Court-Ordered Services. a) The Contractor shall provide any Benefit Package services to Enrollees as ordered by a court of competent jurisdiction, regardless of whether such services are provided by Participating Providers within the plan or by a SECTION 10 (BENEFIT PACKAGE, COVERED AND NON-COVERED SERVICES) October 1, 2004 10-4 Non-Participating Provider in compliance with such court order. The Non-Participating Provider shall be reimbursed by the Contractor at the Medicaid fee schedule. The Contractor is responsible for court-ordered services to the extent that such court-ordered services are covered by and reimbursable by Medicaid. b) Court Ordered Services are those services ordered by the court performed by, or under the supervision of a physician, dentist, or other provider qualified under State Law to furnish medical, dental, behavioral health (including mental health and/or Chemical Dependence), or other Medicaid covered services. The Contractor is responsible for payment of those Medicaid services as covered by the Benefit Package, even when the providers are not in the Contractor's provider network.
Appears in 7 contracts
Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)
Court-Ordered Services. a) The Contractor shall provide any Benefit Package services to Enrollees as ordered by a court of competent jurisdiction, regardless of whether such services are provided by Participating Providers within the plan or by a SECTION 10 (BENEFIT PACKAGE, COVERED AND NON-COVERED SERVICES) October 1, 2004 10-4 Non-Participating Provider in compliance with such court order. The Non-Participating Provider shall be reimbursed by the Contractor at the Medicaid fee schedule. The Contractor is responsible for court-ordered services to the extent that such court-ordered services are covered by and reimbursable by Medicaid.
b) Court Ordered Services are an those services ordered by the court performed by, or under the supervision of a physician, dentist, or other provider qualified under State Law to furnish medical, dental, behavioral health (including mental health and/or Chemical Dependence), or other Medicaid covered services. The Contractor is responsible for payment of those Medicaid services as covered by the Benefit Package, even when the providers are not in the Contractor's provider network.
Appears in 1 contract
Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)
