Common use of Provider Directory Clause in Contracts

Provider Directory. The CHC-MCO must maintain a single directory for all types of Network Providers. The CHC-MCO must utilize a web-based Provider directory. The web-based Provider directory must be available in a machine-readable file and format as specified in 42 C.F.R. § 438.10. The web-based Provider directory must be updated no less than thirty (30) days after the CHC-MCO receives updated information from the Provider. The CHC-MCO must establish a process to address the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The CHC-MCO must perform at least monthly reviews and revisions of the web-based Provider directory, subject to random monitoring by the Department. The CHC-MCO must provide the IEB with an updated electronic version of its Provider directory on at least a weekly basis. The file must include information regarding terminations, additions, PCPs and specialists not accepting new assignments, and other information determined by the Department to be necessary. The CHC-MCO must utilize the file layout and format specified by the Department. The file must include the information specified in Exhibit N, Provider Directory, but not be limited to: • Correct MMIS Provider ID • All Providers in the CHC-MCO’s Network • Locations where the PCP will see Participants and if evening or weekend hours are available • Wheelchair accessibility of Provider sites • List of non-English language(s) spoken by Providers. The CHC-MCO must notify its Participants annually of their right to request and obtain a hard copy of the Provider directory and where the online directory may be found. Upon request, the CHC-MCO must provide Participants with a hard copy of its Provider directory in the prevalent languages specified by the Department and in alternative formats. The CHC- MCO must review the Provider directory information and make any necessary updates at least monthly. Upon request from a Participant, the CHC-MCO must print the most recent electronic version from its Provider file and mail it to the Participant. The CHC-MCO must submit the Provider directory to the Department for advance written approval before distribution to its Participants. Unless the CHC-MCO makes significant format or substantive changes, the CHC-MCO is not required to submit changes to the Department for approval. The CHC-MCO must reference and include a link to the Provider directory for the aligned D-SNP in the Provider directory so that Participants enrolled in both plans may easily reference the D-SNP directory.

Provider Directory. The CHC-MCO Provider Directory for each applicable HMO Program, and any substantive revisions, must maintain a single directory for all types of Network Providersbe approved by HHSC prior to publication and distribution. The CHC-MCO HMO is responsible for submitting draft Provider directory updates to HHSC for prior review and approval if changes other than PCP information or clerical corrections are incorporated into the Provider Directory. As described in Attachment B-1, Section 7, during the Readiness Review, the HMO must utilize develop and submit to HHSC the draft Provider Directory template for approval and must submit a web-based final Provider directoryDirectory incorporating changes required by HHSC prior to the Operational Start Date. Such draft and final Provider Directories must be submitted according to the deadlines established in Attachment B-1, Section 7. 1.5.1 above and must include critical elements in the Uniform Managed Care Manual. The web-based Provider directory Directory must be available include only Network Providers credentialed by the HMO in a machine-readable file accordance with Section 8.1.4.4. If the HMO contracts with limited Provider Networks, the Provider Directory must comply with the requirements of 28 T.A.C. §11.1600(b)(11), relating to the disclosure and format as specified in 42 C.F.R. § 438.10notice of limited Provider Networks. CHIP Perinatal HMOs must develop Provider Directories for both CHIP Perinates and CHIP Perinate Newborns. The web-based Provider directory must Directory for CHIP Perinate Newborns may be updated no less than thirty (30) days after the CHC-MCO receives updated information from same as that used for the ProviderCHIP Program. The CHC-MCO HMO must establish update the Provider Directory on a process to address the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The CHC-MCO must perform at least monthly reviews and revisions of the web-based Provider directory, subject to random monitoring by the Department. The CHC-MCO must provide the IEB with an updated electronic version of its Provider directory on at least a weekly quarterly basis. The file HMO must include information regarding terminations, additions, PCPs and specialists not accepting new assignmentsmake such update available to existing Members on request, and other information must provide such update to the HHSC Administrative Services Contractor at the beginning of each state fiscal quarter. HHSC will consult with the HMOs and the HHSC Administrative Services Contractors to discuss methods for reducing the HMO’s administrative costs of producing new Provider Directories, including considering submission of new