Common use of Case-by-Case Added Services Clause in Contracts

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.

Appears in 5 contracts

Samples: Contract (Centene Corp), Contract Amendment (Centene Corp), Contract No. 529 12 0002 00006 N (Centene Corp)

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