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Healthy Families Program and the health plans delivering the C-CHIP services are the same health plans. Thus, the information produced for the Healthy Families Program will be reflective of the quality of services provided for C-CHIP. 7.2. Describe the methods used, including monitoring, to assure: (2102(a)(7)(B)) (42CFR 457.495) The enabling statute for the Healthy Families program requires MRMIB to contract with a broad range of health plans in providing services to subscribers participating in the purchasing pool. MRMIB has used this strategy in contracting for health services in the HIPC and currently contracts with 20 health plans that provide HIPC subscribers access to 84% of California’s licensed practicing physicians. The Healthy Families Program will similarly contract with a large number of health plans to maximize enrollee choice of plans and providers within their communities. The program has also been structured to encourage participation of traditional and safety net providers who have been serving many of the low-income uninsured. The program components to encourage participation are detailed in Section 3. MRMIB will also take a number of steps to monitor access to covered services. Some of these are: • MRMIB will monitor the ongoing status of health plans with their regulators to assure quality services are available to subscribers. • MRMIB will use plan enrollment and disenrollment reports as a early warning signal of access problems with a health plan. All families choosing to switch their child from one health plan to another will be surveyed to find out why they are requesting a plan change. This survey will alert MRMIB staff to family concerns regarding access to specialty care, wait time for appointments, provider network instability or other access related barriers. • CHDP and CCS services are monitored through authorization of services and claims review by county CHDP and CCS programs. County staff can serve an important role in training, and review of service provision. Effective Date: Approval Date: November 1, 2009 HFP Family Contribution Increase November 1, 2009 HFP Co-Payment Increase November 1, 2009 HFP Limited Dental Plan Choice for New Subscribers

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