Provider Directories on a semi-annual rather than a quarterly basis if a HMO has not made major changes in its Provider Network, as determined by HHSC. HHSC will establish weight limits for the Department Provider Directories. Weight limits may vary by Service Area. HHSC will require HMOs that exceed the weight limits to be necessarycompensate HHSC for postage fees in excess of the weight limits. The CHC-MCO HMO must utilize send the file layout and format specified by the Department. The file must include the information specified in Exhibit N, most recent Provider Directory, but not be limited to: • Correct MMIS Provider ID • All Providers in the CHC-MCO’s Network • Locations where the PCP will see Participants and if evening or weekend hours are available • Wheelchair accessibility of Provider sites • List of non-English language(s) spoken by Providersincluding any updates, to Members upon request. The CHC-MCO must notify its Participants annually of their right to request and obtain a hard copy of the Provider directory and where the online directory may be found. Upon requestHMO must, the CHC-MCO must provide Participants with a hard copy of its Provider directory in the prevalent languages specified by the Department and in alternative formats. The CHC- MCO must review the Provider directory information and make any necessary updates at least monthly. Upon request from a Participantannually, the CHC-MCO must print the most recent electronic version from include written and verbal offers of such Provider Directory in its Provider file Member outreach and mail it to the Participant. The CHC-MCO must submit the Provider directory to the Department for advance written approval before distribution to its Participants. Unless the CHC-MCO makes significant format or substantive changes, the CHC-MCO is not required to submit changes to the Department for approval. The CHC-MCO must reference and include a link to the Provider directory for the aligned D-SNP in the Provider directory so that Participants enrolled in both plans may easily reference the D-SNP directoryeducation materials.

Provider Directory. The CHC-MCO PASSE must maintain a single Provider Directory that, at a minimum, does the following: a. Provides information on each participating provider, including: i. Name; ii. Group affiliations, if any; iii. Street address(es); iv. Telephone number(s); v. Website URLs, if any; vi. Specialties, as appropriate; vii. If the provider is accepting new Medicaid clients; viii. Cultural and linguistic capabilities, including the languages offered by the provider or skilled medical interpreter at the provider’s office; and ix. Whether the provider’s office/facility has accommodations for individuals with physical disabilities, including offices, exam rooms, and equipment. b. Clearly explains the difference between a participating provider and an out-of- network provider; c. States that some providers may choose not to perform certain services based on religious or moral beliefs, as required by the Act; and d. Contains an attestation from the PASSE that its Provider Network meets DHS’s required network adequacy standards, set out in the PASSE Medicaid Provider Manual. e. The PASSE must submit to DHS an electronic file of the PASSE provider network directory for all types of Network Providersand network services on a monthly basis. The CHC-MCO PASSE provider network directory or a link to the PASSE provider network directory will be posted on the Arkansas Medicaid website. If no Provider Network changes occurs during the month, the PASSE must utilize a web-based file an attestation to that affect with DHS. f. The Provider directoryDirectory must be updated within thirty (30) calendar days of the PASSE’s receipt of updated provider information. g. The PASSE must ensure the Provider Directory being distributed to enrolled members and potential members, either through mail, email or the website, matches the most recent Provider Network file submitted to DHS. h. The PASSE must make its Provider Directory available online, and in print form upon request. The web-based Provider directory online version must be available in a machine-readable file and format as specified in 42 C.F.R. § 438.10. The web-based Provider directory must be updated no less than thirty (30) days after the CHC-MCO receives updated information from the Provider. The CHC-MCO must establish a process to address the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The CHC-MCO must perform at least monthly reviews and revisions of the web-based Provider directory, subject to random monitoring by the Department. The CHC-MCO must provide the IEB with an updated electronic version of its Provider directory on at least a weekly basis. The file must include information regarding terminations, additions, PCPs and specialists not accepting new assignmentsformat, and other information determined by the Department to be necessary. The CHC-MCO must utilize the file layout and format specified by the Department. The file must include the information specified listed in Exhibit N, Section 4.2.4 above. i. The online version of the Provider Directory, but not Directory must be limited searchable according to: • Correct MMIS : i. Provider ID • All