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NEW YORK STATE DEPARTMENT OF HEALTH, OFFICE OF HEALTH INSURANCE PROGRAMS
Guidance for Required Changes to Final Adverse Determination Notices
I. Purpose
To provide guidance to Mainstream Managed Care
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What is 42 cfr 438 mmc?
42 CFR 438 MMC refers to the federal regulation that outlines the requirements for Medicaid managed care programs, specifically the standards for care and services provided to Medicaid beneficiaries.
Who is required to file 42 cfr 438 mmc?
Medicaid managed care organizations (MCOs) that operate under Medicaid programs are required to comply with the requirements set forth in 42 CFR 438 MMC.
How to fill out 42 cfr 438 mmc?
Filling out 42 CFR 438 MMC typically involves completing specific forms that detail the managed care organization's compliance with the regulations, including reporting on services provided, quality measures, and other relevant data.
What is the purpose of 42 cfr 438 mmc?
The purpose of 42 CFR 438 MMC is to ensure that Medicaid beneficiaries receive high-quality managed care services and that MCOs meet standards for access, quality, and financial accountability.
What information must be reported on 42 cfr 438 mmc?
Information required includes data on service utilization, quality measures, beneficiary complaints, and compliance with state and federal regulations.
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