Common Contracts
1 similar null contracts
Memorandum of Understanding between the Centers for Medicare & Medicaid Services (CMS) and the New York State Department of Health to Operate Integrated Grievance and Appeals Processes for Certain Integrated Medicare and Medicaid PlansOctober 6th, 2022
This Demonstration is testing integrated grievance and appeals processes that will apply to all items and services covered by participating MAP plans and MAP-participating D-SNPs other than those provided under Medicare Part D. The integrated grievance and appeals process does not apply to: 1) Medicare and Medicaid items and services that are excluded from the plans’ benefit packages; and 2) Medicare Part D benefits. MAP plans and MAP-participating D-SNPs will apply the integrated grievance process described in 42 CFR § 422.630 to all plan-level grievances, whether relating to Medicare or to Medicaid. The plans will also apply the integrated coverage determination and reconsideration process described at 42 CFR § 422.629 and §§ 422.631 through 422.634. Any modifications to the grievance and plan-level appeals rules under 42 CFR §§ 422.629-422.634 will be consistent with the flexibilities available under those rules and are described in Appendix 3 to the MOU. For appeals subsequent to t
