Process and Implementation

Changes in language describing covered benefits, as found in Medicaid contracts with MCOs/ACOs:

• Documentation of change in coverage benefits for evidence-based treatments, leading to a new or enhanced Medicaid service/benefit, compared to prior language describing benefits.

Changes in language describing covered benefits, as found in State Plan Amendments, Section 1115 waiver letters, or documents that give notice of administrative changes to covered benefits (example: annual notice of requirements or other relevant documents).

Based on state activities

Promotion of benefits – Promoting benefits to providers and enrollees.

Provider education – Provider resources on billing and coding.

Based on state activities

Communication – Increased frequency and alignment of communication between state public health and Medicaid agencies, including regular meetings around joint goals.

Coordination – Increased coordination between agencies around activities for promotion, programming, data collection and use, etc.

Staff – Dedicated staff members (e.g., liaison between agencies).

Data sharing – Data sharing agreements.

Understanding – Increased understanding of partner agency’s operations and processes.

Based on state activities