Federally Qualified Health Centers (FQHCs) Sample Clauses

Federally Qualified Health Centers (FQHCs). In voluntary counties, the Contractor is not required to contract with FQHCs. However, when an FQHC is part of the provider network (voluntary or mandatory counties) the Provider Agreement must include a provision whereby the SECTION 21 (PROVIDER NETWORK AND AGREEMENTS) October 1, 2004 21-10 Contractor agrees to compensate the FQHC for services provided to Enrollees at a payment rate that is not less than the level and amount for a similar set of services which the Contractor would make to a provider that is not an FQHC. In mandatory counties, the Contractor shall contract with FQHCs operating in its Service Area. However, the Contractor has the option to make a written request to the SDOH for an exemption from the FQHC contracting requirement, if the Contractor can demonstrate, with supporting documentation, that it has adequate capacity and will provide a comparable level of clinical and enabling services (e.g., outreach, referral services, social support services, culturally sensitive services such as training for medical and administrative staff, medical and non-medical and case management services) to vulnerable populations in lieu of contracting with an FQHC in its Service Area. Written requests for exemption from this requirement are subject to approval by HCFA. When the Contractor is participating in a county where an MCO that is sponsored, owned and/or operated by one or more FQHCs exists, the Contractor is not required to include any FQHCs within its network in that county.
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Federally Qualified Health Centers (FQHCs). Pursuant to the Three-Way Contract, MCOP payments to FQHCs should be no less than the sum of the following:
Federally Qualified Health Centers (FQHCs). 4.8.8.1 The Contractor shall include in its Provider network all FQHCs in its Service Region based on PPS rates. 4.8.8.2 The Contractor shall maintain copies of all letters and other correspondence related to its efforts to include FQHCs in its network. This documentation shall be provided to DCH upon request. 4.8.8.3 The FQHC must agree to provide those primary care services typically included as part of a physician’s medical practice, as described in §901 of State Medicaid Manual Part II for FQHC (the Manual). Services and supplies deemed necessary for the provision of a Core services as described in §901.2 of the Manual are considered part of the FQHC service. In addition, an FQHC can provide other ambulatory services of the following state Medicaid Program, once enrolled in the programs: · Health Check (COS 600), · Mental Health (COS 440), · Dental Services (COS 450 and 460), · Refractive Vision Care services (COS 470), · Podiatry (COS 550), · Pregnancy Related services (COS 730), and
Federally Qualified Health Centers (FQHCs). Pursuant to the Three-Way Contract, MCOP payments to FQHCs should be no less than the sum of the following: 1. The level and amount of payment that the MCOP would make for such services provided by a non-FQHC provider; and 2. The difference between 80% of the Medicare fee-for-service rate for the FQHC and the Medicaid prospective payment system (PPS) amount for the FQHC, where the Medicaid PPS amount exceeds 80% of the Medicare rate. The MCOP shall provide an expedited unbundled payment on a per-service basis (by procedure code) in an amount no less than the payment made to other providers for the same or similar service.
Federally Qualified Health Centers (FQHCs). A. Federally Qualified Health Centers (FQHCs) are federally funded Community Health Centers, Migrant Health Centers and Health Care for the Homeless Projects that receive grants under Sections 329, 330 and 340 of the US Public Health Services Act. The current federal statute, Section 1902(a)(13)(E) of the Social Security Act, specifies that states shall guarantee access to FQHCs and Rural Health Centers (RHCs) under Medicaid managed care programs; therefore, the CONTRACTOR shall provide access to FQHCs and RHCs to the extent that access is required under federal law. B. The CONTRACTOR shall contract with as many FQHCs and RHCs as necessary to permit beneficiaries access to participating FQHCs and RHCs without having to travel a significant distance. At least one FQHC shall specialize in provider health care for the homeless in Bernalillo County. At least one FQHC shall be with one urban Indian FQHC in Bernalillo County. C. The CONTRACTOR shall contract with FQHCs and RHCs in accordance with the 30-minute travel time standards for routinely used delivery sites. A CONTRACTOR with an FQHC or RHC on its panel that has no capacity to accept new patients shall not satisfy these requirements unless there exist no other FQHCs or RHCs in the area. D. The CONTRACTOR shall offer FQHCs and RHCs terms and conditions, including reimbursement, that are at least equal to those offered to other providers of comparable services. E. If the CONTRACTOR cannot satisfy the standard for FQHC and RHC access at any time while the CONTRACTOR holds a Medicaid contract, the CONTRACTOR shall allow its members to seek care from non-contracting FQHCs and RHCs and shall reimburse these providers at the Medicaid fee schedule.
Federally Qualified Health Centers (FQHCs). 2.11.6.1.1 The CONTRACTOR is encouraged to contract with FQHCs and other safety net providers (e.g., rural health clinics) in the CONTRACTOR’s service area to the extent possible and practical. Where FQHCs are not utilized, the CONTRACTOR must demonstrate to DHHS, the Tennessee DHS and TENNCARE that both adequate capacity and an appropriate range of services for vulnerable populations exist to serve the expected enrollment in the CONTRACTOR’s service area without contracting with FQHCs. 2.11.6.1.2 FQHC reporting information shall be submitted to TENNCARE as described in Section 2.30.7.6 of this Agreement.
Federally Qualified Health Centers (FQHCs) 
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Related to Federally Qualified Health Centers (FQHCs)

