ACCREDITATION AND STANDARDS. The PHP hereby agrees to: (a) Be licensed to provide PHP services within the applicable jurisdiction in which it operates. (b) PHPs shall be currently accredited by and remain in compliance with standards issued by the TJC, CARF, CoA, or an accrediting organization approved by the Director, DHA. The regional contractor may submit, via the TRO, additional accrediting organizations for TRICARE authorization, subject to approval by the Director, DHA. (c) Accept the allowable partial hospitalization program rate, as provided in 32 CFR 199.14(a)(2)(ix), as payment in full for services provided. (d) Comply with all requirements of 32 CFR 199.4 applicable to institutional providers generally concerning preauthorization, concurrent care review, claims processing, beneficiary liability, double coverage, utilization and quality review, and other matters. (e) Ensure that all mental health services are provided by qualified mental health providers who meet the requirements for individual professional providers. (Exception: PHPs that employ individuals with master’s or doctoral level degrees in a mental health discipline who do not meet the licensure, certification, and experience requirements for a qualified mental health provider but are actively working toward licensure or certification, may provide mental health services within the per diem rate but the individual must work under the direct clinical supervision of a fully qualified mental health provider employed by the PHP.) All other program services will be provided by trained, licensed staff.
Appears in 9 contracts
Samples: Participation Agreement for Freestanding Psychiatric and Substance Use Disorder (Sud) Partial Hospitalization Program (Php) Services, Participation Agreement, Participation Agreement for Freestanding Psychiatric and Substance Use Disorder (Sud) Partial Hospitalization Program (Php) Services
ACCREDITATION AND STANDARDS. The PHP IOP hereby agrees to:
(a) Be licensed to provide PHP IOP services within the applicable jurisdiction in which it operates.
(b) PHPs shall be currently Be specifically accredited by and remain in compliance with standards issued for IOPs by the TJC, CARF, CoA, or an accrediting organization approved by the Director, DHA. The regional contractor may submit, via the TRICARE Regional Office (TRO), additional accrediting organizations for TRICARE authorization, subject to approval by the Director, DHA.
(c) Accept the allowable partial hospitalization program IOP rate, as provided in 32 CFR 199.14(a)(2)(ix), as payment in full for services provided.
(d) Comply with all requirements of 32 CFR 199.4 applicable to institutional providers generally concerning preauthorization, concurrent care review, claims processing, beneficiary liability, double coverage, utilization and quality review, and other matters.
(e) Ensure that all mental health services are provided by qualified mental health providers who meet the requirements for individual professional providers. (Exception: PHPs IOPs that employ individuals with master’s or doctoral level degrees in a mental health discipline who do not meet the licensure, certification, and experience requirements for a qualified mental health provider but are actively working toward licensure or certification, may provide mental health services within the per diem rate but the individual must work under the direct clinical supervision of a fully qualified mental health provider employed by the PHPIOP.) All other program services will be provided by trained, licensed staff.
Appears in 3 contracts
Samples: Participation Agreement for Intensive Outpatient Program (Iop) Services, Participation Agreement for Intensive Outpatient Program (Iop) Services, Participation Agreement for Intensive Outpatient Program (Iop) Services
