative approaches to ensure member understanding of the Hoosier Healthwise program. The Contactor shall, at minimum, provide program information to the member through required notices and other communications prescribed by the State. The Contractor's educational activities and services shall also address the special needs of specific Hoosier Healthwise subpopulations (e.g., pregnant women, newborns, early childhood, at-risk members, children with special needs) as well as its general membership. The Contractor shall demonstrate how these educational interventions reduce barriers to health care and improve health outcomes for members. The Contractor shall have in place policies and procedures to ensure that materials are accurate in content, accurate in translation relevant to language or alternate formats and do not defraud, mislead or confuse the member. The Contractor may review with the member the specific document types the member wishes to receive in braille versus other formats. The Contractor may outreach to members to inquire if braille documents are still the desired format. Unless a member specifically states their alternate-format request is a one-time request, the Contractor shall provide information requested by consider the Staterequest an ongoing request and supply all future mailed materials in the preferred format to the member. For first-time or one-time requests from a member, or the State’s designeeContractor shall mail the alternate version of the document in no more than seven (7) business days from the date of the request. If, for use example, the member received a wellness visit reminder flyer and called the Contractor to ask for the flyer to be sent in braille, the Contractor shall take no more than seven (7) business days to mail the braille version from the date of the member education request call. For first-time or one-time requests from a member, when the mailing is governed by NCQA or statutory requirements, the Contract shall have two (2) additional days from the NCQA or statutory timeframe to mail the document if no mailing has yet been sent to the member. For first-time or one-time requests from a member, when the mailing is governed by NCQA or statutory requirements and enrollmentthe statutory notice has already been fulfilled with a regular printed letter, upon the Contractor shall mail the alternate version of the document in no more than seven (7) business days from the date of the request.. For existing on-going alternate format requests, the Contractor shall have two (2) additional

Member Information, Outreach and Education. The Contractor shall provide the information listed under this section within a reasonable timeframe, following the notification from the State fiscal agent of the member’s enrollment in the Contractor. This information shall be included in the member handbook. The Contractor shall notify all members of their right to request and obtain information in accordance with 42 CFR 438.10. In addition to providing the specific information required at 42 CFR 438.10(f438.10(f)(6) upon enrollment in the Welcome Packet as described in Section 4.2.1, the Contractor shall notify members at least once a year of their right to request and obtain this information. Written notice shall be given to each member of any significant change in this information at least thirty (30) days before the intended effective date of the change. Significant change is defined as any change that may impact member accessibility to the Contractor’s services and benefits. The Contractor shall make written information available in English and Spanish and other prevalent non-English languages identified by OMPP, upon OMPP’s or the member’s request. At the time of enrollment with the Contractor, the State shall provide the primary language of each member. The Contractor shall utilize this information to ensure communication materials are distributed in the appropriate language. In addition, the Contractor shall identify additional languages that are prevalent among the Contractor’s membership. For purposes of this requirement, prevalent language is defined as any language spoken by at least three percent (3%) of the general population in the Contractor’s service area. Written information shall be provided in any such prevalent languages identified by the Contractor. Per Section 1557 of the Affordable Care Act / 45 CFR 92.1, Contractor shall ensure that for significant publications and communications taglines (short statements written in non-English languages to alert individuals with limited English proficiency to the availability of language assistance services, free of charge, and how the services can be obtained) must be included in the State’s top 15 languages spoken by limited English proficient populations, and for small-size significant publications and significant communications a tagline must be included in the State’s top two languages spoken by limited English proficient populations. The Contractor shall inform members that information is available upon request in alternative formats and how to obtain them. OMPP defines alternative formats as Braille, large font letters, audiotape, prevalent languages and verbal explanation of written materials. To the extent possible, written materials shall not exceed a fifth grade reading level. The Contractor shall provide notification to OMPP, to the Enrollment Broker and to its members of any covered services that the Contractor or any of its sub-contractors or networks do not cover on the basis of moral or religious grounds and guidelines for how and where to obtain those services, in accordance with 42 CFR 438.102, which relates to provider-enrollee communications. This information shall be relayed to the member before and during enrollment and within ninety (90) calendar days after adopting the policy with respect to any particular service. Refer to Section 6.3.3 for additional information. The Contractor shall inform the members that, upon the member’s request, the Contractor will provide information on the structure and operation of the Contractor and, in accordance with 42 CFR 438.10(f)(3438.6(h), will provide information on the Contractor’s provider incentive plans. Grievance, appeal and fair hearing procedures and timeframes shall be provided to members in accordance with 42 CFR 438.10(g)(2)(xi438.10(g)(1), which requires specific information be provided to enrollees. Please see Section 4.9 for further information about grievance, appeal and fair hearing procedures, as well as the kind of information that the Contractor shall provide to members. The Contractor shall be responsible for developing and maintaining member education programs designed to provide the members with clear, concise and accurate information about the Contractor’s program, the Contractor’s network and the Hoosier Healthwise program. The State encourages the Contractor to incorporate community advocates, support agencies, health departments, other governmental agencies and public health associations in its outreach and member education programs. The State encourages the Contractor to develop community partnerships with these types of organizations, in particular with school based health centers, community mental health centers, WIC clinics, county health departments and prenatal clinics to promote health and wellness within its membership. The Contractor shall develop communication strategies that meet the requirements of this section, and provide innovative approaches to ensure member understanding of the Hoosier Healthwise program. The Contactor shall, at minimum, provide program information to the member through required notices and other communications prescribed by the State. The Contractor's educational activities and services shall also address the special needs of specific Hoosier Healthwise subpopulations (e.g., pregnant women, newborns, early childhood, at-risk members, and children with special needs) as well as its general membership. The Contractor shall demonstrate how these educational interventions reduce barriers to health care and improve health outcomes for members. The Contractor shall have in place policies and procedures to ensure that materials are accurate in content, accurate in translation relevant to language or alternate formats and do not defraud, mislead or confuse the member. The Contractor shall provide information requested by the State, or the State’s designee, for use in member education and enrollment, upon request.