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Materials Guide

Per the Families and Children contract Section 2.80 and similar sections of the Seniors and Special Needs BasicCare contracts, “marketing materials” means materials that: 1) are produced in any medium by or on behalf of an MCO; and 2) can reasonably be interpreted as intended to influence individuals to enroll or reenroll in the MCO’s product(s) under this Contract. [42 CFR §§438.104(a); 438.56(d)(2)(iv)]

Any marketing material not specifically named in this document should be submitted to the Contract Manager for review. If MCO has other materials not on this list, please work with your contract manager to determine the appropriate process.

DHS Approval Required

Materials required to be submitted to Contract Manager for review and approval. Subject to up to 30-day review.  Materials submitted as templates must strictly adhere to the approved model template, excluding MCO-specific contact information. Materials included in this category:

  • Materials identified in MCO contract as requiring approval
  • Materials that require CMS review (not including those materials identified under the “Submit as FYI” category)
  • Any materials which contain statements describing Minnesota Health Care Programs (MHCP) benefit package or changes, including incentives, copays or transportation

Materials that are applicable to unique public health emergencies (i.e. pandemic, natural disasters, etc.) would follow the guidance given specific to that situation (i.e. executive orders, waivers, etc.) and must be submitted to Contract Manager for review and approval. 

Materials requiring approval include, but are not limited to, the following:

  • Advance Directive Materials
  • Annual Notice of Change (ANOC) – MSHO and SNBC integrated 
  • Buck Slips
  • Care Coordination
  • Complaint Block (CB) 
  • Collaborative materials between MCOs (submitted by the lead MCO to their contract manager)
  • Denial, Termination and Reduction (DTR) notices, Grievance or Appeal Forms, Member Rights documents
  • Emails (Group Communication)
  • Explanation of Benefits (EOB)
  • Formulary Change Letters
  • Icon Display Templates (ADA, No English, Combined ADA/No English) 
  • Inbound/Outbound Medicare Sales Scripts
  • Initial Enrollee Screening Documents
  • Language Block (LB) 
  • List of Covered Drugs (Medicaid and Integrated Products), including Preferred Drug List (PDL)
  • Low Income Subsidy (LIS) Rider – MSHO and SNBC integrated
  • Marketing Letters and Materials, such as direct marketing mailings or brochures including marketing materials targeted to American Indians
  • Member Handbooks (also known as Evidence of Coverage (EOC) for Integrated SNBC), Addenda, and Plan Guides
  • Member Identification Cards
  • Newsletters – sent only to MHCP enrollees or articles specific to MHCP
  • MCO Enrollment form (SNP)
  • MCO’s website Information directed to MHCP members
  • Performance Improvement Project (PIP) Collaborative Model Final Documents
  • Presentations/Posters for MCO Public Programs
  • Provider Directory and Subdirectories (This applies only to annual wrap language)
  • Provider Termination/Clinic Closure Letters
  • Radio/TV Commercials, Bus Wraps, Bus Shelters, Billboards, and others of that nature
  • Release of Information and Consent Forms (e.g., Release of Protected Health Information)
  • Restricted Recipient Letters & Brochures
  • Social Media Communication (Facebook, Twitter, etc.) 
  • Text Message Communication (Group Communication)
  • Welcome Letters

Submit as FYI (For DHS information only)

(DHS reserves the right to review and comment if materials are not accurate or do not meet materials requirements.)

MCOs may publish FYI materials on the date submitted to the Contract Manager. During the Contract Manager’s review, if changes are required, the MCO must update their published materials incorporating these changes.

  • Access Information (instructions for accessing care), e.g., mail-order pharmacy forms, nurse line brochure
  • Annual Report to Enrollees (e.g., Financial Statement Summary and Organization Description)
  • Attestation for Non-English materials (attestation/certificate of translation should be from the translation company)
  • Coordination of Benefits surveys and other member surveys
  • DHS/CMS-Identified Templates and Models used without modification for Special Use [e.g., Medicare Advantage Enrollment Form and Notices, County Enrollment Forms (SNP), SNP Enrollment/Disenrollment information, Medicare Part D formulary change template, Transaction Reply Report (TRR) Letters]  
  • Enrollee Education Materials, including disease or health education, health promotion, and enrollee education for appropriate benefit use (note, this is not an exhaustive list):
    • Disease Management Program materials
    • Health Promotion Materials
      • Dental care promotion
      • Healthy habits
      • Healthy pregnancy program
      • Member phone scripts specific to health promotion outreach efforts
      • Tobacco cessation
      • Vaccination reminders
      • Well child visits, etc. 
    • Benefit use 
      • Appropriate ER use 
      • Coordination of benefit information 
      • Generics vs. brand name prescription drugs 
      • Medication Therapy Management Program (MTM) materials
  • Privacy Statements for all MHCP products
  • Provider Directory Monthly/Quarterly Change Reports

NOTE: Any material containing statements regarding benefits, incentives or copays must be submitted for approval

Do Not Submit

  • Websites which merely link to the DHS website and other websites for information, such as:
    • Americans with Disabilities Act (ADA)
    • Centers for Medicare & Medicaid Services (CMS)
    • Centers for Disease Control and Prevention (CDC)
    • Minnesota Department of Health (MDH), etc.
  • Materials specific to an individual enrollee, such as phone script responses, letters or other health-related information (e.g., letters regarding missed appointments, appeal resolution letters)
  • Press releases and correspondence about general MCO news or announcements
  • Third party materials, such as Disease Education information (e.g., brochures, social media and websites developed by American Heart Association, American Dental Association, American Medical Association and American Cancer Society) (This does not include materials created by a subcontractor on MCO behalf.)
  • Translated documents
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