Source: https://healthlaw.org/resource/medicaid-sunshine-and-accountability-listing-of-requirements-for-information/
Timestamp: 2019-04-26 11:48:12+00:00

Document:
This paper describes requirements on managed care organizations (MCO) regarding information collection and reporting.
in a format that may be easily understood.? 42 C.F.R. § 438.10(b)(1).
limited or have limited reading proficiency. 42 C.F.R. § 438.10(d)(1).
information upon request.? 42 C.F.R. § 438.10(e).
42 U.S.C.§ 1396u-2(b)(5); 42 C.F.R. § 438.207.
that ensures continuity of care and adequate primary care and specialized services capacity.?
and non-clinical areas and that measure performance objectively. 42 C.F.R. §§ 438.240(b), (d).
when requested.? 42 C.F.R. § 438.364(b).
(currently 80 percent of children should be screened).
care. 42 U.S.C. § 1397hh(e)(2).
NOTE: HEDIS measures do not necessarily comply with the Medicaid requirements.
second birthday. Morever, HEDIS did not even include this measure until 2008.
hearing decisions must be publicly available. 42 C.F.R. § 431.))).
may include the agreement between the company and the state Medicaid agency.
statements and provides a picture of the company?s ongoing financial situation.
information could describe a recent acquisition or major litigation involving the company.
executive compensation and board of director membership.
1 www.ncqa.org/LinkClick.aspx?fileticket=ClkKqM0a%2Bfk%3D (accessed Dec. 30, 2009).
3 The medical cost ratio, is also called the medical loss ratio, medical care ratio, or benefit ratio.

References: § 438
 § 438
 § 438
 § 438
 § 438
 § 1397
 § 431