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Mark Your Calendars: Important Medicare-Medicaid Plan Network Submission Coming Up

Key Dates: The Medicare-Medicaid Plan (MMP) Network Submission Deadline is approaching. Read our blog post to learn about the key dates and network submission process.

Don’t Miss the Deadline: Submit Your Medicare-Medicaid Plan Network by September 19, 2023, at 8 p.m. Eastern Time.

Time flies when you’re managing a Medicare-Medicaid Plan (MMP) provider network. Before you know it, the network submission deadline is just around the corner—and we’re here to ensure your success. Get ready to take note of the important details!

Network Submission Due Date Reminder

Key Dates and Times

Let’s dive straight into the specifics. The initial deadline for the 2023 MMP Network Submission is September 19, 2023, at 8 p.m. Eastern time. Be sure to submit your network through the CMS Health Plan Management System (HPMS) before this time. Make a note of it: the MMP Network submission in the HPMS Network Management Module (NMM) will be open from September 5, 2023, at 9 a.m. Eastern time, until September 19, 2023, at 8 p.m. Eastern time. You have a two-week window to complete your network submission. Pro Tip: Don’t leave it until the last minute! Learn how Quest Enterprise Services can help you stay review-ready and compliant-confident. 

MMP Provider and MMP Facility Table Templates: What You Need to Know

Instructions and Template Overview

Now that you know the submission deadline, let’s discuss the necessary steps. The MMP Network Submission requires you to submit Health Service Delivery (HSD) tables for the service area reflected in the CMS HPMS. Use the current provider and facility templates located in HPMS to submit your HSD tables.

  • MMP Provider Table Template
  • MMP Facility Table Template

Automated Criteria Check Reports

Assessing the Status of Your Network

After you’ve submitted your MMP HSD tables, you’ll receive an Automated Criteria Check (ACC) report. Think of it as your network’s report card. It will show you which providers and facilities meet the MMP access standards and identify any deficiencies that need to be addressed in your network.

Reminder: CMS will apply rounding for the MMP network submission to results of 89.5% or higher. Be sure your network meets or exceeds this threshold.

MMP Annual Network Submission HSD Exception Request Template

Addressing Network Deficiencies

What happens if there’s a deficiency in your network? For those providers and/or facilities that do not meet the MMP network standards, there’s still hope. You have the opportunity to submit an exception request using the current MMP Annual Network Submission HSD Exception Request template. 

Making a Strong Case: What You Need to Include in Your Exception Request

When submitting your exception request, it’s vital to provide the necessary information and documentation to support your case. The MMP Annual Network Submission HSD Exception Request template will guide you through the specific requirements, ensuring that you don’t miss any critical details.

Expediting the Process. Eliminating Exception Requests.

Discover how Quest Enterprise Services Exceptions helped a health plan eliminate the need for exception requests. Download Now

Key Requirements to Keep in Mind

Consider the following when submitting your MMP Annual Network Submission HSD Exception Request. 

Exception Request Timelines

Timing is Everything: Mark Your Calendar for the Submission Timeframe

The gates for the MMP Exception Request submission in the HPMS NMM will be open from 9 a.m. Eastern time on September 20, 2023, to 8 p.m. Eastern time on October 4, 2023. Be sure to submit your exception request within this timeframe to be considered.

Use the Correct Template

Current MMP Annual Network Submission HSD Exception Request Template

When it comes to submitting your exception request, it’s crucial to use the current MMP Annual Network Submission HSD Exception Request template. This is the one that will be accepted by the CMS. Exception requests submitted using the Medicare Advantage application template or any previous versions of the MMP exception request templates will not be accepted. 

Be sure to double-check that you have the right template and fill it out with all the necessary information.

CMS Communication

The Light at the End of the Tunnel: HPMS Email Notifications 

CMS will provide you with an HPMS email notification indicating the completion of the exception request review and the availability of updated ACC reports in HPMS. Based on those updated ACC reports, you will have an opportunity to submit corrected networks. CMS will notify your organization through an automated email when the NMM gates will be open for that resubmission. So, keep an eye out for that!

Stay Review-Ready: Medicare-Medicaid Plan Network Adequacy Compliance

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You're Ready for the Upcoming MMP Network Submission

Now you have the necessary information, it’s time to prepare for the forthcoming MMP Network submission. Don’t forget to mark your calendar, use the provided templates, carefully review your network for any deficiencies, and remember that we’re here to support you every step of the way. Good luck, and may your networks be strong and compliant!

CMS Resources

  • Medicare-Medicaid Plan (MMP) Application & Annual Requirements are available on the CMS website

 

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