Common use of Continuing Services Clause in Contracts

Continuing Services. MCO Covered Services that were previously authorized by the Contractor and are the subject of an Internal Appeal or BOH Appeal, if applicable, involving a decision by the Contractor to terminate, suspend, or reduce the previous authorization and which are provided by the Contractor pending the resolution of the Internal Appeal or BOH Appeal, if applicable. Contract – the Contract between EOHHS and the Contractor awarded pursuant to the RFR. Contract Effective Date – The date on which the Contract is effective, which shall be the date this Contract is fully executed by both parties. Contract Operational Start Date (Operational Start Date) – the date on which the Contractor starts to provide MCO Covered Services to Enrollees, March 1, 2018. Contract Year (CY) – For Contract Year 1, a ten-month period commencing March 1, 2018 and ending December 31, 2018, unless otherwise specified by EOHHS. For other Contract Years, a twelve-month period commencing January 1 and ending December 31, unless otherwise specified by EOHHS. Contractor – any entity that enters into an agreement with EOHHS for the provision of services described in the Contract. Contractor’s Plan (or Plan) – the managed care program administered by the Contractor pursuant to the Contract. Co-Morbid Disorders – the simultaneous manifestation of a physical disorder and a behavioral health disorder, or two different physical health disorders. Co-Occurring Disorders (or Dual Diagnoses) – medical conditions involving the simultaneous manifestation of a mental health disorder and a substance use disorder. Coverage Type – a scope of medical services, other benefits, or both, that are available to members who meet specific MassHealth eligibility criteria. EOHHS’s current Coverage Types with Members who may be enrolled with the Contractor are: Standard, Family Assistance, CarePlus and CommonHealth. See 130 CMR 450.105 for an explanation of each Coverage Type. Credentialing Criteria – criteria establishing the qualifications of Network Providers. See Section 2.8.H. of this Contract.

Continuing Services. MCO Covered Services that were previously authorized by the Contractor and are the subject of an Internal Appeal or BOH Appeal, if applicable, involving a decision by the Contractor to terminate, suspend, or reduce the previous authorization and which are provided by the Contractor pending the resolution of the Internal Appeal or BOH Appeal, if applicable. Contract – the Contract between EOHHS and the Contractor awarded pursuant to the RFR. Contract Effective Date – The date on which the Contract is effective, which shall be the date this Contract is fully executed by both parties. Contract Operational Start Date (Operational Start Date) – the date on which the Contractor starts to provide MCO Covered Services to Enrollees, March 1, 2018. Contract Year (CY) – For Contract Year 1, a ten-month period commencing March 1, 2018 and ending December 31, 2018, unless otherwise specified by EOHHS. For other Contract Years, a twelve-month period commencing January 1 and ending December 31, unless otherwise specified by EOHHS. Contractor – any entity that enters into an agreement with EOHHS for the provision of services described in the Contract. Contractor’s Plan (or Plan) – the managed care program administered by the Contractor pursuant to the Contract. Co-Morbid Disorders – the simultaneous manifestation of a physical disorder and a behavioral health disorder, or two different physical health disorders. Co-Occurring Disorders (or Dual Diagnoses) – medical conditions involving the simultaneous manifestation of a mental health disorder and a substance use disorder. Coverage Type – a scope of medical services, other benefits, or both, that are available to members who meet specific MassHealth eligibility criteria. EOHHS’s current Coverage Types with Members who may be enrolled with the Contractor are: Standard, Family Assistance, CarePlus and CommonHealth. See 130 CMR 450.105 for an explanation of each Coverage Type. Credentialing Criteria – criteria establishing the qualifications of Network Providers. See Section 2.8.H. of this Contract. Cultural and Linguistic Competence – competence, understanding, and awareness with respect to Culturally and Linguistically Appropriate Services.