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HEP Compliance for those without State Dental Coverage

Those who do not have State dental coverage may be receiving letters from Care Management Solutions (CMS) stating non-compliance due to the absence of dental cleanings.  If you are not enrolled in the State's dental plan, you do not need to complete the 2 annual cleanings.  There is no action that needs to be taken to resolve this issue; the letters of non-compliance are inaccurate for this situation and HEP compliance will not be impacted

SEBAC 2011 Attachment B reads:  Dental cleanings: two free cleanings per year for participants.  Participants not enrolled in dental coverage through the State Health Plan do not have to meet this screening requirement.

The HEP Compliance deadline for 2013 is February 28, 2014.  All required elements for 2013 must be completed by this date to be considered compliant for 2013. 

If you have completed all requirements but received a letter from Care Management Solutions (CMS) stating that you are non-compliant, you must have the Physician's Notification form (CO-1317) completed indicating compliance for the identified issue(s).  The Physician Notification form must be submitted to the indicated address or fax number.

Those with HEP Chronic Conditions who did not receive a counseling call must visit the CTHEP.com website to complete and submit the on-line Counseling and Education Attestation.

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