Enrollment with the State. All network providers that order, refer, or render Medicaid covered services must enroll with BMS, through the fiscal agent, as a Medicaid provider, as required by 42 CFR §438.602(b). Enrollment with BMS does not obligate the MCO provider to offer services under the FFS delivery system. The MCO is not required to contract with a provider enrolled with BMS that does not meet their credentialing or other requirements. As part of the provider enrollment process, the fiscal agent, on behalf of BMS, will perform monthly federal databases checks as required by 42 CFR §455.436 and share results with the MCO. The MCO must collaborate with the fiscal agent to ensure compliance of all entities per Article II, Section 8.7. The MCO may execute a provider agreement, pending the outcome of this screening, enrollment, and revalidation, for up to one hundred twenty (120) days. However, the MCO must terminate the network provider immediately upon notification from the state that the network provider cannot be enrolled, or if the one hundred twenty (120) day period expired without state enrollment of the provider. Upon termination of the provider from the MCO’s network, the MCO must notify all affected enrollees.
Appears in 3 contracts
Samples: Model Purchase of Service Provider Agreement, Service Provider Agreement, Model Purchase of Service Provider Agreement
Enrollment with the State. All network providers that order, refer, or render Medicaid covered services must enroll with BMSthe Department, through the fiscal agent, as a Medicaid provider, as required by 42 CFR §438.602(b). Enrollment with BMS the Department does not obligate the MCO provider to offer services under the FFS delivery system. The MCO is not required to contract with a provider enrolled with BMS the Department that does not meet their credentialing or other requirements. As part of the provider enrollment process, the fiscal agent, on behalf of BMSthe Department, will perform monthly federal databases checks as required by 42 CFR §455.436 and share results with the MCO. The MCO must collaborate with the fiscal agent to ensure compliance of all entities per Article II, Section 8.7. The MCO may execute a provider agreement, pending the outcome of this screening, enrollment, and revalidation, for up to one hundred twenty (120) days. However, the MCO must terminate the network provider immediately upon notification from the state that the network provider cannot be enrolled, or if the one hundred twenty (120) day period expired without state enrollment of the provider. Upon termination of the provider from the MCO’s network, the MCO must notify all affected enrollees.
Appears in 3 contracts
Samples: Service Provider Agreement, dhhr.wv.gov, dhhr.wv.gov
Enrollment with the State. All network providers that order, refer, or render Medicaid covered services must enroll with BMSthe Department, through the fiscal agent, as a Medicaid provider, as required by 42 CFR §438.602(b). Enrollment with BMS the Department does not obligate the MCO provider to offer services under the FFS delivery system. The MCO is not required to contract with a provider enrolled with BMS the Department that does not meet their credentialing or other requirements. As part of the provider enrollment process, the fiscal agent, on behalf of BMSthe Department, will perform monthly federal databases checks as required by 42 CFR §455.436 and share results with the MCO. The MCO must collaborate with the fiscal agent to ensure compliance of all entities per Article II, Section 8.7. The MCO may execute a provider agreement, pending the outcome of this screening, enrollment, and revalidation, for up to one hundred twenty (120) days. However, the MCO must terminate the network provider immediately upon notification from the state that the network provider cannot be enrolled, or if the one hundred twenty (120) day period expired without state enrollment of the provider. Upon termination of the provider from the MCO’s network, the MCO must notify all affected enrollees.
Appears in 2 contracts
Samples: dhhr.wv.gov, dhhr.wv.gov
Enrollment with the State. All network providers that order, refer, or render Medicaid covered services must enroll with BMS, through the fiscal agent, as a Medicaid provider, as required by 42 CFR §438.602(b). Enrollment with BMS does not obligate the MCO provider to offer services under the FFS delivery system. The MCO is not required to contract with a provider enrolled with BMS that does not meet their credentialing or other requirements. As part of the provider enrollment process, the fiscal agent, on behalf of BMS, will perform monthly federal databases checks as required by 42 CFR §455.436 and share results with the MCO. The MCO must collaborate with the fiscal agent to ensure compliance of all entities per Article II, Section 8.7. The MCO may execute a provider agreement, pending the outcome of this screening, enrollment, and revalidation, for up to one hundred twenty (120) days. However, the MCO must terminate the network provider immediately upon notification from the state that the network provider cannot be enrolled, or if the one hundred twenty (120) day period expired without state enrollment of the provider. Upon termination of the provider from the MCO’s network, the MCO must notify all affected enrollees.
Appears in 2 contracts
Samples: Model Purchase of Service Provider Agreement, Service Provider Agreement