Description

Explains what a Model of Care (MOC) document is and its requirements for Special Needs Plans (SNPs) to describe its targeted populations, how the SNP coordinates care, its provider network contracted to provide health care services, and its quality improvement goals and plan. Discusses requirements and changes for the Calendar Year (CY) submission and the process by which organizations submit a MOC for approval, including how NCQA is the reviewer of MOCs for the Centers for Medicare & Medicaid Services (CMS). Describes how MOCs are scored at initial submission, possible cure options available, and final approval statuses. Provides insights on the detail required when writing a comprehensive MOC.

Learning Objectives:

• Explain what a MOC is and the four major areas of focus that must be described in detail.
• Discuss the process for submitting an initial MOC, the cure process, the final approval statuses, and the role NCQA has in reviewing MOCs for CMS.
• Recall the timeline for submitting a renewal and new SNP MOC.
• Explain the level of detail required for writing a comprehensive MOC.

Length: 2 Hours

Price:

List Price for Non MHR Clients: $5,000

MHR Clients: [20% discount off List Price] $4,000