Common use of Coverage and Services Clause in Contracts

Coverage and Services. The MCO must post prominent, easily understood information on its website for members and providers regarding the optimization of pregnancy outcomes. The MCO must include information for providers, trusted messengers (i.e., community health workers), and members about the prevention of preterm birth through the use of progesterone treatment by linking to the Ohio Perinatal Quality Collaborative's information about progesterone best practices at xxxxx://xxx.xxxx.xxx/prematurity-prevention?adlt=strict and the Ohio Department of Health's progesterone-messaging toolkit located at xxxx://XxXxxxXxxXxxx.xxx. The MCO must include a link to the official ODM notification of pregnancy and risk assessment form (PRAF 2.0) located at xxxxx://xxxxxxxx.xxxx.xxx/Provider/PRAF with a statement encouraging network providers to complete and submit the form to assist pregnant women in maintaining Medicaid eligibility and connecting to needed services and supports (e.g., home visiting). The MCO must post on its website the MCO's criteria for medical necessity determinations for services requiring authorization. In accordance with 42 CFR 438.915(a), the MCO must provide a hard copy of the MCO's medical necessity criteria to providers and members upon request. The MCO must receive prior written approval from ODM before adding any information to its website that would require ODM's prior approval in hard copy form (e.g., member handbook information). The MCO must include additional information on its website as determined necessary by ODM.

Coverage and Services. The MCO must post prominent, easily understood information on its website for members and providers regarding the optimization of pregnancy outcomes. The MCO must include information for providers, trusted messengers (i.e., community health workers), and members about the prevention of preterm birth through the use of progesterone treatment by linking to the Ohio Perinatal Quality Collaborative's information about progesterone best practices at xxxxx://xxx.xxxx.xxx/prematurity-prevention?adlt=strict and the Ohio Department of Health's progesterone-messaging toolkit located at xxxx://XxXxxxXxxXxxx.xxx. xxxxx://xxx.xxxx.xxx/prematurity- prevention?adlt=strict.. The MCO must include a link to the official ODM notification of pregnancy and risk assessment form (PRAF 2.0) located at xxxxx://xxxxxxxx.xxxx.xxx/Provider/PRAF xxxxx://xxxxxxxxxxxx.xxxxxxxxxxx.xxx/login with a statement encouraging network providers to complete and submit the form to assist pregnant women in maintaining Medicaid eligibility and connecting to needed services and supports (e.g., home visiting). The MCO must post on its website the MCO's criteria for medical necessity determinations for services requiring authorization. In accordance with 42 CFR 438.915(a), the MCO must provide a hard copy of the MCO's medical necessity criteria to providers and members upon request. The MCO must receive prior written approval from ODM before adding any information to its website that would require ODM's prior approval in hard copy form (e.g., member handbook information). The MCO must include additional information on its website as determined necessary by ODM.

Coverage and Services. The MCO must post prominent, easily understood information on its website for members and providers regarding the optimization of pregnancy outcomes. The MCO must include information for providers, trusted messengers (i.e., community health workers), and members about the prevention of preterm birth through the use of progesterone treatment by linking to the Ohio Perinatal Quality Collaborative's information about progesterone best practices at xxxxx://xxx.xxxx.xxx/prematurity-prevention?adlt=strict and the Ohio Department of Health's progesterone-messaging toolkit located at xxxx://XxXxxxXxxXxxx.xxx. xxxxx://xxx.xxxx.xxx/prematurity-prevention?adlt=strict.. The MCO must include a link to the official ODM notification of pregnancy and risk assessment form (PRAF 2.0) located at xxxxx://xxxxxxxx.xxxx.xxx/Provider/PRAF with a statement encouraging network providers to complete and submit the form to assist pregnant women in maintaining Medicaid eligibility and connecting to needed services and supports (e.g., home visiting). The MCO must post on its website the MCO's criteria for medical necessity determinations for services requiring authorization. In accordance with 42 CFR 438.915(a), the MCO must provide a hard copy of the MCO's medical necessity criteria to providers and members upon request. The MCO must receive prior written approval from ODM before adding any information to its website that would require ODM's prior approval in hard copy form (e.g., member handbook information). The MCO must include additional information on its website as determined necessary by ODM.