Common use of Quarterly Operational Reports Clause in Contracts

Quarterly Operational Reports. The Commonwealth must submit progress reports in the format specified in Attachment C no later than 60 days following the end of each quarter. The intent of these reports is to present the Commonwealth’s analysis and the status of the various operational areas under the demonstration. These quarterly reports must include, but are not limited to: Updated budget neutrality monitoring spreadsheets; Events occurring during the quarter or anticipated to occur in the near future that effect health care delivery including approval and contracting with new plans, benefits, enrollment, grievances, quality of care, access, proposed changes to payment rates, health plan financial performance that is relevant to the demonstration, payment reform initiatives or delivery system reforms impacting demonstration population and/or undertaken in relation to the SNCP including ICB grant programs, updates on activities related to the pediatric bundled payment pilot program, pertinent legislative activity, and other operational issues; Action plans for addressing any policy and administrative issues identified; Quarterly enrollment reports that include the member months for each demonstration population; Updates on any state health care reform activities to coordinate the transition of coverage through the Affordable Care Act; Activities and planning related to payments made under the Safety Net Care Pool pursuant to reporting requirements outlined in section VIII of the STCs; Updates on data related to the provisional eligibility authority. Total number of Medicaid/CHIP applicants for the specified quarter Total number Medicaid/CHIP applicants with identified income inconsistencies for the specified quarter Average number of days to resolve inconsistency Number of Medicaid CHIP applicants disenrolled due to income ineligibility identified Basis for ineligibility Quality of initial data Expenditures for ineligible individuals Evaluation activities and interim findings.

Quarterly Operational Reports. The Commonwealth must submit progress reports in the format specified in Attachment C no later than 60 days following the end of each quarter. The intent of these reports is to present the Commonwealth’s analysis and the status of the various operational areas under the demonstration. These quarterly reports must include, but are not limited to: : a) Updated budget neutrality monitoring spreadsheets; ; b) Events occurring during the quarter or anticipated to occur in the near future that effect health care delivery including approval and contracting with new plans, benefits, enrollment, grievances, quality of care, access, proposed changes to payment rates, health plan financial performance that is relevant to the demonstration, payment reform initiatives or delivery system reforms impacting demonstration population and/or undertaken in relation to the SNCP including ICB grant programsSNCP, updates on activities related to the pediatric bundled payment pilot program, pertinent legislative activity, and other operational issues; ; c) Action plans for addressing any policy and administrative issues identified; ; d) Quarterly enrollment reports that include the member months for each demonstration population; ; e) Updates on any state health care reform activities to coordinate the transition of coverage through the Affordable Care Act; ; f) Activities and planning related to payments made under the Safety Net Care Pool pursuant to reporting requirements outlined in section VIII of the STCs; ; g) Updates on data related to the provisional eligibility authority. authority  Total number of Medicaid/CHIP applicants for the specified quarter  Total number Medicaid/CHIP applicants with identified income inconsistencies for the specified quarter  Average number of days to resolve inconsistency  Number of Medicaid CHIP applicants disenrolled due to income ineligibility identified  Basis for ineligibility  Quality of initial data  Expenditures for ineligible individuals individuals h) Evaluation activities and interim findings.

Quarterly Operational Reports. The Commonwealth must submit progress reports in the format specified in Attachment C no later than 60 days following the end of each quarter. The intent of these reports is to present the Commonwealth’s analysis and the status of the various operational areas under the demonstration. These quarterly reports must include, but are not limited to: : a) Updated budget neutrality monitoring spreadsheets; ; b) Events occurring during the quarter or anticipated to occur in the near future that effect health care delivery including approval and contracting with new plans, benefits, enrollment, grievances, quality of care, access, proposed changes to payment rates, health plan financial performance that is relevant to the demonstration, payment reform initiatives or delivery system reforms impacting demonstration population and/or undertaken in relation to the SNCP including ICB grant programs, updates on activities related to the pediatric bundled payment pilot program, pertinent legislative activity, and other operational issues; ; c) Action plans for addressing any policy and administrative issues identified; ; d) Quarterly enrollment reports that include the member months for each demonstration population; ; e) Updates on any state health care reform activities to coordinate the transition of coverage through the Affordable Care Act; ; f) Activities and planning related to payments made under the Safety Net Care Pool pursuant to reporting requirements outlined in section VIII of the STCs; ; g) Updates on data related to the provisional eligibility authority. . 1) Total number of Medicaid/CHIP applicants for the specified quarter quarter 2) Total number Medicaid/CHIP applicants with identified income inconsistencies for the specified quarter quarter 3) Average number of days to resolve inconsistency inconsistency 4) Number of Medicaid CHIP applicants disenrolled due to income ineligibility identified 5) Basis for ineligibility Quality of initial data Expenditures for ineligible individuals Evaluation activities and interim findings.ineligibility