CCO Contract Forms Archive

Financial Reports

Other Reports

To view documents from past contract years, click the "Effective Date" field to display documents and due dates for a specific contract year.

For documents from older contract years, email the CCO Contract Administrator.

Category	Effective date	URL
Other Reports	6/2/2023	Member Handbook CCO Model Handbook 2024
Other Reports	6/2/2023	Member Handbook Submission and Review Guidelines 2024
Other Reports	6/2/2023	Member Handbook CCO Model Member Handbook Redline Changes List 2024
Other Reports	6/2/2023	Member Handbook Evaluation Criteria 2024
Other Reports	1/30/2023	IIBHT Quarterly Report Template 2023
Other Reports	1/27/2023	Hep C DAA CY 2022 Case Management Data Template
Other Reports	12/28/2022	PCPCH Reporting - Reference Copy, 12-2022
Other Reports	11/30/2022	Personal Injury Liens Policies and Procedures Evaluation Criteria, 11-2022
Other Reports	11/30/2022	Personal Injury Liens Requirements - Policy and Procedure Guidance , 11-2022
Other Reports	11/17/2022	EPSDT Guidance, 11-17-2022
Other Reports	9/20/2022	MCE Nondiscrimination Statement Checklist
Other Reports	9/20/2022	Member Notice Template Evaluation Criteria_2022
Other Reports	9/8/2022	Affiliated Medicare Advantage Plan Report, 09-2022
Other Reports	9/8/2022	Affiliated Medicare Advantage Plan Guidance, 09-2022
Other Reports	9/6/2022	Member Handbook Evaluation Criteria_Final 2023
Other Reports	9/6/2022	Member Handbook CCO Model Handbook_Final 2023
Other Reports	8/15/2022	Grievance and Appeals Log, 08-2022
Other Reports	8/15/2022	Grievance System Report, 08-2022
Other Reports	8/15/2022	Grievance System Reporting Instructions, 08-2022
Other Reports	8/11/2022	THW Deliverables Instructions and Plan Update Template, 08-2022
Other Reports	8/11/2022	THW Deliverables Guidance and Evaluation Criteria, 08-22
Other Reports	8/11/2022	THW Integration and Utilization Data Report Template, 08-2022
Other Reports	8/8/2022	NOABD and Prior Authorization sample evaluation criteria, 08-2022
Other Reports	8/1/2022	Comprehensive Behavioral Health Plan Progress Report Evaluation Criteria, 04-2022
Other Reports	6/1/2022	Member Handbook Submission and Review Guidelines_Final 2023
Other Reports	6/1/2022	NEMT Rider Guide Submission and Review Guidelines 2023
Other Reports	6/1/2022	NEMT Rider Guide_Evaluation Criteria_Final 2023
Other Reports	5/31/2022	Quality Pool Distribution Plan Template, 05-2022
Other Reports	5/26/2022	Care Coordination Report Template, 05-2022
Other Reports	5/26/2022	Comprehensive Behavioral Health Plan Evaluation Criteria and Guidance Document Crosswalk, 05-2022

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