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Status Not under consideration
Categories Social Program Management Platform
Created by Sigitas Jakucionis
Created on Sep 18, 2020

RELATED IDEAS

Certification Period should not span for more than 12 months

Our request is to have a hook to specifically disable the ProgramGroupManagerImpl.alignPrograms() method invocation in the OOTB Manage Program Group flow which is invoked during reassessments. This invocation overrides the customizations done in the Product Managers where new PDCs are created and the certification start and end dates are specified. It does not help that the OOTB flow overrides the cert. start date on a new QHP PDC from, say, 1/1/2020 to some other date in the past after all the custom logic has been executed to determine 1/1/2020 as the certification start date.
The program group alignment logic should continue to be allowed to be invoked in other scenarios like when transitioning from public program to private program due to a change in circumstance. It adds value in those scenarios. Currently MN code does use case groups and program alignment utility API in rules(Statics class) so we should continue to be able to invoke the program group alignment logic from custom code.

The hook should be applicable to all product types – MA/QHP/State Basic Health Plan(referred to as Minnesota Care/MCRE in MN)

With regards to the limit on adjustment of start date, currently in MN:-
- The maximum retroactive coverage allowed is 90 days(3 months) for MA
- In some appeals scenarios, programs may give past eligibility up to 12 months in the same certification period.

Therefore we don't see any reason to allow certification period start date to be moved back to more than 12 months in the past.

(Support case WH00010257 , METS defect number RTC 38651)

Customer Name Minnesota
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  • Guest
    Reply
    |     Nov 25, 2020

    Hi Sigitas,

    We have not received the additional information we previously requested from you that would allow us to fully understand and evaluate your enhancement request. Since we have not received the information within the 30 day timeframe, we are closing this request.

    If you are able to provide the additional information in the future, please open a new enhancement request and we will be glad to review. We do appreciate the time you take to share your ideas with us and utilize your inputs to improve our product offering.

    Thank you,
    Shane McFadden, SPM Offering Management team
    You can find more information on the request process here.

  • Guest
    Reply
    |     Oct 1, 2020

    Hi Sigitas,

    We have reviewed your enhancement suggestion and require more information to properly understand the issue and the business scenario you are trying to support.

    Out of the box functionality is working as it does to ensure there are no gaps in eligibility and therefore our initial thoughts on this would be that such a hook is problematic because it breaks the OOTB attempt at addressing gaps in eligibility. Have gaps in eligibility been considered, or are there alternative plans for how you would prevent or address that concern?

    Please provide the requested information within 30 days so we may proceed with our evaluation. If we do not hear from you within that timeframe we will have to close the request due to insufficient information.

    Thank you,
    Shane McFadden, SPM Offering Management team
    You can find more information on the request process here.

  • Guest
    Reply
    |     Sep 21, 2020

    Hi Sigitas,

    Thank you for taking the time to share your ideas with us. We are committed to involving our users in building our product roadmap and appreciate your suggestions.

    We will review the information you have provided and get back to you within 30 days. If additional details are required in order to complete our evaluation, we will send you a request for more information.

    Thank you,
    Shane McFadden, SPM Offering Management team
    You can find more information on the request process here.