Open Case Management Spans for Disenrolled Members Sample Clauses

Open Case Management Spans for Disenrolled Members. Measure: The percentage of the MCP’s case management records in CAMS for the ABD program that have open case management date spans for members who have disenrolled from the MCP.
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Open Case Management Spans for Disenrolled Members. Measure: The percentage of the MCP's case management records in CAMS for the ABD program that have open case management date spans for members who have disenrolled from the MCP. Report Period: January - March 2007, and April - June 2007 report periods. For the SFY 2008 contract period, July — September 2007, October — December 2007, January - March 2008, and April - June 2008 report periods. Data Quality Standard: A rate of open case management spans for disenrolled members of no more than 1.0%. Statewide Approach: MCPs will be evaluated using a statewide result specific for the ABD program, including all regions in which an MCP has ABD membership. An MCP will not be evaluated until the MCP has at least 3,000 ABD members statewide who have had at least three months of continuous enrollment during each month of the entire report period. As the ABD Medicaid managed care program expands statewide and regions become active in different months, statewide results will include every region in which an MCP has membership [Example: MCP AAA has: 6,000 members in the South West region beginning in January 2007; 7,000 members in the West Central region beginning in February 2007; and 8,000 members in the South East region beginning in March 2007. MCP AAA's statewide results for the April-June 2007 report period will include data for the Xxxxx Xxxx, Xxxx Xxxxxxx, xxx Xxxxx Xxxx regions.] Penalty for noncompliance: If an MCP is noncompliant with the standard, then the ODJFS will issue a Sanction Advisory informing the MCP that a monetary sanction will be imposed if the MCP is noncompliant for any future report periods. Upon all subsequent semi-annual measurements of performance, if an MCP is again determined to be noncompliant with the standard, ODJFS will impose a monetary sanction of one-half of one percent of the current month's premium payment. Appendix L Once the MCP is performing at standard levels and violations/deficiencies are resolved to the satisfaction ofODJFS, the money will be refunded.
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Related to Open Case Management Spans for Disenrolled Members

  • Case Management Prompt resolution of any dispute is important to both parties; and the parties agree that the arbitration of any dispute shall be conducted expeditiously. The arbitrators are instructed and directed to assume case management initiative and control over the arbitration process (including scheduling of events, pre-hearing discovery and activities, and the conduct of the hearing), in order to complete the arbitration as expeditiously as is reasonably practical for obtaining a just resolution of the dispute.

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