1/30/08 - Upon investigation of Small Smiles all services has been restored.

Dear Health Right Medicaid Member:

Your prescription drug plan, administered by PharmaCare, will implement quantity limits on certain medications, effective August 1, 2007. These quantity limits are based on indications and dosing recommendations provided by the Food and Drug Administration (FDA) and are designed to ensure appropriate use. Effective August 1, 2007 sexual dysfunction agents such as Viagra, Levitra, Cialis, Caverject, MUSE, and Edex will no longer be covered.

If you have questions about quantity limits and how they affect your current prescription medications, please call PharmaCare customer service at 1-888-645-9303. Representatives are available24 hours a day Monday through Friday, Saturdays from 9 a.m. to 8 p.m., and Sundays from 9 a.m. to 6 p.m. You and your doctor can view additional information on your prescription drug plan at http://www.pharmacare.com/ members.

 

July 31, 2007
Health Right, Inc., a Medicaid Managed Care Organization completed the NCQA- Certified HEDIS Compliance Audit. The scope of the NCQA HEDIS Compliance Audit includes the following domains: Effectiveness of Care; Access/Availability of Care; Satisfaction with the Experience of Care; Health Plan Stability; Use of Services; Cost of Care; and Health Plan Descriptive Information. Health Right, Inc. has undergone a Full Audit.

NCQA is a private, not-for-profit organization dedicated to improving health care quality. Each HEDIS Compliance Audit ä begins with a review of a health plan’s overall information systems capabilities. NCQA’s audit standards address whether a health plan has adequate and sound capabilities for processing medical, member, and provider information as a foundation for accurate and automated HEDIS reporting. Since its introduction in 1993, the Healthcare Effectiveness Data and Information Set (HEDIS)^® has evolved to become the gold standard in managed care performance measurement.

NCQQ HEDIS Compliance Audit ä is a trademark of the National Committee for Quality Assurance (NCQA).

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA)

February 22, 2007

DISTRICT OF COLUMBIA MEDICAID HEALTH PLAN AMONG NATION’S BEST ON HEALTH QUALITY MEASURES.

January 19, 2007