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

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, 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

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

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

SNP MOC questions contact: MMP MOC questions contact: Questions