Common use of Recipient Education Clause in Contracts

Recipient Education. (A) The STATE or the Local Agency, will inform Medical Assistance Recipients who reside in the Service Area of the options available in health care coverage. The STATE or Local Agency shall describe through presentations and/or written materials the various MCOs available to Enrollees in a particular geographic area. The STATE or Local Agency shall complete enrollment by obtaining the signature of Enrollees or their Authorized Representatives on the enrollment form. For MSHO, the MCO also may complete enrollment. For Enrollees in MSC+ who are assigned to an MCO, a signature will not be obtained. Tribal governments may assist the STATE or Local Agency in presenting or developing materials describing the various MCO options for their members. If the tribal government revises any MCO materials, the MCO may review them prior to distribution. If the MCO deems the revisions to be substantial, the MCO shall have thirty (30) days to respond to the tribal government and no MCO materials will be distributed until there is mutual agreement on the revisions. (B) Neither the STATE nor the Local Agency will distribute to Enrollees written educational materials which describe the MCO or its health care plan without providing reasonable notice and opportunity for review by the MCO. Any inaccuracies will be corrected prior to dissemination, but final approval by the MCO is not required. (C) This section does not prohibit the MCO or its subcontractors from providing information: (1) For MSHO, to Recipients eligible for MSHO for the purposes of educating Recipients about Provider choices available through the MCO, subject to the limitations in the Marketing Restrictions section. (2) For MSC+, to Recipients who are enrolled in the MCO for the purpose of educating Enrollees about Provider choices available through the MCO, subject to the limitations in the Marketing Restrictions section. (D) Local Agency staff and MCO staff shall make available to Recipients the information about Providers as specified in section 3.2.6(B).

Recipient Education. ‌ (A) The STATE or and the Local Agency, MCO will inform Medical Assistance Recipients who reside in the Service Area of the options available in health care coverage. The STATE or Local Agency MCO shall describe through presentations and/or written materials the various MCOs available to Enrollees Recipients in a particular geographic area. The STATE or STATE, Local Agency and/or MCO shall complete enrollment of Recipients by obtaining the signature of Enrollees Recipients or their Authorized Representatives on the enrollment form. For MSHO, the MCO also may complete enrollment. For Enrollees in MSC+ who are assigned to an MCO, a signature will not be obtained. Tribal governments may assist the STATE or Local Agency in presenting or developing materials describing the various MCO options for their members. If the tribal government revises any MCO materials, the MCO may review them prior to distribution. If the MCO deems the revisions to be substantial, the MCO shall have thirty (30) days to respond to the tribal government and no MCO materials will be distributed until there is mutual agreement on the revisions. (B) Neither the STATE nor the Local Agency will distribute to Enrollees written educational materials which describe the MCO or its health care plan without providing reasonable notice and opportunity for review by the MCO. Any inaccuracies will be corrected prior to dissemination, but final approval by the MCO is not required. (C) This section does not prohibit the MCO Enrollment Education. The MCO, or its subcontractors subcontractors, is not prohibited from providing information: (1) For MSHO, information to Recipients eligible for MSHO MnDHO for the purposes of educating Recipients about Provider choices available through the MCO, subject to the limitations in the Marketing Restrictions section. (2) For MSC+, to Recipients who are enrolled in the MCO for the purpose of educating Enrollees about Provider choices available through the MCO, subject to the limitations in the Marketing Restrictions sectionthis Contract. (D) Local Agency staff and MCO staff shall make available to Recipients Enrollees the information about Providers as specified in section 3.2.6(B3.2.10(B)(2). (E) If an Enrollee currently receives Community Alternative Care Waiver (CAC) services, the MCO shall inform the Recipients in writing that, by leaving CAC to enroll in MnDHO, the Recipient may not be able to later re-enroll back into CAC.