Providers in Name; ii. Provider Type; iii. Distance from the CHC-MCOmember’s Network • Locations where address; iv. Zip code; and v. Whether the PCP will see Participants provider is accepting new patients. j. The PASSE must furnish each newly enrolled member the most recent version of the Provider Directory and if evening may choose to distribute a printed version of the Provider Directory via surface mail or weekend hours are available • Wheelchair accessibility of provide written notification to the enrolled member that explains how to obtain the Provider sites • List of non-English language(s) spoken by ProvidersDirectory from the PASSE’s website. The CHC-MCO This notification must notify its Participants annually of their right to also detail how the member can request and obtain a hard copy of the printed Provider directory and where Directory from the online directory may be found. Upon requestPASSE, at no charge. k. When distributing printed Provider Directories, the CHC-MCO PASSE must provide Participants with a hard copy of its Provider directory in the prevalent languages specified by the Department and in alternative formats. The CHC- MCO must review the Provider directory information and make any necessary updates at least monthly. Upon request from a Participant, the CHC-MCO must print the most recent electronic version from its Provider file and mail it to the Participant. The CHC-MCO must submit the Provider directory to the Department for advance written approval before distribution to its Participants. Unless the CHC-MCO makes significant format or substantive changes, the CHC-MCO is not required to submit changes to the Department for approval. The CHC-MCO must reference and include a link append to the Provider directory for Directory a list of the aligned Dproviders who have left the network and those who have been added since the Provider Directory was printed or, in lieu of the appendix to the Provider Directory, enclose a letter stating that the most current listing of providers is available by calling the PASSE at its toll-SNP free telephone number, or at the PASSE’s website. The letter must include the toll-free telephone number and the Internet address that will take the enrolled member or potential member directly to the online Provider Directory. l. The PASSE must mail a Welcome Packet to a member who was disenrolled due to loss of Medicaid eligibility, and is subsequently re-enrolled in the Provider directory so that Participants enrolled PASSE, if: i. It has been more than 180 days since the disenrollment; or ii. It has been less than 180 days and there was a significant change in both plans may easily reference the D-SNP directorymember materials during the time they were disenrolled.

Provider Directory. The CHC-MCO Provider Directory for each applicable HMO Program, and any substantive revisions, must maintain a single directory for all types of Network Providersbe approved by HHSC prior to publication and distribution. The CHC-MCO HMO is responsible for submitting draft Provider directory updates to HHSC for prior review and approval if changes other than PCP information or clerical corrections are incorporated into the Provider Directory. As described in Attachment B-1, Section 7, during the Readiness Review, the HMO must utilize develop and submit to HHSC the draft Provider Directory template for approval and must submit a web-based final Provider directoryDirectory incorporating changes required by HHSC prior to the Operational Start Date. Such draft and final Provider Directories must be submitted according to the deadlines established in Attachment B-1, Section 7. 1.5.1 above and must include critical elements in the Uniform Managed Care Manual. The web-based Provider directory Directory must be available include only Network Providers credentialed by the HMO in a machine-readable file accordance with Section 8.1.4.4. If the HMO contracts with limited Provider Networks, the Provider Directory must comply with the requirements of 28 T.A.C. §11.1600(b)(11), relating to the disclosure and format as specified in 42 C.F.R. § 438.10notice of limited Provider Networks. CHIP Perinatal HMOs must develop Provider Directories for both CHIP Perinates and CHIP Perinate Newborns. The web-based Provider directory must Directory for CHIP Perinate Newborns may be updated no less than thirty (30) days after the CHC-MCO receives updated information from same as that used for the ProviderCHIP Program. The CHC-MCO HMO must establish update the Provider Directory on a process to address the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The CHC-MCO must perform at least monthly reviews and revisions of the web-based Provider directory, subject to random monitoring by the Department. The CHC-MCO must provide the IEB with an updated electronic version of its Provider directory on at least a weekly quarterly basis. The file HMO must include information regarding terminations, additions, PCPs and specialists not accepting new assignmentsmake such update available to existing Members on request, and other information must provide such update to the HHSC Administrative Services Contractor at the beginning of each state fiscal quarter. HHSC will consult with the HMOs and the HHSC Administrative Services Contractors to discuss methods for reducing the HMO’s administrative costs of producing new Provider Directories, including considering submission of new Provider Directories on a semi-annual rather than a quarterly basis if a HMO has not made major changes in its Provider Network, as determined by HHSC. HHSC will establish weight limits for the Department Provider Directories. Weight limits may vary by Service Area. HHSC will require HMOs that exceed the weight limits to be necessarycompensate HHSC for postage fees in excess of the weight limits. Responsible Office: HHSC Office of General Counsel (OGC) Subject: Attachment B-1 – HHSC Joint Medicaid/CHIP HMO RFP, Section 8 Version 1.7 The CHC-MCO HMO must utilize send the file layout and format specified by the Department. The file must include the information specified in Exhibit N, most recent Provider Directory, but not be limited to: • Correct MMIS Provider ID • All Providers in the CHC-MCO’s Network • Locations where the PCP will see Participants and if evening or weekend hours are available • Wheelchair accessibility of Provider sites • List of non-English language(s) spoken by Providersincluding any updates, to Members upon request. The CHC-MCO must notify its Participants annually of their right to request and obtain a hard copy of the Provider directory and where the online directory may be found. Upon requestHMO must, the CHC-MCO must provide Participants with a hard copy of its Provider directory in the prevalent languages specified by the Department and in alternative formats. The CHC- MCO must review the Provider directory information and make any necessary updates at least monthly. Upon request from a Participantannually, the CHC-MCO must print the most recent electronic version from include written and verbal offers of such Provider Directory in its Provider file Member outreach and mail it to the Participant. The CHC-MCO must submit the Provider directory to the Department for advance written approval before distribution to its Participants. Unless the CHC-MCO makes significant format or substantive changes, the CHC-MCO is not required to submit changes to the Department for approval. The CHC-MCO must reference and include a link to the Provider directory for the aligned D-SNP in the Provider directory so that Participants enrolled in both plans may easily reference the D-SNP directoryeducation materials.

Provider Directory. The CHC-MCO must maintain make a single directory for all types of Network Providers. The CHC-MCO must utilize a web-based Provider directory. The web-based Provider directory must be available in a machine-readable file and format as specified in 42 C.F.R. § 438.10. The web-based Provider directory must be updated no less than thirty (30) days after the CHC-MCO receives updated information from the Provider. The CHC-CHC- MCO must establish a process to address the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The CHC-MCO must perform at least monthly reviews and revisions of the web-based Provider directory, subject to random monitoring by the Department. The CHC-MCO must provide the IEB IEE with an updated electronic version of its Provider directory at a minimum on at least a weekly basis. The file must CHC-MCO will include information regarding terminations, additions, PCPs and specialists not accepting new assignments, and other information determined by the Department to be necessary. The CHC-MCO must utilize the file layout and format specified by the Department. The file must include the information specified in Exhibit N, Provider Directoryformat will include, but not be limited to: • Correct MMIS Provider ID • All Providers in the CHC-MCO’s Network • Locations The location where the PCP will see Participants and if Participants, as well as whether the PCP has evening or and/or weekend hours are available • Wheelchair accessibility Accessibility of the Provider sites site to persons with physical disabilities • List of Language indicators including non-English language(s) language spoken by the Providers. The CHC-MCO must notify its Participants annually of their right to request and obtain a hard copy of the Provider directory and where the online directory may be found. Upon request, the CHC-MCO must provide Participants with a hard copy of its Provider directory which includes, at a minimum, the information listed in the prevalent languages specified by the Department and in alternative formats. The CHC- MCO must review the Exhibit S, Provider directory information and make any necessary updates at least monthlyDirectories. Upon request from a the Participant, the CHC-CHC- MCO must will print the most recent electronic version from its Provider file and mail it to the Participant. The CHC-MCO must submit the Provider directory to the Department for advance written approval before distribution to its Participants. Unless the CHC-MCO makes significant format or substantive changes, the CHC-MCO is not required to submit changes to the Department for approval. The CHC-MCO must reference and include a link to the Provider directory for the aligned D-SNP in the Provider directory so that Participants enrolled in both plans may easily reference the D-SNP directory.

