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Missouri Application for the State Children’s Health Insurance Program Effective Date: 05/01/2009 Approval Date:

Prior Approval Date: 09/28/2007 - 29 - for assuring the confidentiality of data and information. Access to data is granted in accordance with state and federal laws. Access is limited to data needed to fulfill the requestor's responsibilities and/or to provide services. The MOHSAIC system is utilized by the MO HealthNet Fee-For-Service and MO HealthNet Managed Care Programs. The DHSS also monitors services provided to members with special health care needs. External monitoring includes an annual, external quality review of the MCOs by an external quality review organization. The review is comprised of a compliance review analysis, encounter data validation, medical record review, and validation of MCO performance improvement projects and measures. An external, annual evaluation will be conducted on SCHIP 1 and SCHIP 2. The evaluation is for the collection and analysis of information about SCHIP 1 and SCHIP 2 to study the impact of state agency policy decisions about the SCHIP 1 and SCHIP 2 on the enrollees in the program and on program participation by the uninsured. 7.2 Describe the methods used, including monitoring, to assure: (2102(a)(7)(B)) (42 CFR 457.495) 7.2.1 Access to well-baby care, well-child care, well-adolescent care and childhood and adolescent immunizations (Section 2102(a)(7)) (42 CFR 457.495(a)) Response: The delivery systems described below apply to MO HealthNet, SCHIP 1, and SCHIP 2. MO HealthNet Fee-For-Service Delivery System The MO HealthNet Division continues to identify barriers and develop strategies that guarantee maximum screening of Early Periodic Screening, Diagnosis, and Treatment (EPSDT) eligible children under both MO HealthNet Fee-For-Service and MO HealthNet Managed Care. The MO HealthNet Division continues to collaborate with other state and local agencies to identify problem areas that affect the screening and health care of children. Activities to increase awareness of the importance of preventative health screenings include, but are not limited to, the following:

 The MO HealthNet Division continues to provide brochures regarding available EPSDT services. Missouri FSD county offices, and any other