Case-by-Case Added Services. Except as provided below, the MCO may offer additional benefits that are outside the scope of services to individual Members on a case-by-case basis. Case-by-case services may be based on Medical Necessity, cost-effectiveness, the wishes of the Member/Member’s family, the potential for improved health status of the Member, and for STAR+PLUS Members based on Functional Necessity. Section 8.1. 2.2, “Case-by-Case Added Services,” does not apply to the CHIP Perinate Members (unborn children).
Appears in 9 contracts
Samples: Contract Amendment (Centene Corp), Contract (Centene Corp), Contract (Centene Corp)
