Carve-out of California Children’s Services Sample Clauses

Carve-out of California Children’s Services. (CCS) Program services. Health care services to treat CCS-eligible conditions are “carved out” of HEALTH NET’s coverage obligations under the Healthy Families Agreement. However, PPG and its Participating Providers are required to identify and timely refer Members with possible CCS-eligible conditions to the County CCS Program. Upon referral, the Participating Provider shall inform the Member’s parent or guardian. The CCS Program requires eligible children to be treated at CCS-certified facilities by CCS-paneled providers. The CCS Program may require transfer to CCS-certified facilities with CCS-paneled providers. The CCS Program is financially responsible for payment of health care costs to treat a CCS-eligible condition. The parties understand and agree that HEALTH NET is not financially responsible for payment of services related to CCS-eligible conditions.
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Related to Carve-out of California Children’s Services

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