Common use of Continued Eligibility for Services Clause in Contracts

Continued Eligibility for Services. (1) Reassessment by the provider and reauthorization of services by Contractor determine whether a continued need for services is warranted. This activity is completed according to the UA protocols and TRR UM Guidelines every 90days or more frequently, as needed; (2) Assignment of diagnosis in CARE is required at any time the primary diagnosis changes and at least annually from the last diagnosis entered into CARE. f) The LPHA’s determination of diagnosis shall include an interview with the individual and/or guardian/LAR, conducted either face-to-face or via tele- medicine/tele-health. In order to assign a diagnosis to an individual, documentation of the required diagnostic criteria shall be included in the client record. This information shall be included as part of the required assessment information.