Provider Directory. The CHC-MCO must maintain make a single directory for all types of Network Providers. The CHC-MCO must utilize a web-based Provider directory. The web-based Provider directory must be available in a machine-readable file and format as specified in 42 C.F.R. § 438.10. The web-based Provider directory must be updated no less than thirty (30) days after the CHC-MCO receives updated information from the Provider. The CHC-CHC- MCO must establish a process to address the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The CHC-MCO must perform at least monthly reviews and revisions of the web-based Provider directory, subject to random monitoring by the Department. The CHC-MCO must provide the IEB IEE with an updated electronic version of its Provider directory at a minimum on at least a weekly basis. The file must CHC-MCO will include information regarding terminations, additions, PCPs and specialists not accepting new assignments, and other information determined by the Department to be necessary. The CHC-MCO must utilize the file layout and format specified by the Department. The file must include the information specified in Exhibit N, Provider Directoryformat will include, but not be limited to: • Correct MMIS Provider ID • All Providers in the CHC-MCO’s Network • Locations The location where the PCP will see Participants and if Participants, as well as whether the PCP has evening or weekend hours are available and/or weekendhours • Wheelchair accessibility Accessibility of the Provider sites site to persons with physical disabilities • List of Language indicators including non-English language(s) language spoken by the Providers. The CHC-MCO must notify its Participants annually of their right to request and obtain a hard copy of the Provider directory and where the online directory may be found. Upon request, the CHC-MCO must provide Participants with a hard copy of its Provider directory which includes, at a minimum, the information listed in the prevalent languages specified by the Department and in alternative formats. The CHC- MCO must review the Exhibit S, Provider directory information and make any necessary updates at least monthlyDirectories. Upon request from a the Participant, the CHC-CHC- MCO must will print the most recent electronic version from its Provider file and mail it to the Participant. The CHC-MCO must submit the Provider directory to the Department for advance written approval before distribution to its Participants. Unless the CHC-MCO makes significant format or substantive changes, the CHC-MCO is not required to submit changes to the Department for approval. The CHC-MCO must reference and include a link to the Provider directory for the aligned D-SNP in the Provider directory so that Participants enrolled in both plans may easily reference the D-SNP directory.

Provider Directory. The CHC-MCO must maintain provide a single directory for all types of Network Providers. The CHC-MCO must utilize a web-based Provider directory. The web-based Provider directory must be available in a machine-machine readable file and format as specified in 42 C.F.R. § 438.10. The web-based Provider directory must be updated no less than thirty (30) days after the CHC-MCO receives updated information from the Provider. The CHC-MCO must establish a process to address the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The CHC-MCO must perform at least monthly reviews and revisions of the web-based Provider directory, subject to random monitoring by the Department. The CHC-MCO must provide the IEB with an updated electronic version of its Provider directory Directory at a minimum on at least a weekly basis. The file must CHC-MCO will include information regarding terminations, additions, PCPs and specialists not accepting new assignments, and other information determined by the Department to be necessary. The CHC-MCO must utilize the file layout and format specified by the Department. The file directory must include but not be limited to the information specified in Exhibit N, Provider Directory, but not be limited to: • Correct MMIS Provider ID • All Providers in the CHC-MCO’s Network • Locations where the PCP will see Participants and if evening or weekend hours are available • Wheelchair accessibility of Provider sites • List of non-English language(s) spoken by Providers. The CHC-MCO must notify its Participants annually of their right to request and obtain a hard copy of the Provider directory and where the online directory may be found. Upon request, the CHC-MCO must provide Participants with a hard copy of its Provider directory in the prevalent languages specified by the Department and in alternative formats. The CHC- MCO must review the Provider directory information and make any necessary updates at least monthly. Upon request from a Participant, the CHC-MCO must print the most recent electronic version from its Provider file and mail it to the Participant. The CHC-MCO must submit the Provider directory to the Department for advance written approval before distribution to its Participants. Unless the CHC-MCO makes significant format or substantive changes, the CHC-MCO is not required to submit changes to the Department for approval. The CHC-MCO must reference and include a link to the Provider directory for the aligned D-SNP in the Provider directory so that Participants enrolled in both plans may easily reference the D-SNP directory.

