Common use of Self-Monitoring and Reporting Clause in Contracts

Self-Monitoring and Reporting. Alabama Medicaid will prepare and provide to the Department two reports, the first by no later than January 23, 2023, and the second by no later than July 22, 2023, containing the following information: a. Alabama Medicaid will notify the Department of the date any benchmark listed in Paragraphs 11-15 above was completed during the appropriate reporting period. b. The results of a review of all requests received by Alabama Medicaid for DAA treatment during the appropriate reporting period (for the first report – from October 1, 2022 through the reporting date, and for the second report – from the first reporting date through the second reporting date). For any such requests that were denied on the basis of the use of drugs or alcohol, Alabama Medicaid will remedy the denial and report the following information to the Department: the date and nature of the denial, the name of the provider involved, the date and nature of Alabama Medicaid’s remedy of the denial, corrective measures taken by Alabama Medicaid to avoid future denials, and all documentation regarding the denial. c. For any complaint, charge, or grievance (formal or informal) regarding access to DAA treatment for HCV for any reason related to use of drugs or alcohol received by Alabama Medicaid during the appropriate reporting period, Alabama Medicaid will report the following information: the nature of the allegation, the name of the provider involved, Alabama Medicaid’s corrective measures to investigate and promptly address the allegations, and all documentation regarding the allegation (including, but not limited to, correspondence with Medicaid providers regarding the allegation).