Geographic Access. Upon United’s written request, Vendor shall provide United with a current listing of Participating Providers. Vendor’s Participating Provider network will be sufficient to ensure that all Members within United Service Area have reasonable access to Covered Services and in accordance with applicable state and federal law or state contract availability and access requirements. If United reasonably determines that there are not sufficient Participating Providers to provide Covered Services to Members: - United shall notify Vendor of the alleged deficiency; - United and Vendor shall meet to discuss the alleged deficiency; and - If appropriate, develop a mutually satisfactory plan of correction within thirty (30) days of such notice. United shall have the ability to impose unilaterally a corrective plan of action if the parties cannot develop such a plan in a timely and mutually satisfactory manner. United shall notify Vendor in writing at least ninety (90) days prior to any modification of United’s Service Area. Vendor shall use best efforts to arrange for Participating Providers in such expanded Service Area within ninety (90) days of receiving such notice, at which time the definition of Service Area in this Agreement shall include such expansion without further compliance with Section 11.2 of the Agreement.
Geographic Access. (a) CompCare shall assure that one hundred percent (100%) of all Members residing within the Service Area are within thirty (30) miles or thirty (30) minutes of a CompCare Provider.
(b) CompCare shall provide on a monthly basis to Health Plans a current listing of CompCare Providers, as required by Exhibit E. In the event Health Plans reasonably determine that there are not sufficient CompCare Providers to provide MHSA Services to Members, Health Plans shall notify CompCare of the alleged deficiency, and within ten calendar (10) days, Health Plans and CompCare shall meet to assess the alleged deficiency, and if directed by Health Plans, CompCare shall develop and successfully implement a correction plan acceptable to Health Plans.
Geographic Access. 2.5.1.3.1. The Contractor shall establish and maintain adequate arrangements to ensure reasonable proximity of Participating Providers to the residence of Members so as not to result in unreasonable barriers to access and to promote continuity of care, taking into account the usual means of transportation ordinarily used by Members. The Contractor shall have Providers located throughout the Contractor’s Service Area within thirty (30) miles or thirty (30) minutes travel time to the extent such services are available.
Geographic Access. The DEPARTMENT will randomly monitor geographic access by reviewing the mileage to the nearest town containing a PCP for every town in which the MCO has Members. SANCTION: In any sampling, if more than two (2) percent of Members reside in towns beyond fifteen (15) miles of a town containing a PCP the DEPARTMENT may impose a strike towards a Class A sanction pursuant to Section 7.05. Part II 15 August 13 2003
Geographic Access. The following lists guidelines for urban geographic access for the DMAHS population. (Standards for non-urban areas are included in the table in H. above). The State shall review (and approve) exceptions on a case-by-case basis to determine appropriateness for each situation. For each contractor and for each municipality in each county in which the contractor is operational, the access shall be reviewed in accordance with the number and percentage of:
1. Beneficiary children who reside within 6 miles of 2 PCPs whose specialty is Family Practice, General Practice or Pediatrics or 2 CNPs/CNSs; within 2 miles of 1 PCP whose specialty is Family Practice, General Practice or Pediatrics or 1 CNP or 1 CNS 2 Beneficiary adults who reside within 6 miles of 2 PCPs whose specialty is Family Practice, General Practice or Internal Medicine or 2 CNPs or 2 CNSs; within 2 miles of 1 PCP whose specialty is Family Practice, General Practice or Internal Medicine or 1 CNP or 1 CNS
Geographic Access. Upon written request, Vendor shall provide United with a current listing of Dental Providers. In the event United reasonably determines that there are not sufficient Dental Providers to provide Dental Services to Covered Persons: (i) United shall notify Vendor of the alleged deficiency; (ii) United and Vendor shall meet to discuss the alleged deficiency, and (iii) If appropriate, United and Vendor shall develop a mutually satisfactory plan of correction within thirty (30) days of such notice. United shall notify Vendor in writing at least ninety (90) days prior to any modification of United Service Area. Vendor shall use best efforts to arrange for Dental Providers in such expanded Service Area within ninety (90) days of receiving such notice, at which time the definition of Service Area in the Agreement shall include such expansion without further compliance with Section 13.2 of the Agreement.
Geographic Access. The Contractor shall establish and maintain adequate arrangements to ensure reasonable proximity of Participating Providers to the residence of Members so as not to result in unreasonable barriers to access and to promote continuity of care, taking into account the usual means of transportation ordinarily used by Members in accordance with 42 CFR 438.6(k)(2). The Contractor’s PCMP network shall have a sufficient number of PCMPs so that each Member has a PCMP and each Member has their choice of at least two (2) PCMPs within their zip code or within thirty (30) minutes of driving time from their location, whichever area is larger. For rural and frontier areas, the Department may adjust this requirement based on the number and location of available providers.
Geographic Access. 12 4.4. APS TRIAGE OF CARE ................................................ 13 4.5. PROVISION OF MHSA SERVICES AND UM SERVICES ........................ 13 4.6. AVAILABILITY OF IN-NETWORK MHSA SERVICES .......................... 14 4.7.
Geographic Access. The DEPARTMENT will randomly monitor geographic access by reviewing the mileage to the nearest town containing a PCP for every town in which the MCO has Members.
Geographic Access. 4.3.1. NETWORK CONFIGURATION. PBHC shall configure its network of MHSA Providers as required by applicable law. Upon request by an HMO Subsidiary, PBHC shall provide each HMO Subsidiary with current directories of MHSA Providers in that HMO Subsidiary's Service Area. In the event an HMO Subsidiary reasonably determines that there are not sufficient MHSA Providers to provide MHSA Services to Members, an HMO Subsidiary shall notify PBHC of the alleged deficiency and within 30 days, the HMO Subsidiary and PBHC shall meet to assess the alleged deficiency, and if appropriate, develop a mutually satisfactory plan of correction.
