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Contents  \nSECTION 1.0 SCOPE OF CONTRACT ................................................................................................................. 9  \n1.1 APPLICABLE LAWS, REGULATIONS, AND INTERPRETATIONS ......................................................................9  \n1.2 COMMITMENT TO DEPARTMENT GOALS FOR DELIVERY SYSTEM REFORM AND PAYMENT TRANSFORMATION ................................................................................................................................................. 10  \n1.3 DEPARTMENTAL MEETINGS ..................................................................................................................... 10  \nSECTION 2.0 REQUIREMENTS PRIOR TO OPERATIONS .................................................................................. 11  \n2.1 ORGANIZATIONAL STRUCTURE ................................................................................................................. 11  \n2.2 READINESS REVIEW ..................................................................................................................................13  \n2.3 LICENSURE ................................................................................................................................................ 14  \n2.4 CERTIFICATION OF QUALITY ..................................................................................................................... 14  \n2.5 NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) ACCREDITATION .........................................15  \n2.6 DUAL ELIGIBLE SPECIAL NEEDS PLAN (D-SNP) .......................................................................................... 15  \n2.7 BUSINESS ASSOCIATE AGREEMENT (BAA) ................................................................................................ 16  \n2.8 AUTHORIZATION TO CONDUCT BUSINESS IN THE COMMONWEALTH .....................................................17  \n2.9 CONFIDENTIALITY STATUTORY REQUIREMENTS ...................................................................................... 17  \n2.10 DISCLOSURE OF OWNERSHIP AND CONTROL INTEREST ...........................................................................18  \n2.11 PROHIBITED AFFILIATIONS WITH ENTITIES DEBARRED BY FEDERAL AGENCIES .......................................20  \n2.12 EXCLUDED ENTITIES ..................................................................................................................................21  \n2.13 CONTRACTOR COMPLIANCE PROGRAM ...................................................................................................21  \nSECTION 3.0 ENROLLMENT AND ASSIGNMENT PROCESS .............................................................................. 23  \n3.1 ELIGIBILITY AND ENROLLMENT RESPONSIBILITIES ...................................................................................23  \n3.2 CCC PLUS ENROLLMENT PROCESS ............................................................................................................26  \nSECTION 4.0 BENEFITS AND SERVICE REQUIREMENTS .................................................................................. 36  \n4.1 GENERAL BENEFITS PROVISIONS ..............................................................................................................36  \n4.2 BEHAVIORAL HEALTH SERVICES ................................................................................................................36  \n4.3 DENTAL AND RELATED SERVICES ..............................................................................................................50  \n4.4 EARLY AND PERIODIC SCREENING, DIAGNOSTIC, AND TREATMENT (EPSDT) ..........................................52  \n4.5 EARLY INTERVENTION (EI) ................................","cbCaiporYaQKAWxe","https://ap.wps.com/l/cbCaiporYaQKAWxe","pdf",5384433,551,"English","# SECTION 1.0 SCOPE OF CONTRACT\n## 1.1 APPLICABLE LAWS, REGULATIONS, AND INTERPRETATIONS\n## 1.2 COMMITMENT TO DEPARTMENT GOALS FOR DELIVERY SYSTEM REFORM AND PAYMENT TRANSFORMATION\n## 1.3 DEPARTMENTAL MEETINGS\n# SECTION 2.0 REQUIREMENTS PRIOR TO OPERATIONS\n## 2.1 ORGANIZATIONAL STRUCTURE\n## 2.2 READINESS REVIEW\n## 2.3 LICENSURE\n## 2.4 CERTIFICATION OF QUALITY\n## 2.5 NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) ACCREDITATION\n## 2.6 DUAL ELIGIBLE SPECIAL NEEDS PLAN (D-SNP)\n## 2.7 BUSINESS ASSOCIATE AGREEMENT (BAA)\n## 2.8 AUTHORIZATION TO CONDUCT BUSINESS IN THE COMMONWEALTH\n## 2.9 CONFIDENTIALITY STATUTORY REQUIREMENTS\n## 2.10 DISCLOSURE OF OWNERSHIP AND CONTROL INTEREST\n## 2.11 PROHIBITED AFFILIATIONS WITH ENTITIES DEBARRED BY FEDERAL AGENCIES\n## 2.12 EXCLUDED ENTITIES\n## 2.13 CONTRACTOR COMPLIANCE PROGRAM\n# SECTION 3.0 ENROLLMENT AND ASSIGNMENT PROCESS\n## 3.1 ELIGIBILITY AND ENROLLMENT RESPONSIBILITIES\n## 3.2 CCC PLUS ENROLLMENT PROCESS\n# SECTION 4.0 BENEFITS AND SERVICE REQUIREMENTS\n## 4.1 GENERAL BENEFITS PROVISIONS\n## 4.2 BEHAVIORAL HEALTH SERVICES\n## 4.3 DENTAL AND RELATED SERVICES\n## 4.4 EARLY AND PERIODIC SCREENING, DIAGNOSTIC, AND TREATMENT (EPSDT)\n## 4.5 EARLY INTERVENTION (EI)\n## 4.6 EMERGENCY AND POST-STABILIZATION SERVICES\n## 4.7 LONG TERM SERVICES AND SUPPORTS\n## 4.8 PHARMACY SERVICES\n## 4.9 TELEMEDICINE AND TELEHEALTH SERVICES\n## 4.10 NON-EMERGENCY MEDICAL TRANSPORTATION SERVICES\n## 4.11 CARVED OUT SERVICES\n## 4.12 STATE PLAN SUBSTITUTED (IN LIEU OF) SERVICES\n## 4.13 ENHANCED BENEFITS\n## 4.14 SERVICES RELATED TO FEDERAL MORAL/RELIGIOUS OBJECTIONS\n## 4.15 TRANSLATION & INTERPRETER SERVICES\n## 4.16 MEDICAID WORKS\n## 4.17 ACA MINIMUM ESSENTIAL BENEFITS FOR MEDICAID EXPANSION POPULATION\n## 4.18 FOSTER CARE AND ADOPTION ASSISTANCE CHILDREN","[{\"question\":\"What is the contract time period for CCC Plus?\",\"answer\":\"The CCC Plus contract period runs from July 1, 2020 to June 30, 2021.\"},{\"question\":\"What pre-operation requirements are specified before the contractor begins operations?\",\"answer\":\"The contract table of contents includes readiness review, licensure, certification of quality, NCQA accreditation, D-SNP planning, a business associate agreement, authorization to conduct business in the Commonwealth, confidentiality requirements, ownership/control disclosure, prohibited affiliations, excluded entities, and a contractor compliance program.\"},{\"question\":\"Which benefit and service areas are covered in the CCC Plus model of care section?\",\"answer\":\"The table of contents lists behavioral health, dental services, EPSDT, early intervention, emergency and post-stabilization services, long-term services and supports, pharmacy, telemedicine/telehealth, non-emergency medical transportation, carved-out and substituted services, enhanced benefits, translation and interpreter services, Medicaid Works, and specific foster care and adoption assistance populations.\"}]","Commonwealth Coordinated Care Plus MCO Contract for Managed Long Term Services and Supports - July 1, 2020 - June 30, 2021 | PDF",1789590093,193]