State Medicaid Managed Care Advisory Committee (SMMCAC) Complaints, Appeals, and Fair Hearings (CAFH) Subcommittee

The  Complaints, Appeals, and Fair Hearings (CAFH) Subcommittee focuses on more effectively leveraging complaints data to identify potential problems in the Medicaid program, opportunities for improved MCO contract oversight and increasing program transparency. Also focuses on appeals and fair hearings processes, including implementation of an independent external medical reviewer. In attendance: Jane Concha, Marcella Ford, Shane Curnell, Carl Sorrell Call to order, introductions, and roll call. The meeting was convened by Dr. Sjorrell, Chair. A quorum was present. Consideration of May 8, 2025, draft meeting minutes. The minutes were adopted as presented. Medically Dependent Children Program (MDCP) eligibility data update Changes may be related to population growth, but this is just speculation. The numbers are very tight. Future data will be  presented over the same timeframe: Total number of initial / Total number of reassessments per month Total au