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Special Needs Plans Medicare and Medicaid Plans CY 2015 Model of Care Submission Training January 21, 2014 Susan Radke.

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Presentation on theme: "Special Needs Plans Medicare and Medicaid Plans CY 2015 Model of Care Submission Training January 21, 2014 Susan Radke."— Presentation transcript:

1 Special Needs Plans Medicare and Medicaid Plans CY 2015 Model of Care Submission Training January 21, 2014 Susan Radke

2 All Models of Care (MOC) are submitted via the Health Plan Management System (HPMS) Online Application User’s Manual SNP Upload Guide MOC Upload Matrix Document (revised)  Follow the MOC Upload Matrix format to develop your MOC narrative for NCQA review  No appendices, attachments, or additional documentation needed  Be clear and concise Model of Care Submission

3 How will I know if my MOC is due during the 2015 application submission timeframe? All one-year MOC approvals are due to submit a MOC with the CY 2015 application All service area expansion (SAE) applications require a MOC submission, which is due with the CY 2015 SAE application HPMS will signal if a MOC submission is required Model of Care Submission

4 Multi-year Approvals Three year approval period If the MOC approval start date is January 1, 2012, the 3-year approval period is January 1, December 31, The plan must submit a MOC by February 25, Model of Care Submission MOC Approval PeriodYEAR January 1, 2012 through December 31, January 1, 2013 through December 31, January 1, 2014 through December 31, 20143

5 Multi-year Approvals Two year approval period If the MOC start approval date is January 1, 2013, the 2-year approval period is January 1, December 31, The plan must submit a MOC for review and approval by February 25, Model of Care Submission MOC Approval PeriodYEAR January 1, 2013 – December 31, January 1, 2014– December 31, 20142

6 All MOC approvals and approval periods apply to the Contract Number/type/subtype and not to Plan Benefit Packages (PBPs) Check HPMS to determine if your MOC submission is due for the CY 2015 application year via the following link: HPMS Home Page>Contract Management>Basic Contract Management>Select Contract Number>Submit Application Data The MOC Renewal Application information appears on the last screen Model of Care Submission

7 SNP MOC questions contact: MMP MOC questions contact: Questions


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