  • Extended Health Care Plan ‌ The Employer shall pay the monthly premium for regular employees entitled to coverage under a mutually acceptable extended health care plan.

  • Please see the current Washtenaw Community College catalog for up-to-date program requirements Conditions & Requirements

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  • Extended Health Care Benefits The City will provide for all employees by contract through an insurer selected by the City an Extended Health Care Plan which will provide extended health care benefits. The City shall pay one hundred per cent (100%) of the premiums, which will include any premiums payable under The Health Insurance Act, R.S.O. 1990, as amended.

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  • Family and Medical Leave Act (FMLA In accordance with the Family and Medical Leave Act (FMLA) of 1993, the Board will grant a leave of absence for one or more of the following: 1. Because of the birth of a son or daughter of the employee, and in order to care for such son or daughter; 2. Because of the placement of a son or daughter with the employee for adoption or xxxxxx care; 3. To care for the employee's spouse, son or daughter, or par- ent, in laws or members of blended families or other per- sons in a similar relationship that live in the family house- hold or are in a similar family relationship who has a serious health condition; or, 4. The employee is unable to perform the essential job func- tions because of a serious health condition. 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Continuation of medical, optical and dental benefits and the right to job restoration ceases when an employee has used twelve (12) work weeks of FMLA leave in the twelve (12) month period. (See Section B, Medical Leave of Absence). An employee requesting a FMLA leave must provide the Xxxxx- xxxx Superintendent of Human Resources at least thirty (30) days advance notice of when the leave is to begin. If such no- xxxx is not practicable, then notice is to be provided as soon as practicable. When a leave denoted as (1) or (2) above is granted, the leave must be taken in one (1) continuous increment, and must be concluded within twelve (12) months of the date of birth or placement. Employees granted such leave must utilize accu- mulated vacation days and accumulated personal business days (in that order), after which time the leave is unpaid. 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Leaves denoted as (3) or (4) above must be supported by med- ical certification from a health care provider stating (1) the date on which the serious health condition commenced, (2) the probable duration of the condition, (3) the appropriate medical facts, and (4) a statement that the employee is unable to per- form the essential functions of his/her position, or that the em- ployee is needed to care for the person. The District reserves the right to require the employee to obtain the opinion of a sec- ond health care provider designated or approved by the District concerning any information within the medical certification. When a FMLA leave denoted as (1) or (2) above is granted to spouses who are both employed by the District, the total amount of time on leave (in total for both employees) cannot exceed twelve (12) weeks of FMLA time. 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