Provider Directory. The CHC-MCO must maintain a single directory for all types of Network Providers. The CHC-MCO must utilize a web-based Provider directory. The web-based Provider directory must be available in a machine-machine readable file and format as specified in 42 C.F.R. § 438.10. The web-based Provider directory must be updated no less than thirty (30) days after the CHC-MCO receives updated information from the Provider. The CHC-MCO must establish a process to address the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The CHC-MCO must perform at least monthly reviews and revisions of the web-based Provider directory, subject to random monitoring by the Department. The CHC-MCO must provide the IEB with an updated electronic version of its Provider directory on at least a weekly basis. The file must include information regarding terminations, additions, PCPs and specialists not accepting new assignments, and other information determined by the Department to be necessary. The CHC-MCO must utilize the file layout and format specified by the Department. The file must include the information specified in Exhibit N, Provider Directory, but not be limited to: • Correct MMIS Provider ID • All Providers in the CHC-MCO’s Network • Locations where the PCP will see Participants and if evening or weekend hours are available • Wheelchair accessibility of Provider sites • List of non-English language(s) spoken by Providers. The CHC-MCO must notify its Participants annually of their right to request and obtain a hard copy of the Provider directory and where the online directory may be found. Upon request, the CHC-MCO must provide Participants with a hard copy of its Provider directory in the prevalent languages specified by the Department and in alternative formats. The CHC- MCO must review the Provider directory information and make any necessary updates at least monthly. Upon request from a Participant, the CHC-MCO must print the most recent electronic version from its Provider file and mail it to the Participant. The CHC-MCO must submit the Provider directory to the Department for advance written approval before distribution to its Participants. Unless the CHC-MCO makes significant format or substantive changes, the CHC-MCO is not required to submit changes to the Department for approval. The CHC-MCO must reference and include a link to the Provider directory for the aligned D-SNP in the Provider directory so that Participants enrolled in both plans may easily reference the D-SNP directory.

Provider Directory. The CHC-MCO Provider Directory for each applicable HMO Program, and any substantive revisions, must maintain a single directory for all types of Network Providersbe approved by HHSC prior to publication and distribution. The CHC-MCO HMO is responsible for submitting draft Provider directory updates to HHSC for prior review and approval if changes other than PCP information or clerical corrections are incorporated into the Provider Directory. As described in Attachment B-1, Section 7, during the Readiness Review, the HMO must utilize develop and submit to HHSC the draft Provider Directory template for approval and must submit a web-based final Provider directoryDirectory incorporating changes required by HHSC prior to the Operational Start Date. Such draft and final Provider Directories must be submitted according to the deadlines established in Attachment B-1, Section 7. 1.5.1 above and must include critical elements in the Uniform Managed Care Manual. The web-based Provider directory Directory must be available in a machine-readable file and format as specified in 42 C.F.R. § 438.10. The web-based Provider directory must be updated no less than thirty (30) days after the CHC-MCO receives updated information from the Provider. The CHC-MCO must establish a process to address the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The CHC-MCO must perform at least monthly reviews and revisions of the web-based Provider directory, subject to random monitoring include only Network Providers credentialed by the DepartmentHMO in accordance with Section 8.1.4.4. If the HMO contracts with limited Provider Networks, the Provider Directory must comply with the requirements of 28 T.A.C. §11.1600(b)(11), relating to the disclosure and notice of limited Provider Networks. Responsible Office: HHSC Office of General Counsel (OGC) Subject: Attachment B-1 – HHSC Joint Medicaid/CHIP HMO RFP, Section 8 Version 1.0 The CHC-MCO HMO must provide update the IEB with an updated electronic version of its Provider directory Directory on at least a weekly quarterly basis. The file HMO must include information regarding terminations, additions, PCPs and specialists not accepting new assignmentsmake such update available to existing Members on request, and other information must provide such update to the HHSC Administrative Services Contractor at the beginning of each state fiscal