Common use of Assessing Access to Care Clause in Contracts

Assessing Access to Care. (3 pages, plus one additional page per additional MCO Program bid if the Respondent’s response is different by MCO Program) 1. Identify the process(es) by which the Respondent must measure and regularly verify: a. Network compliance, including pharmacy, regarding travel distance access in Section 8.1.3.2; b. Provider compliance regarding appointment access standards in Section 8.1.3.1, and c. PCP compliance with after-hours coverage standards in Section 8.1.4.2. 2. Describe the steps the Respondent has taken in the past when it identified: a. a deficiency in its compliance with plan or state travel distance access standards; b. a Provider that was not meeting plan or state appointment access standards, and