Common use of Enrollee Access to Services Clause in Contracts

Enrollee Access to Services. A. General 1. The Contractor must provide services to Enrollees as follows: a. Authorize, arrange, coordinate and provide to Enrollees all Medically Necessary Covered Services as specified in Section 2.4, Appendix A and Appendix B, in accordance with the requirements of the Contract; Offer adequate choice and availability of primacy, specialty, acute care, behavioral health and long term services and support providers that meet CMS and EOHHS standards as provided in Section 2.8.B; Reasonably accommodate persons and ensure that the programs and services are as accessible (including physical and geographic access) to an individual with disabilities as they are to an individual without disabilities. The Contractor and its Network Providers must comply with the American with Disabilities Act (ADA) (28 C.F.R. § 35.130) and Section 504 of the Rehabilitation Act of 1973 (Section 504) (29 U.S.C. § 794) and maintain capacity to deliver services in a manner that accommodates the needs of its Enrollees. The Contractor shall have written policies and procedures to assure compliance, including ensuring that physical, communication, and programmatic barriers do not inhibit individuals with disabilities from obtaining all Covered Services from the Contractor by: Providing flexibility in scheduling to accommodate the needs of the Enrollees; Ensuring that individuals with disabilities are provided with reasonable accommodations to ensure effective communication, including auxiliary aids and services. Reasonable accommodations will depend on the particular needs of the individual and include but are not limited to: Providing large print (at least 16-point font) versions of all written materials to individuals with visual impairments; Ensuring that all written materials are available in formats compatible with optical recognition software; Reading notices and other written materials to individuals upon request; Assisting individuals in filling out forms over the telephone; Ensuring effective communication to and from individuals with disabilities through email, telephone, and other electronic means; TTY, computer-aided transcription services, telephone handset amplifiers, assistive listening systems, closed caption decoders, videotext displays and qualified American Sign Language interpreters for the Deaf; and Individualized forms of assistance; Ensuring safe and appropriate physical access to buildings, services and equipment; Demonstrating compliance with the ADA by conducting an independent survey or site review of facilities for both physical and programmatic accessibility;, documenting any deficiencies in compliance and monitoring correction of deficiencies;