Basic Benefit Package. After consideration of third party liability, including Medicare coverage pursuant to OAC rules 5160-58-01.1 and 5160-26-09.1, the MCOP shall ensure its members have timely access to all medically necessary medical, drug, emergency and post-stabilization, behavioral health, nursing facility, and home and community-based waiver services covered by Medicaid pursuant to OAC rules 5160-58-03, 5160-58-04, and 42 CFR 438.114 in an amount, duration, and scope that is no less than the amount, duration, and scope for the same services furnished to members under FFS Medicaid in accordance with 42 CFR 438.210. This coverage shall be with limited exclusions, limitations, and clarifications (see OAC rule 5160-58-03 and specified in this appendix). The MCOP shall also ensure its members have access to any additional services specified in this Agreement. For information on Medicaid-covered services, the MCOP shall refer to the Ohio Department of Medicaid (ODM) website. Services covered by the MCOP benefit package include:
Appears in 3 contracts
Samples: The Ohio Department of Medicaid Mycare Ohio Provider Agreement for Mycare Ohio Plan, The Ohio Department of Medicaid Mycare Ohio Provider Agreement for Mycare Ohio Plan, The Ohio Department of Medicaid Mycare Ohio Provider Agreement for Mycare Ohio Plan
Basic Benefit Package. After consideration of third party liability, including Medicare coverage pursuant to OAC rules 5160-58-01.1 and 5160-26-09.1, the MCOP shall ensure its members have timely access to all medically medically-necessary medical, drug, emergency and post-stabilization, behavioral health, nursing facility, and home and community-based waiver services covered by Medicaid pursuant to OAC rules 5160-58-03, 5160-58-04, and 42 CFR 438.114 in an amount, duration, and scope that is no less than the amount, duration, and scope for the same services furnished to members under FFS Medicaid in accordance with 42 CFR 438.210. This coverage shall be with limited exclusions, limitations, and clarifications (see OAC rule 5160-58-03 and specified in this appendix). The MCOP shall also ensure its members have access to any additional services specified in this Agreement. For information on Medicaid-covered services, the MCOP shall refer to the Ohio Department of Medicaid (ODM) website. Services covered by the MCOP benefit package include:
Appears in 1 contract
Samples: The Ohio Department of Medicaid Mycare Ohio Provider Agreement for Mycare Ohio Plan
