Additional Network Provider Requirements Sample Clauses
Additional Network Provider Requirements. (A) In accordance with Article 6.6 of this attachment, if the Contractor has a Physician Incentive Plan with a physician or physician group, the Contractor shall ensure the physicians abide by the requirements of Section 1877(E)(3)(B) of the Social Security Act.
(B) The Contractor shall ensure its Network Providers and staff are knowledgeable about methods to detect domestic violence, about mandatory reporting laws when domestic violence is suspected, and about resources in the community to which patients can be referred.
(C) The Contractor shall ensure its Network Providers are aware of the Contractor’s QAPIP and activities. The Contractor’s Network Provider agreements shall include a requirement securing cooperation with the Contractor’s QAPIP and activities and shall allow the Contractor access to the medical records of Enrollees being treated by Network Providers.
(D) All Providers that provide services under this Contract shall have a unique identifier in accordance with the system established under Section 1173(b) of the Social Security Act and in accordance with the Health Insurance Portability and Accountability Act.
(E) The Contractor shall ensure its Network Providers are either enrolled with the Department as a full or limited Provider.
(F) The Contractor shall ensure its Providers who prescribe medication are enrolled with the Department otherwise the Provider's pharmacy Claims will not be paid.
(G) The Contractor shall ensure its Network Providers are aware of the requirements in Article 6.1.3 of this attachment regarding reporting requirements of potential Fraud, Waste or Abuse.
Additional Network Provider Requirements. (A) In accordance with Article 6.6 of this attachment, if the Contractor has a Physician Incentive Plan with a physician or physician group, the Contractor shall ensure the physicians abide by the requirements of Section 1877(E)(3)(B) of the Social Security Act.
(B) The Contractor shall ensure its Network Providers and staff are knowledgeable about methods to detect domestic violence, about mandatory reporting laws when domestic violence is suspected, and about resources in the community to which patients can be referred.
(C) The Contractor shall ensure its Network Providers are aware of the Contractor’s QAPIP and activities. The Contractor’s Network Provider agreements shall include a requirement securing cooperation with the Contractor’s QAPIP and activities and shall allow the Contractor access to the medical records of Enrollees being treated by Network Providers.
(D) All Providers that provide services under this Contract shall have a unique identifier in accordance with the system established under Section 1173(b) of the Social Security Act and in accordance with the Health Insurance Portability and Accountability Act.
(E) The Contractor shall ensure its Network Providers are either enrolled with the Department as a full or limited Provider.
Additional Network Provider Requirements. (A) In accordance with Article 6.6, if the Contractor has a physician incentive plan with a physician or physician group, the Contractor shall ensure the Network Providers abide by the requirements of Section 1877(E)(3)(B) of the Social Security Act.
(B) The Contractor shall ensure that Network Providers and staff are knowledgeable about methods to detect domestic violence, about mandatory reporting laws when domestic violence is suspected, and about resources in the community to which patients can be referred.
(C) All of the Contractor’s Network Providers shall be aware of the Contractor’s Quality Assessment and Performance Improvement Plan (QAPIP) and activities. All of the Contractor’s agreements with Network Providers shall include a requirement securing cooperation with the Contractor’s QAPIP and activities and shall allow the Contractor access to the medical records of Enrollees being treated by Network Providers.
(D) All physicians who provide services under this Contract shall have a unique identifier in accordance with the system established under Section 1173(b) of the Social Security Act and in accordance with the Health Insurance Portability and Accountability Act.
(E) The Contractor shall ensure its Network Providers are either enrolled with the Department as a Medicaid Fee-for-Service provider or are enrolled with the Department as a “Managed Care Only provider.”
Additional Network Provider Requirements. A. The Contractor shall attempt to enroll the following Providers in its network as follows:
1. Teaching hospitals;
2. FQHCs and rural health clinics;
3. The Kentucky Commission for Children with Special Health Care Needs; and