Mo healthnet managed care policy statements table of contents



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PURPOSE

The purpose of the Communication Plan is to facilitate communication between the State agency and the MO HealthNet Managed Care health plans for business functions and requirements under the contract. This plan addresses communication with the units responsible for compliance, enrollment, marketing and member education, quality and systems issues.


Please note that the process for submitting all reports required under the contract are addressed in Reporting Requirements located and periodically updated on the MO HealthNet Website at Reporting Requirements (http://dss.mo.gov/business-processes/managed-care/reporting-requirements.pdf)


PROCESS



Communication by email should be directed to the staff indicated in the Communication Plan. Communication by postal or delivery service or phone should be made to:
Staff Name

MO HealthNet Managed Care

P.O. Box 6500

Jefferson City, MO 65102-6500
For Fed Ex deliveries:

615 Howerton Court

Jefferson City, MO 65109
MO HealthNet Managed Care Phone Numbers

Main Number: (573) 526-4274

Fax: (573) 526-3946

COMPLIANCE
Requests for MO HealthNet Policy Clarification

MO HealthNet Managed Care health plans may have questions regarding MO HealthNet policy. Please direct your questions via email to the liaison within MHD to facilitate a response to your question unless otherwise directed.


Please define your request and its purpose. Provide any beneficial background information. Attach examples and supporting documentation when appropriate. A sample template for submission of such requests is provided on the next page. Please address your questions to the following staff assigned to each health plan.
Julie Pace

Julie.A.Pace@dss.mo.gov

(573) 526-4274

Aetna Better Health of Missouri

Sandra Talken



Sandra.L.Talken@dss.mo.gov

(573) 526-4274

Missouri Care
Kelly Connell

Kelly.Connell@dss.mo.gov

(573) 526-4274

Home State Health Plan


MO HealthNet MANAGED CARE

HEALTH PLAN POLICY CLARIFICATION REQUEST



Title of Request:

Define the request and purpose. State any beneficial background information. Attach examples and supporting documentation when appropriate.


Requestor


Health Plan

Tele No

Fax

Email

Date



ENROLLMENT ISSUES

Member enrollment questions should be directed to:


Renee Riley

Laverna.R.Riley@dss.mo.gov

(573) 526-5741

MARKETING AND MEMBER EDUCATION MATERIALS

Direct all marketing and member education submissions, requests for additional benefits or incentive programs to the Marketing Unit at MHD.MCMarketing@dss.mo.gov Additional contact information for the Marketing Unit is:


Brenda Shipman

MHD.MCMarketing@dss.mo.gov

(573) 751-9290

Fax: (573) 526-3946
Prior to submission of marketing and educational materials, review internally to ensure the following guidelines are met:


  • In your email, provide the following information:

    • How the submission will be used.

    • The timeframe for using the submission.

    • The type of media that will be used for distributing the submission.

  • Use the same title and tracking number in the subject line of your email for any correspondence regarding that submission.

  • Ensure the submission complies with all contract requirements including all of Section 2.13, Marketing and Member Education.

  • Ensure the submission complies with Missouri Mandatory Language.

  • Submit the piece in a format that can be electronically edited to the extent possible (Word, Excel, and Adobe).

  • Provide proof of reading level.

  • Maintain all comments made by the State as well as the health plan until the final submission is approved.

  • When resubmitting a piece, indicate any new language.

  • Ensure that the submission is Missouri specific and health plan specific. Any submissions that reference other states or other health plans will be denied.

  • Use “Medicaid” only when referring to the federal Medicaid program.

  • Use “MO HealthNet” when referring to the State of Missouri Medicaid program.

  • Health plans may use the term “doctor” when referring to the primary care provider. We prefer that you use “primary care provider” but will no longer deny “doctor”.

  • Health plans may use the term “free” when referring to items such as free pamphlets or educational booklets.

  • Health plans must comply with contract provision 2.13.3.g and may not portray covered benefits as enhanced, additional or free.

  • See new guidelines for approval of non-English versions of marketing/member education.

  • See guidelines for requesting expedited reviews.
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