CCO Contract Forms Archive

Financial Reports

Other Reports

To view documents from past contract years, click the "Effective Date" field to display documents and due dates for a specific contract year.

For documents from older contract years, email the CCO Contract Administrator.

Category	Effective date	URL
Other Reports	6/7/2024	Health Related Social Needs Guidance Document
Other Reports	4/19/2024	DSN Provider Specialty Matrix, April 2024
Other Reports	2/27/2024	Health Related Social Needs Guidance for March 2024 implementation
Other Reports	2/14/2024	DSN Provider Specialty Matrix, February 2024
Other Reports	1/1/2024	Subcontractor and Delegated Work Report Attestation, 01-2024
Other Reports	1/1/2024	Subcontractor Performance Report Evaluation Criteria, 2024
Deliverable, Other Reports	1/1/2024	Member Notice Template Self-Evaluation Checklist for CY 2024
Deliverable, Other Reports	12/27/2023	Grievance and Appeal System member notice templates attestation, 12-27-2023
Deliverable, Other Reports	12/27/2023	Grievance and Appeal System P&Ps Attestation, 12-27-2023
Other Reports	12/8/2023	Indian Health Care Provider Reimbursement Guidance for 2024, 12-2023
	12/1/2023	DSN Provider Specialty Matrix, 12-2023
Other Reports	11/30/2023	Attestation for PA Determinations for SUD Services - 2023
Other Reports	10/12/2023	Member Materials - Annual Letters Evaluation Criteria
Other Reports	8/15/2023	Member Handbook Submission and Review Guidelines 2024, updated: 08/15/2023
Other Reports	8/15/2023	Member Handbook CCO Model Handbook 2024, updated: 08/15/2023
Other Reports	8/15/2023	Member Handbook Evaluation Criteria 2024, updated: 08/15/23
Other Reports	8/15/2023	Member Handbook CCO Model Member Handbook Redline Changes List 2024, updated: 08/15/2023
Other Reports	6/30/2023	NEMT Rider Guide Evaluation Criteria 2024
Other Reports	6/30/2023	NEMT Rider Guide Submission and Review Guidelines 2024
Other Reports	6/2/2023	Member Handbook CCO Model Handbook 2024
Other Reports	6/2/2023	Member Handbook Submission and Review Guidelines 2024
Other Reports	6/2/2023	Member Handbook CCO Model Member Handbook Redline Changes List 2024
Other Reports	6/2/2023	Member Handbook Evaluation Criteria 2024
Other Reports	5/31/2023	DSN Narrative Evaluation Q&A, CY 2023
Other Reports	5/25/2023	Indian Health Care Provider Reimbursement Guidance for 2023, 05-2023
Other Reports	5/1/2023	DSN Narrative Evaluation Tool and Reporting Template, CY 2023
	4/28/2023	System of Care Statewide Steering Committee Quarterly Report Template, 04-2023
Other Reports	4/14/2023	Health Equity Plan Training and Education Reporting Template, 05-2021
Other Reports	4/14/2023	Health Equity Plan Template, 04-2023
Other Reports	4/14/2023	Health Equity Plan Guidance Document, 04-2023

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