proceeding/litigation? Include your organization’s parent organization, affiliates, and subsidiaries in this response. E.4 Identify whether your organization has had any contract 10 listed in response to E.1 terminated or not renewed within the past five (5) years. If so, describe the reason(s) for the termination/nonrenewal, the parties involved, and provide the address and telephone number of the client; and If the contract was terminated/non-renewed, based on your organization’s performance, describe any action taken to prevent any future occurrence of the problem leading to the termination/non-renewal. Include your organization’s parent organization, affiliates, and subsidiaries in this response. E.5 Provide evidence of current accreditation by national 2 entity either URAC or NCQA for at least one state product – line listed in response to E.1. If you have national accreditation, have you ever had your accreditation status (e.g., NCQA) in any state for any product line adjusted down, suspended, or revoked? If so, identify the state and product line and provide an explanation. Include your organization’s parent organization, affiliates, and subsidiaries in this response. E.6 Provide as an attachment a copy of the most recent 3 external quality review report (pursuant to Section 1932(c)(2) of the Social Security Act) for the Medicaid contract identified in response to item B.1 E.1 of this section that had the largest number of enrollees as of January 1, 2014. Provide the entire report. In addition, provide a copy of any corrective action plan(s) requested of your organization as a result of this review.
proceeding/litigation? Include your organization’s parent organization, affiliates, and subsidiaries in this response. E.4 Identify whether your organization has had any contract listed in response to E.1 terminated or not renewed within the past five (5) years. If so, describe the reason(s) for the termination/nonrenewal, the parties involved, and provide the address and telephone number of the client; and If the contract was terminated/non-renewed, based on your organization’s performance, describe any action taken to prevent any future occurrence of the problem leading to the termination/non-renewal. Include your organization’s parent organization, affiliates, and subsidiaries in this response. 10 E.5 Provide evidence of current accreditation by national entity – either URAC or NCQA for at least one state product line listed in response to E.1. If you have national accreditation, have you ever had your accreditation status (e.g., NCQA) in any state for any product line adjusted down, suspended, or revoked? If so, identify the state and product line and provide an explanation. Include your organization’s parent organization, affiliates, and subsidiaries in this response. 2 E.6 Provide as an attachment a copy of the most recent external quality review report (pursuant to Section 1932(c)(2) of the Social Security Act) for the Medicaid contract identified in response to item B.1 E.1 of this section that had the largest number of enrollees as of January 1, 2014. Provide the entire report. In addition, provide a copy of any corrective action plan(s) requested of your organization as a result of this review. 3
AppendixKK.docx