quarter. HHSC will consult with the HMOs and the HHSC Administrative Services Contractors to discuss methods for reducing the HMO’s administrative costs of producing new Provider Directories, including considering submission of new Provider Directories on a semi-annual rather than a quarterly basis if a HMO has not made major changes in its Provider Network, as determined by HHSC. HHSC will establish weight limits for the Department Provider Directories. Weight limits may vary by Service Area. HHSC will require HMOs that exceed the weight limits to be necessarycompensate HHSC for postage fees in excess of the weight limits. The CHC-MCO HMO must utilize send the file layout and format specified by the Department. The file must include the information specified in Exhibit N, most recent Provider Directory, but not be limited to: • Correct MMIS Provider ID • All Providers in the CHC-MCO’s Network • Locations where the PCP will see Participants and if evening or weekend hours are available • Wheelchair accessibility of Provider sites • List of non-English language(s) spoken by Providersincluding any updates, to Members upon request. The CHC-MCO must notify its Participants annually of their right to request and obtain a hard copy of the Provider directory and where the online directory may be found. Upon requestHMO must, the CHC-MCO must provide Participants with a hard copy of its Provider directory in the prevalent languages specified by the Department and in alternative formats. The CHC- MCO must review the Provider directory information and make any necessary updates at least monthly. Upon request from a Participantannually, the CHC-MCO must print the most recent electronic version from include written and verbal offers of such Provider Directory in its Provider file Member outreach and mail it to the Participant. The CHC-MCO must submit the Provider directory to the Department for advance written approval before distribution to its Participants. Unless the CHC-MCO makes significant format or substantive changes, the CHC-MCO is not required to submit changes to the Department for approval. The CHC-MCO must reference and include a link to the Provider directory for the aligned D-SNP in the Provider directory so that Participants enrolled in both plans may easily reference the D-SNP directoryeducation materials.

Provider Directory. ‌ The CHC-MCO must maintain provide a single directory for all types of Network Providers. The CHC-MCO must utilize a web-based Provider directory. The web-based Provider directory must be available in a machine-machine readable file and format as specified in 42 C.F.R. § 438.10. The web-based Provider directory must be updated no less than thirty (30) days after the CHC-MCO receives updated information from the Provider. The CHC-MCO must establish a process to address the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The CHC-MCO must perform at least monthly reviews and revisions of the web-based Provider directory, subject to random monitoring by the Department. The CHC-MCO must provide the IEB with an updated electronic version of its Provider directory Directory at a minimum on at least a weekly basis. The file must CHC-MCO will include information regarding terminations, additions, PCPs and specialists not accepting new assignments, and other information determined by the Department to be necessary. The CHC-MCO must utilize the file layout and format specified by the Department. The file directory must include but not be limited to the information specified in Exhibit N, Provider Directory, but not be limited to: • Correct MMIS Provider ID • All Providers in the CHC-MCO’s Network • Locations where the PCP will see Participants and if evening or weekend hours are available • Wheelchair accessibility of Provider sites • List of non-English language(s) spoken by Providers. The CHC-MCO must notify its Participants annually of their right to request and obtain a hard copy of the Provider directory and where the online directory may be found. Upon request, the CHC-MCO must provide Participants with a hard copy of its Provider directory in the prevalent languages specified by the Department and in alternative formats. The CHC- MCO must review the Provider directory information and make any necessary updates at least monthly. Upon request from a Participant, the CHC-MCO must print the most recent electronic version from its Provider file and mail it to the Participant. The CHC-MCO must submit the Provider directory to the Department for advance written approval before distribution to its Participants. Unless the CHC-MCO makes significant format or substantive changes, the CHC-MCO is not required to submit changes to the Department for approval. The CHC-MCO must reference and include a link to the Provider directory for the aligned D-SNP in the Provider directory so that Participants enrolled in both plans may easily reference the D-SNP directory.