Medicaid Contract Purchasing Specifications
Cultural Competence
Language to implement a Contractor's duty to furnish covered services
to enrollees in a culturally competent manner has been consolidated into
one set of purchasing specifications (CC). These specifications are not
specific to children but apply to all enrollee groups. They reflect many
of the national standards on culturally and linguistically appropriate
health care services published by the Office of Minority Health of the
Department of Health and Human Services in December 2000. The illustrative
language is applicable to the delivery of both physical and behavioral
health services to children and other enrollee groups though either an
MCO or a Behavioral Health Organization (BHO). These cultural competence
purchasing specifications could be used as an appendix to a purchasing
agreement, or different parts, such as provisions relating to oral interpreter
services or provider training, may be incorporated into such agreements.
|
Purchasing Specification
|
Related Contract Language
|
|
CC
|
- §102 (enrollee information)
- §103 (oral interpreter
services)
- §104 (coverage determination
standards and procedures)
- §105 (provider network)
- §106 (quality measurement
and improvement)
- §107 (data collection
and reporting)
- §108 (administration)
- §109 (complaints and
grievances)
|
‡The "prime/prime" arrangement has two primary contractors—the
MCO and the BHO—to which the state purchaser makes capitation payments.
Under this arrangement, a child is enrolled in both the MCO and the BHO.
The "prime/subprime" arrangement involves one primary contractor
and a subcontractor. The state purchaser contracts with and makes capitation
payments to an MCO; the MCO, in turn, subcontracts with the BHO for the
provision of behavioral health services.
-
ACCESS = Access to
Services (July 2000)
-
CD = Child Development
Services (July 2000)
-
CW = Child Welfare
(December 2001)
-
CBHN = Children with
Behavioral Health Needs (December 2000)
-
CSHCN = Children with
Special Health Care Needs (August 2000)
-
CC = Cultural Competence
(Updated, November 2001)
-
DENTAL = Dental and
Oral Pediatric Health Services (March 2000)
-
IMMUN = Immunizations
(May 1998)
-
LEAD = Childhood Lead
Poisoning Services (November 1998)
-
MEDIPED = Medicaid Pediatric
Services (September 1999)
-
SBHC = School-Based Health
Center Services (January 2002)
-
SCHIP = SCHIP Pediatric
Services (April 2002)
|
