Common use of Additional Network Provider Requirements Clause in Contracts

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 attachment6.6, if the Contractor has a Physician Incentive Plan with a physician or physician group, the Contractor shall ensure the physicians these Network Providers 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 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 full or limited ProviderUtah Medicaid providers. (F) The Contractor shall ensure its Providers who prescribe medication are enrolled with the Department otherwise the Provider's pharmacy Claims related to a Provider will not be paid. (G) The Contractor shall ensure its Network Providers are aware of the requirements in Article of Articles 6.1.3 of this attachment and 6.1.4 regarding reporting requirements of potential Fraud, Waste or Abuse.

Additional Network Provider Requirements. (A) In accordance with Article 6.6 of this attachment6.6, if the Contractor has a Physician Incentive Plan physician incentive plan with a physician or physician group, the Contractor shall ensure the physicians Network Providers abide by the requirements of Section 1877(E)(3)(B) of the Social Security Act. (B) The Contractor shall ensure its 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) The Contractor shall ensure its All of the Contractor’s Network Providers are shall be aware of the Contractor’s QAPIP Quality Assessment and Performance Improvement Plan (QAPIP) and activities. The All of the Contractor’s agreements with Network Provider agreements 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 Providers that provide providers who administer 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 Providerprovider. The Contractor shall include a provision in its Network Provider agreements that the Network Provider shall be enrolled with the Department as a provider. (F) The Contractor shall ensure that its Providers who prescribe medication are enrolled with the Department otherwise the Provider's Providers’ pharmacy Claims 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.