Notification of Optional MCP Membership. In order to comply with the terms of the ODJFS State Plan Amendment for the managed care program (i.e., 42 CFR 438.50), MCPs in mandatory membership service areas must inform new members that MCP membership is optional for certain populations. Specifically, MCPs must inform any applicable pending member or member that the following CFC populations are not required to select an MCP in order to receive their Medicaid healthcare benefit and what steps they need to take if they do not wish to be a member of an MCP: - Indians who are members of federally-recognized tribes. - Children under 19 years of age who are: o Eligible for Supplemental Security Income under title XVI; o In xxxxxx care or other out-of-home placement; o Receiving xxxxxx care of adoption assistance; o Receiving services through the Ohio Department of Health’s Bureau for Children with Medical Handicaps (BCMH) or any other family-centered, community-based, coordinated care system that receives grant funds under section 501(a)(1)(D) of title V, and is defined by the State in terms of either program participation or special health care needs.
Notification of Optional MCP Membership. In order to comply with the terms of the ODJFS State Plan Amendment for the managed care program (i.e., 42 CFR 438.50), MCPs in mandatory membership service areas must inform new members, as applicable, that MCP membership is optional for certain populations. Specifically, MCPs must inform any applicable pending member or member that the following ABD population is not required to select an MCP in order to receive their Medicaid healthcare benefit and what steps they need to take if they do not wish to be a member of an MCP: - Indians who are members of federally-recognized tribes, except as permitted under 42 C.F.R 438.50(d)(21).
Notification of Optional MCP Membership. In order to comply with the terms of the ODM State Plan Amendment for the managed care program (i.e., 42 CFR 438.50), the MCP must inform new members that MCP membership is optional for certain populations. Specifically, the MCP must inform any applicable ABD or CFC pending member or member that the following population is not required to select an MCP in order to receive their Medicaid healthcare benefit and what steps they need to take if they do not wish to be a member of an MCP: - Indians who are members of federally-recognized tribes, except as permitted under 42 CFR 438.50(d)(2). Additionally, the MCP must inform any applicable CFC pending member or member that the following populations are not required to select an MCP in order to receive their Medicaid healthcare benefits, and describe what steps the member must take if he or she does not wish to become a member of an MCP: - Children under 19 years of age who are: o In xxxxxx care or other out-of-home placement; o Receiving xxxxxx care or adoption assistance; o Receiving services through the Ohio Department of Health’s Bureau for Children with Medical Handicaps (BCMH) or any other family- centered, community-based, coordinated care system that receives grant funds under section 501(a)(1)(D) of Title V, and is defined by the state in terms of either program participation or special health care needs.
Notification of Optional MCP Membership. In order to comply with the terms of the ODJFS State Plan Amendment for the managed care program (i.e., 42 CFR 438.50), MCPs in mandatory membership service areas must inform new members, as applicable, that MCP membership is optional for certain populations. Specifically, MCPs must inform any applicable pending member or member that the following ABD population is not required to select an MCP in order to receive their Medicaid healthcare benefit and what steps they need to take if they do not wish to be a member of an MCP: - Indians who are members of federally-recognized tribes, except as permitted under 42 C.F.R 438.50(d)(21). Appendix C Page 9 27. HIPAA Privacy Compliance Requirements The Health Insurance Portability and Accountability Act (HIPAA) Privacy Regulations at 45 CFR. § 164.502(e) and § 164.504(e) require ODJFS to have agreements with MCPs as a means of obtaining satisfactory assurance that the MCPs will appropriately safeguard all personal identified health information. Protected Health Information (PHI) is information received from or on behalf of ODJFS that meets the definition of PHI as defined by HIPAA and the regulations promulgated by the United States Department of Health and Human Services, specifically 45 CFR 164.501, and any amendments thereto. MCPs must agree to the following:
Notification of Optional MCP Membership. In order to comply with the terms of the ODJFS State Plan Amendment for the managed care program (i.e., 42 CFR 438.50), MCPs in mandatory membership service areas must inform new members that MCP membership is optional for certain populations. Specifically, MCPs must inform any applicable pending member or member that the following CFC populations are not required to select an MCP in order to receive their Appendix C Covered Families and Children (CFC) population Page 9 Medicaid healthcare benefit and what steps they need to take if they do not wish to be a member of an MCP: - Indians who are members of federally-recognized tribes. - Children under 19 years of age who are: O Eligible for Supplemental Security Income under title XVI; O In fxxxxx care or other out-of-home placement; O Receiving fxxxxx care of adoption assistance; O Receiving services through the Ohio Department of Health’s Bureau for Children with Medical Handicaps (BCMH) or any other family-centered, community-based, coordinated care system that receives grant funds under section 501(a)(1)(D) of title V, and is defined by the State in terms of either program participation or special health care needs.
