Common use of Cost-effective Plan Test Clause in Contracts

Cost-effective Plan Test. Using the Department-approved service authorization policy, test whether a cost- effective plan can be developed for supporting the member’s outcomes and assuring the member’s health and safety during the absence by considering: Is there a reason, related to the member’s long term care outcomes, for the member to be out of the MCO service area? Is there a way for the MCO to effectively arrange and manage the member’s services during the absence? Factors to consider include:

Cost-effective Plan Test. Using the Department-approved service authorization policy, test whether a cost- effective plan can be developed for supporting the member’s outcomes and assuring the member’s health and safety during the absence by considering: Is there a reason, related to the member’s long long-term care outcomes, for the member to be out of the MCO service area? Is there a way for the MCO to effectively arrange and manage the member’s services during the absence? Factors to consider include: