Readiness Review Overview. a. EOHHS will conduct a Readiness Review of the Contactor that may include, at a minimum, one on-site review. This Readiness Review shall be conducted prior to enrollment of Members with the Contractor’s Plan, and at other times during the Contract period at the discretion of EOHHS. EOHHS will conduct the Readiness Review to verify the Contractor’s assurances that the Contractor is ready and able to meet its obligations under the Contract. EOHHS reserves the right to conduct an additional Readiness Review in the event that additional populations become managed care eligible. b. The scope of the Readiness Review will include, but is not limited to, a review of the following elements: 1) Network Provider composition and access, in accordance with Section 2.7; 2) Staffing, including Key Personnel and functions directly impacting on Enrollees (e.g., adequacy of Enrollee Services staffing), in accordance with Section 2.3.A; 3) Marketing materials, in accordance with Section 2.11; 4) Capabilities of Material Subcontractors, in accordance with Section 2.3.C.2; 5) Care Management capabilities, in accordance with Section 2.5.E; 6) Content of Provider Contracts, including any Provider Performance Incentives, in accordance with Sections 2.7.B, 2.13.D and 5.1.H; 7) Contractual Agreements with Community Partners, in accordance with Sections 2.5.F and 2.5.G; 8) Enrollee Services capability (materials, processes and infrastructure, e.g., call center capabilities), in accordance with Section 2.10; 9) Comprehensiveness of quality management/quality improvement strategies, in accordance with Section 2.13; 10) Comprehensiveness of Utilization Management strategies, in accordance with
Appears in 3 contracts
Samples: Masshealth Managed Care Organization Contract, Managed Care Organization Contract, Managed Care Organization Contract
Readiness Review Overview. a. EOHHS will conduct a Readiness Review of the Contactor Contractor that may include, at a minimum, one on-site review. This Readiness Review shall be conducted prior to enrollment of Members with the Contractor’s Plan, and at other times during the Contract period at the discretion of EOHHS. EOHHS will conduct the Readiness Review to verify the Contractor’s assurances that the Contractor is ready and able to meet its obligations under the Contract. EOHHS reserves the right to conduct an additional Readiness Review in the event that additional populations become managed care eligible.
b. The scope of the Readiness Review will include, but is not limited to, a review of the following elements:
1) Network Provider composition and access, in accordance with Section 2.7;
2) Staffing, including Key Personnel and functions directly impacting on Enrollees (e.g., adequacy of Enrollee Services staffing), in accordance with Section 2.3.A;
3) Marketing materials, in accordance with Section 2.11;
4) Capabilities of Material Subcontractors, in accordance with Section 2.3.C.2.;
5) Care Management capabilities, in accordance with Section 2.5.E;
6) Content of Provider Contracts, including any Provider Performance Incentives, in accordance with Sections 2.7.B2.7.B., 2.13.D 2.13.D. and 5.1.H6.1.H;
7) Contractual Agreements with Community Partners, in accordance with Sections 2.5.F and 2.5.G;2.5.G.
8) Enrollee Services capability (materials, processes and infrastructure, e.g., call center capabilities), in accordance with Section 2.10;
9) Comprehensiveness of quality management/quality improvement strategies, in accordance with Section 2.13; 10) Comprehensiveness of Utilization Management strategies, in accordance withwith Section 2.6.D;
Appears in 3 contracts
Samples: Accountable Care Partnership Plan Contract, Accountable Care Partnership Plan Contract, Accountable Care Partnership Plan Contract
Readiness Review Overview. a. EOHHS will conduct a Readiness Review of the Contactor that may include, at a minimum, one on-site review. This Readiness Review shall be conducted prior to enrollment of Members with the Contractor’s Plan, and at other times during the Contract period at the discretion of EOHHS. EOHHS will conduct the Readiness Review to verify the Contractor’s assurances that the Contractor is ready and able to meet its obligations under the Contract. EOHHS reserves the right to conduct an additional Readiness Review in the event that additional populations become managed care eligible.
b. The scope of the Readiness Review will include, but is not limited to, a review of the following elements:
1) Network Provider composition and access, in accordance with Section 2.7;
2) Staffing, including Key Personnel and functions directly impacting on Enrollees (e.g., adequacy of Enrollee Services staffing), in accordance with Section 2.3.A;
3) Marketing materials, in accordance with Section 2.11;
4) Capabilities of Material Subcontractors, in accordance with Section 2.3.C.2.;
5) Care Management capabilities, in accordance with Section 2.5.E;
6) Content of Provider Contracts, including any Provider Performance Incentives, in accordance with Sections 2.7.B2.7.B., 2.13.D and 5.1.H;
7) Contractual Agreements with Community Partners, in accordance with Sections 2.5.F and 2.5.G;
8) Enrollee Services capability (materials, processes and infrastructure, e.g., call center capabilities), in accordance with Section 2.10;
9) Comprehensiveness of quality management/quality improvement strategies, in accordance with Section 2.13; 10) Comprehensiveness of Utilization Management strategies, in accordance with
Appears in 1 contract
