Common use of Hospital Services Clause in Contracts

Hospital Services. Enrollees shall have a choice of two (2) hospitals within the applicable time and distance standards set forth in Section 2.8. 2.1.1 except that if only one (1) hospital is located within a County, the second hospital may be within a fifty (50) mile radius of the Enrollee’s ZIP code of residence; