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Agency Communications to SMMC Plans

Applicable ONLY to SMMC Contracts Effective 2018-2023

2021
Ad Hoc Request for Encounter Data Validation (EDV) Study PT 2021-30 10/01/2021
Deadline Extension for Potentially Preventable Events and Potentially Preventable Dental-Related Emergency Department Visits Performance Improvement Projects (PIPs) PT 2021-29-R 09/17/2021
MMA Physician Incentive Program (MPIP) Requirements Year 6 PT 2021-28 09/03/2021
Achieved Savings Rebate (ASR) Dental Financial Report RCN 2021-12 09/02/2021
Achieved Savings Rebate (ASR) Financial Report RCN 2021-11 09/02/2021
Provider Complaint Notice of Status Requirements PT 2021-27 08/27/2021
Update to PT 2021-21: COVID-19 State of Emergency: COVID-19 Vaccine Administration Initiative PT 2021-26 08/19/2021
Coverage of Medication Assisted Treatment (MAT) Drugs PT 2021-25 07/23/2021
Medical Foster Care Services Report PT 2021-24 07/06/2021
Provider Satisfaction Survey PT 2021-23 06/23/2021
Health Insurance Provider Fee (IRS Form 8963) PT 2021-22 06/23/2021
COVID-19 State of Emergency: COVID-19 Vaccine Administration Initiative PT 2021-21 06/18/2021
COVID-19 State of Emergency: Ending Temporary Flexibilities PT 2021-20 06/18/2021
Hospital Terminations PT 2021-19 06/14/2021
Marketing/Public/Educational Events Report RCN 2021-10 06/09/2021
Screening, Brief Intervention, and Referral to Treatment (SBIRT) Procedure Codes Added Effective January 1, 2021 PT 2021-18 05/24/2021
Performance Measure Reporting Requirements Effective July 1, 2021
  • Policy Transmittal: 2021-17 [106KB PDF]
  • Attachment 1: Performance Measure Summary Report - redline [132KB PDF]
  • Attachment 2: Performance Measure Report File Layout [60 KB Excel]
    Plans notified via email this report template updated 6/16/2021: The following technical corrections were made to the ‘0210 SUB-MEASURE ABBREV DESC’ tab, (1) the Sub-Measure abbreviation for ‘Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (all three components) were updated to match the sub-measure group descriptions for the different age groups (cell C153, C154, C156, C157, C159, and C160); (2) For the Ambulatory Care (AMBa) measure, there were two different age groups in one cell. A change was made to remove the incorrect age group in Cells D26 and D27; On the ‘0211 SUB-MEASURE ABBREV DESC’ tab an update was made to correct the comma misplacement on measures calculated using member months. All instances for these measures now read “Per 100,000 member months”.
    Plans notified via email this report template updated 6/9/2021: A technical correction was made to the ‘0211 SUB-MEASURE ABBREV DESC’ tab; the Sub-Measures abbreviation for ‘All Women Ages 21 to 44 who were provided a long-acting reversible method of contraception (LARC)’ (cell C44) was updated to ccwadlarc.

PT 2021-17 05/18/2021
Well Child Visit Report RCN 2021-09 05/17/2021
Update to PT 2021-09: Updated MMA Physician Incentive Program (MPIP) Requirements Year 5 Effective January 1, 2021 and Delayed Submission of MPIP Year 6 Proposals PT 2021-16 05/17/2021
SMMC Contract Submission Requirements PT 2021-15 05/13/2021
Electronic Visit Verification (EVV) Requirements PT 2021-14 05/05/2021
Non-Discrimination Compliance Requirements PT 2021-13 05/04/2021
Ad Hoc Request for EVV Personal Care Procedure Codes PT 2021-12 04/26/2021
Integrated Behavioral Health Care Survey PT 2021-11 04/15/2021
COVID-19 State of Emergency: Non-Emergency Transportation Services for Vaccine Transportation CI 2021-01 04/08/2021
Update to PT 2020-71-R: COVID-19 State of Emergency: Vaccine Administration PT 2021-10 04/07/2021
Updated MMA Physician Incentive Program (MPIP) Requirements Year 5 Effective January 1, 2021 and Delayed Submission of MPIP Year 6 Proposals PT 2021-09 03/25/2021
Non-Emergency Transportation Timeliness Report RCN 2021-08 03/19/2021
Marketing Agent Status Report RCN 2021-07 03/19/2021
Update on PT 2020-61 Ad Hoc Request for Real Time Reporting of Private Duty Nursing (PDN) Issues Report PT 2021-08 03/04/2021
Managed Care Plan Training Report PT 2021-07 03/04/2021
MMA Performance Measures with Race/Ethnicity Stratification Reporting Effective July 1, 2021 PT 2021-06 02/22/2021
Capitation Adjustments for Unauthorized Programs or Activities PT 2021-05 02/15/2021
Durable Medical Equipment and Medical Supplies Benefit PT 2021-04 02/08/2021
Update to PT 2020-67 Annual Performance Improvement Projects (PIPs) Deadline Extension for Potentially Preventable Events (PPE) Report PT 2021-03 01/29/2021
Update to PT 2020-70: Ad Hoc Request for Weekly Home Health Electronic Visit Verification (EVV) Reports PT 2021-02 01/29/2021
Quarterly Fraud and Abuse Activity Report RCN 2021-06 01/22/2021
Suspected/Confirmed Waste Report RCN 2021-05 01/21/2021
Enrollee Complaints, Grievances & Appeals Report RCN 2021-04 01/15/2021
Provider Complaint Report RCN 2021-03 01/15/2021
Denied/Suspended/Terminated Provider Report RCN 2021-02 01/15/2021
Annual Fraud and Abuse Activity Report RCN 2021-01 01/15/2021
Dental Performance Measures and Reporting Requirements for July 1, 2021 Reporting PT 2021-01 01/05/2021

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