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.

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 Contract shall ensure its all Network Providers are aware of the Contractor’s 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 providers 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 FFS provider or are enrolled with the Department as a full or limited ProviderMedicaid provider.