Instructions to Health Plans are subject to the notice requirements under Section 1557 of the Affordable Care Act. For more information, refer to [If do not use the term Services”, plans should replace it with “Member the term the plan uses.] [Where the template instructs inclusion of a phone number, plans must ensure it is a toll-free number and include a toll-free TTY/TDD number and days and hours of operation.] [Plans should note that the EOC is referred to as the Handbook”. “Member If plans do not use the term Handbook,” plans should replace it with “Member the term the plan uses.] should include all drugs/items covered under the Part D and Medicaid pharmacy benefits. This includes only those drugs on plans’ approved Part D formulary and approved Additional Demonstration Drug (ADD) file. Plans may not include OTC drugs and/or items offered as a plan supplemental benefit that are in excess of Medicaid-required OTC drugs and/or items.] [Plans may place a QR code on materials to provide an option for members to go online.] [Plans have the option of deleting the footer following the introduction (e.g., the footer is not necessary in the actual list of drugs)] [Plans may add a Table of Contents to this document.]
Instructions to Health Plans are subject to the notice requirements under Section 1557 of the Affordable Care Act. For more information, refer to [If do not use the term “Member Services”, plans should replace it with the term the plan uses.] [Where the template instructs inclusion of a phone number, plans must ensure it is a toll-free number and include a toll-free TTY/TDD number and days and hours of operation.] [Plans should note that the EOC is referred to as the “Member Handbook”. If plans do not use the term “Member Handbook,” plans should replace it with the term the plan uses.] should include all drugs/items covered under the Part D and Medicaid pharmacy benefits. This includes only those drugs on plans’ approved Part D formulary and approved Additional Demonstration Drug (ADD) file. Plans may not include OTC drugs and/or items offered as a plan supplemental benefit that are in excess of Medicaid-required OTC drugs and/or items.] [Plans may place a QR code on materials to provide an option for members to go online.] [Plans have the option of deleting the footer following the introduction (e.g., the footer is not necessary in the actual list of drugs)] [Plans may add a Table of Contents to this document.]
OHLOCD2018.docx