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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 - 42 - The role of the QA&I subcommittees will be to evaluate, refine, and recommend sentinel indicators, recommend intervention strategies, and review satisfaction and audit data as it relates to maternal and child health and behavioral health issues. The QA&I subcommittees will also communicate provider complaints and system issues to the QA&I Advisory Committee and the MO HealthNet Division and respond to ad hoc requests of the QA&I Committee. The MO HealthNet Managed Care Consumer Advisory Committee (CAC) was formed to advise the Director of the MO HealthNet Division on issues relating to enrollee participation in the MO HealthNet Managed Care Program. The committee meets quarterly in Jefferson City and consists of a minimum of 15 enrollees and advocates. The CAC meetings provide updates from other state agencies that would impact their benefits. The MCOs also attend the meetings. CAC members are given the opportunity to suggest agenda items for each meeting. A notice of open meeting is posted prior to the meetings. The notice of open meeting includes the agenda items for the meetings. The MO HealthNet Division also conducts Quarterly All Plan Meetings for the MCOs. These meetings are an opportunity for the MO HealthNet Division and the MCOs to discuss issues related to the MO HealthNet Managed Care Program. The meetings also provide updates from other state agencies that affect the MO HealthNet Managed Care Program. A notice of open meeting is posted prior to the meetings. The notice of open meeting includes the agenda items for the meetings. The MCOs are given an opportunity to suggest agenda items for each meeting. 9.9.1 Describe the process used by the State to ensure interaction with Indian Tribes and organizations in the State on the development and implementation of the procedures required in 42 CFR part 457.125. (Section 2107(c)) (42 CFR 457.120(c)) Response: There are no federally recognized Indian Tribes and Organizations in the State. CMS officials have held that Missouri has no federally-recognized American Indian/Native American tribes within the state, and, therefore, Missouri has no specific obligations pursuant to 42 CFR § 457. The fact that Missouri has no federally- recognized American Indian/Native American tribes was affirmed by the CMS Region VII office as recently as May 2007. • The Eastern Shawnee Tribe of Oklahoma tribe is not associated with Missouri in the Federal Register’s “Indian Entities Recognized and