60 Will the network adequacy be calculated for No, Network Adequacy reports will be members, versus child members? aggregated by provider type, MCO program, and county. 61 Will separate network adequacy reports be HHSC will conduct calculations for each MCO, calculated, depending on the program, and each program, and each county. Service Delivery Area? For example, STAR versus CHIP versus STAR Kids, and if the MCO Results will include full membership for STAR, holds contracts for several service area, would CHIP, STAR+PLUS, STAR Health, STAR Kids, it be STAR XXX SDA, STAR YYY SDA, STAR Kids and Children’s Dental Services. XXX SDA, etc. Below Questions Received After 6-12-17 MCO Notice Requesting Perceived Errors on Crosswalk, Technical Specifications 62 Regarding, the Prenatal requirement on Star Please see Provider Crosswalk distributed with Kids, can you please provide guidance on how the MCO notices for the week of June 12, the state will define provider type and any 2017 for which provider types and specialties parameters we need to be aware of? correspond to network adequacy requirements for prenatal care.
60 Will the network adequacy be calculated for members, versus child members? No, Network Adequacy reports will be aggregated by provider type, MCO program, and county. 61 Will separate network adequacy reports be calculated, depending on the program, and Service Delivery Area? For example, STAR versus CHIP versus STAR Kids, and if the MCO holds contracts for several service area, would it be STAR XXX SDA, STAR YYY SDA, STAR Kids XXX SDA, etc. HHSC will conduct calculations for each MCO, each program, and each county. Results will include full membership for STAR, CHIP, STAR+PLUS, STAR Health, STAR Kids, and Children’s Dental Services. Below Questions Received After 6-12-17 MCO Notice Requesting Perceived Errors on Crosswalk, Technical Specifications 62 Regarding, the Prenatal requirement on Star Kids, can you please provide guidance on how the state will define provider type and any parameters we need to be aware of? Please see Provider Crosswalk distributed with the MCO notices for the week of June 12, 2017 for which provider types and specialties correspond to network adequacy requirements for prenatal care.