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UNIFORM MANAGED CARE MANUAL

UNIFORM MANAGED care MANUAL . CHAPTER Deliverables Requirements Matrix Version Effective Date: June 25, 2021. Applicability of Chapter This chapter applies to MANAGED care Organizations (MCOs) participating in the STAR, STAR+PLUS [including the Medicare-Medicaid Dual Demonstration (MMDD)], CHIP, STAR Health, and STAR Kids Programs, and Dental Contractors providing Children's Medicaid and CHIP Dental Services to Members through dental health plans. In this chapter, references to CHIP or the CHIP MANAGED care Program(s) apply to the CHIP Program and the CHIP Dental Contractors. References to Medicaid or the Medicaid MANAGED care Program(s) apply to the STAR, STAR+PLUS, STAR Health, and STAR Kids Programs, and the Medicaid Dental Contractors. The term MCO includes health maintenance organizations (HMOs), exclusive provider organizations (EPOs), insurers, Dental Contractors, Medicare-Medicaid Plans (MMPs), and any other entities licensed or approved by the Texas Department of Insurance. A deliverable listed below applies to the MMPs if (1) a specific MMDD contract section number is included in the Contract Reference column, or (2) if no MMDD contract section is cited, the applicable UMCM chapter listed specifically includes the MMDD.

UMCM Deliverable Template Chapters UMCM Chapter(s) or Section Deliverable Name Deliverable Description Contract References Report Frequency:

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  Manual, Care, Managed, Deliverable, Ummc, Managed care manual, Umcm deliverable

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