Family Planning The MCO must ensure that its network includes sufficient family planning providers to ensure timely access to covered family planning services for enrollees. Although family planning services are included within the MCO’s list of covered benefits, Medicaid enrollees are entitled to obtain all Medicaid covered family planning services without prior authorization through any Medicaid provider, who will bill the MCO and be paid on a FFS basis.4 The MCO must give each enrollee, including adolescents, the opportunity to use his/her own primary care provider or go to any family planning center for family planning services without requiring a referral. The MCO must make a reasonable effort to Subcontract with all local family planning clinics and providers, including those funded by Title X of the Public Health Services Act, and must reimburse providers for all family planning services regardless of whether they are rendered by a participating or non-participating provider. Unless otherwise negotiated, the MCO must reimburse providers of family planning services at the Medicaid rate. The MCO may, however, at its discretion, impose a withhold on a contracted primary care provider for such family planning services. The MCO may require family planning providers to submit claims or reports in specified formats before reimbursing services. MCOs must provide their Medicaid enrollees with sufficient information to allow them to make an informed choice including: the types of family planning services available, their right to access these services in a timely and confidential manner, and their freedom to choose a qualified family planning provider both within and outside the MCO’s network of providers. In addition, MCOs must ensure that network procedures for accessing family planning services are convenient and easily comprehensible to enrollees. MCOs must also educate enrollees regarding the positive impact of coordinated care on their health outcomes, so enrollees will prefer to access in-network services or, if they should decide to see out-of-network providers, they will agree to the exchange of medical information between providers for better coordination of care. In addition, MCOs are required to provide timely reimbursement for out-of-network family planning and related STD services consistent with services covered in their contracts. The reimbursement must be provided at least at the applicable West Virginia Medicaid FFS rate 4 Access to family planning services without prior notification is a federal law. Under OBRA 1987 Section 4113(c)(1)(B), “enrollment of an individual eligible for medical assistance in a primary case management system, a health maintenance organization or a similar entity must not restrict the choice of the qualified person, from whom the individual may receive services under Section 1905(a)(4)(c).” Therefore, Medicaid enrollees must be allowed freedom of choice of family planning providers and may receive such services from any family planning provider, including those outside the MCO’s provider network, without prior authorization. appropriate to the provider type (current family planning services fee schedule available from BMS). The MCO, its staff, contracted providers and its contractors that are providing cost, quality, or medical appropriateness reviews or coordination of benefits or subrogation must keep family planning information and records confidential in favor of the individual patient, even if the patient is a minor. The MCO, its staff, contracted providers and its contractors that are providing cost, quality, or medical appropriateness reviews, or coordination of benefits or subrogation must also keep family planning information and records received from non-participating providers confidential in favor of the individual patient even if the patient is a minor. Maternity services, hysterectomies, and pregnancy terminations are not considered family planning services.
Newsletter ☐ Yes, I would like to receive the newsletter. The monthly newsletter serves to keep you informed about new courses, new teachers, new developments, as well as internal and external events hosted by the GMS, its teachers and its partners. To send the newsletter, we use the mail service provider 'Mailchimp' from the United States. The provider is the Rocket Science Group LLC, 000 Xxxxx Xx Xxxx Ave NE, Suite 5000,Atlanta,GA 30308, USA. They store the mail address, and, where applicable, the first name and the IP address. For further information, please read the data protection agreement. ☐ Yes, I hereby grant my consent. Without the agreement it is not possible to subscribe to the newsletter. I can cancel the agreement at any point in the future. Use of photo, audio and video-material To promote itself and its own events, courses and programs the GMS uses photo material and sometimes audio or video recordings. ☐ Yes, I hereby grant my consent to the GMS to use photos of myself (or of my child) as well as audio/video recordings made of courses, workshops or events for promotional purposes without requiring special permission. I can cancel this agreement any point in the future.
JOB FAMILY: APPLICATIONS DEVELOPMENT Job Title: Director, Systems and Programming Job#: 1200 General Characteristics Responsible for the full systems development life cycle management of projects/programs. Provides direction for technical and business resources. Actively participates in long-range strategy planning and manages policy development to address complex business issues, provides leadership to cross-functional teams. Serves as the primary point of contact from project/program inception to delivery. Defines and develops project management infrastructure, manages a methodology driven quality plan, monitors and controls the quality of the deliverable, as well as manages the project completion process through customer acceptance. Works with business unit managers and forms alliances on projects, operational decisions, scheduling requirements/conflicts and vendor contract clarification.
Reducing Text Messaging While Driving Pursuant to Executive Order 13513, 74 FR 51225 (Oct. 6, 2009), Recipient should encourage its employees, subrecipients, and contractors to adopt and enforce policies that ban text messaging while driving, and Recipient should establish workplace safety policies to decrease accidents caused by distracted drivers.
Child Rearing Teachers shall be granted a leave for child rearing purposes of up to one (1) year without pay or increment. This includes both adoption and birth. Upon written request, such leave may be extended up to one (1) year without pay or increment.
Field Training Officer When a Public Safety Officer has been designated as a Field Training Officer for a new employee he/she will receive a five percent (5%) increase for all the hours they provide direct training/instruction.
Federally Qualified Health Centers (A) The Contractor shall not restrict an Enrollee’s right to obtain FQHC services outside the PMHP through the Fee For Service Medicaid program.
Contact Tracing While the employees are on the job site, Producers may require that employees participate in systems that enable contact tracing, such as use of a “punch card” system to record the employee’s location throughout the day or by means of electronic devices (e.g., phone “apps” or wearable electronic devices that track the movement or location of a person or which detect when a person wearing the device comes into close contact with another person wearing the device). Producers may require employees to sign documentation consenting to the use of such electronic devices in contact tracing. In the event that a Producer uses electronic devices for contact tracing, it may access information collected from those devices only for purposes of tracing individuals that the employee has been in contact with during working hours when there has been a COVID- 19-related event, or for purposes of managing and enforcing social distancing protocols.
CHILD AND DEPENDENT ADULT/ELDER ABUSE REPORTING CONTRACTOR shall establish a procedure acceptable to ADMINISTRATOR to ensure that all employees, agents, subcontractors, and all other individuals performing services under this Agreement report child abuse or neglect to one of the agencies specified in Penal Code Section 11165.9 and dependent adult or elder abuse as defined in Section 15610.07 of the WIC to one of the agencies specified in WIC Section 15630. CONTRACTOR shall require such employees, agents, subcontractors, and all other individuals performing services under this Agreement to sign a statement acknowledging the child abuse reporting requirements set forth in Sections 11166 and 11166.05 of the Penal Code and the dependent adult and elder abuse reporting requirements, as set forth in Section 15630 of the WIC, and shall comply with the provisions of these code sections, as they now exist or as they may hereafter be amended.
Family Sick Leave An employee may use Family Sick Leave for the illness of a member of the employee's immediate family who requires the care and assistance of the employee. Up to eighty (80) hours per calendar year of the employee’s accumulated unused sick leave may be used for this purpose.
