Health Information System i. As required by 42 CFR 438.242(a), the MCP shall maintain a health information system that collects, analyzes, integrates, and reports data. The system shall provide information on areas including, but not limited to, utilization, grievances and appeals, and MCP membership terminations for other than loss of Medicaid eligibility.
Health Information System. The Contractor shall maintain a health information system that collects, analyzes, integrates, and reports data. The system must provide information on areas including, but not limited to, utilization, grievances and appeals, and disenrollment for other than loss of Medicaid eligibility. The Contractor must collect data on Enrollee and provider characteristics i.e. trimester of enrollment, tracking of appointments kept and not kept, place of service, provider type, and make all collected data available to the Division, to CMS, to the Mississippi Department of Insurance, and to any other oversight agency of the Division.
Health Information System. Provider shall implement a documented health information system and a privacy security program that includes administrative, technical and physical safe guards designed to prevent the accidental or unauthorized use or disclosure of client PHI and medical records. The information system and the privacy and security program shall, at a minimum, comply with applicable HIPAA regulations regarding the privacy and security of PHI, including but not limited to 42 CFR § 438.242; 45 CFR § 164.306(a); and 45 CFR § 162.200 as well as the HIPAA privacy provisions in Title 13 of the American Recovery and Reinvestment Act of 2009 (“ARRA”). Provider shall adhere to requirements specified in Exhibit A, Data Security.
Health Information System. The Contractor shall maintain a health information system or systems consistent with the requirements established in the Contract, the objectives of 42 C.F.R. Part 438, Subpart D, including 42 C.F.R. § 438.242, and that supports all aspects of the QI Program. Marketing, Outreach, and Enrollee Communications Standards General Marketing, Outreach, and Enrollee Communications Requirements The Contractor is subject to rules governing marketing and Enrollee Communications as specified under section 1851(h) of the Social Security Act, 42 C.F.R. §422.111, §422.2260 et. seq., §423.120(b) and (c), §423.128, §423.2260 et. seq., and § 438.10, and §438.104; the Medicare Communications and Marketing Guidelines as updated from time to time, and the Medicare‑Medicaid marketing guidance, with the following exceptions or modifications: The Contractor must refer Enrollees and Eligible Beneficiaries who inquire about Capitated Financial Alignment Model eligibility or enrollment to the enrollment broker, although the Contractor may provide Enrollees and Eligible Beneficiaries with information about the Contractor’s plan and its benefits prior to referring a request regarding eligibility or enrollment to the enrollment broker; The Contractor must make available to CMS and EOHHS, upon request, current schedules of all educational events conducted by the Contractor to provide information to Enrollees or Eligible Beneficiaries; The Contractor must convene all educational and marketing/sales events at sites within the Contractor’s Service Area that are physically accessible to all Enrollees or Eligible Beneficiaries, including persons with disabilities and persons using public transportation. The Contractor must distribute all materials to its entire Service Area. The Contractor may not offer financial or other incentives, including private insurance, to induce Enrollees or Eligible Beneficiaries to enroll with the Contractor or to refer a friend, neighbor, or other person to enroll with the Contractor; The Contractor may not directly or indirectly conduct door‑to‑door, telephone, email, texting, or other unsolicited contacts (with the exception of direct mail, which is permissible); Calls made by the Contractor to Medicare‑Medicaid eligible individuals enrolled in the Contractor’s other product lines, are not considered unsolicited direct contact and are permissible. Therefore, as provided in the Medicare Communications and Marketing Guidelines and the Medicare‑Medicaid marketing...
Health Information System. Pursuant to Title 42, CFR, Section 438.242 and consistent with Title 9, CCR, Section 1810.376, the Contractor shall maintain a health information system that collects, analyzes, integrates, and reports data. The system shall provide information on areas including, but not limited to, utilization, grievances, and appeals. The Contractor’s health information system shall, at a minimum: