Medicaid HMO Provider-Related Information

Forms:
Involuntary Disenrollment Form (pdf)

2008 Templates:
Financial
Grievance and Appeals
Claims Aging
Child Health Check-UP (2006-2007)

Contract Information:

MEDICAID REFORM CONTRACT INFORMATION

SPECIAL NOTE:   The 2006-2009 HMO Medicaid Contract begins September 1, 2006 and is a three (3) year contract.

Medicaid HMO Contract 2006-2009 (Pdf files)

Amended Contract: (December 2007)
     Standard Contract
     Attachment I: Scope of Services
     Attachment II: Online with Interactive Table of Contents (General Contract)
     Attachments III - V were not amended
     
Original Contract
    Standard Contract
    Attachment I: Scope of Services
    Attachment II: Online with Interactive Table of Contents (General Contract)
    Attachment III: Business Associate Agreement
    Attachment IV: Lobbying
    Attachment V: Debarment Form

Medicaid Prepaid Dental Health Plan Contract:

Standard Contract
Attachment I: Scope of Services  
Attachment II: Business Associate Agreement
Attachment III: Lobbying
Attachment IV: Debarment Form
Attachment V: Subcontractor Utilization Report Form

            NOTE: Please be advised that the online version of the 2006-2009 Medicaid Prepaid Dental Health Plan Contract will not contain general amendments. As a general amendment is posted it should be printed and incorporated into the contract.

Prior Contracts:

Capitation Information

Medicaid HMO Capitation Rates for 2007-2008 Conract Year
Medicaid HMO Capitation Rates for 2006-2007 Contract Year
Medicaid HMO Capitation Rates for 2005-2006 Contract Year
Medicaid HMO Capitation Rates for 2004-2005 Contract Year
Medicaid HMO Capitation Rates for 2003-2004 Contract Year
Medicaid HMO Capitation Rates for 2002-2003 Contract Year
Medicaid HMO Capitation Rates for 2001-2002 Contract Year
Medicaid HMO Capitation Rates for 2000-2001 Contract Year
Medicaid HMO Capitation Rates for 1999-2000 Contract Year

All provider handbooks are available online on the Consultec web site.

Policy Transmittals

2008

2007

Transmittal Archives:

2006 Policy Transmittals Archive
2005 Policy Transmittals Archive
2004 Policy Transmittals Archive
2003 Policy Transmittals Archive
2002 Policy Transmittals Archive
2001 Policy Transmittals Archive
2000 Policy Transmittals Archive
1999 Policy Transmittals Archive

In June of 1999, Policy Transmittal 99-03 described the Vaccines for Children Program (VFC) and its relationship to Title XXI Medikids. This policy statement also addressed billing options. In May of 2001, a revision was published in Policy Transmittal 01-07. Now there is only one billing option: Direct service providers must bill Medicaid fee-for-service. For a copy of the reimbursement rates that apply when providers supply immunizations to Medicaid HMO-enrolled MediKids, access the document titled Immunization Codes for HMOs, HCPCs 2001. You will also find other useful information at this MediKids Publications site.

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