Transcript CMS MOC Training Slides

Special Needs Plans
Medicare and Medicaid Plans
CY 2015 Model of Care Submission Training
January 21, 2014
Susan Radke
Model of Care Submission
• 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
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
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, 2012 - December 31, 2014. The plan
must submit a MOC by February 25, 2014.
MOC Approval Period
YEAR
January 1, 2012 through December 31, 2012
1
January 1, 2013 through December 31, 2013
2
January 1, 2014 through December 31, 2014
3
Model of Care Submission
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, 2013 - December 31, 2014. The plan
must submit a MOC for review and approval by February 25, 2014.
MOC Approval Period
YEAR
January 1, 2013 – December 31, 2013
1
January 1, 2014– December 31, 2014
2
Model of Care Submission
• 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
Questions
SNP MOC questions contact:
[email protected]
MMP MOC questions contact:
[email protected]