Common use of Authorization, Monitoring, and Review Clause in Contracts

Authorization, Monitoring, and Review. (1) For Services to non-Medicaid-eligible Individuals indicated in Exhibit B-1, County shall attach a copy of the bill or receipt, for the item or Service, to a combined monthly invoice, itemized by Individual. Part C funding for Psychiatric Security Review Board (PSRB) non-medically approved Services are only for the period shown and do not carry forward into following years’ allotments. (2) Funding for Specialized Requests, (1) (g) above, will follow a process to assure necessity of services required by an Individual in exceptional need, that would not fit within the Intensive Services Requests of the Rate Review Committee (RRC), with the following structure: (a) A proposal is then reviewed by a minimum of two clinicians to assure initial necessity of services considering the current circumstances, history of interventions, limits of current resources and potential plans for stabilization. (b) If there is sufficient initial necessity, then the proposal will be reviewed by the RRC to determine a recommendation of approval or denial. (c) If approved, the Specialized Request will follow the same process indicated in (2)(a), “Authorization, Monitoring and Review.” (3) If denied, the Requestor will be notified in writing with rationale determined by the RRC.

Authorization, Monitoring, and Review. (1) For Services to non-Medicaid-eligible Individuals indicated in Exhibit B-1, County shall attach a copy of the bill xxxx or receipt, for the item or Service, to a combined monthly invoice, itemized by Individual. Part C funding for Psychiatric Security Review Board (PSRB) non-medically approved Services are only for the period shown and do not carry forward into following years’ allotments. (2) Funding for Specialized Requests, (1) (g) above, will follow a process to assure necessity of services required by an Individual in exceptional need, that would not fit within the Intensive Services Requests of the Rate Review Committee (RRC), with the following structure: (a) A proposal is then reviewed by a minimum of two clinicians to assure initial necessity of services considering the current circumstances, history of interventions, limits of current resources and potential plans for stabilization. (b) If there is sufficient initial necessity, then the proposal will be reviewed by the RRC to determine a recommendation of approval or denial. (c) If approved, the Specialized Request will follow the same process indicated in (2)(a), “Authorization, Monitoring and Review.” (3) If denied, the Requestor will be notified in writing with rationale determined by the RRC.

Authorization, Monitoring, and Review. (1) i. For Services to non-Medicaid-eligible Individuals indicated in Exhibit B-1, County shall attach a copy of the bill or receipt, for the item or Service, to a combined monthly invoice, itemized by Individual. Part C funding for Psychiatric Security Review Board (PSRB) non-medically approved Services are only for the period shown and do not carry forward into following years’ allotments. (2) ii. Funding for Specialized Requests, (1) (g1)(g) above, will follow a process to assure necessity of services required by an Individual in exceptional need, that would not fit within the Intensive Services Requests of the Rate Review Committee (RRC), with the following structure: (a) A. A proposal is then reviewed by a minimum of two clinicians to assure initial necessity of services considering the current circumstances, history of interventions, limits of current resources and potential plans for stabilization. (b) B. If there is sufficient initial necessity, then the proposal will be reviewed by the RRC to determine a recommendation of approval or denial. (c) C. If approved, the Specialized Request will follow the same process indicated in (2)(a), “Authorization, Monitoring and Review.” (3) iii. If denied, the Requestor will be notified in writing with rationale determined by the RRC.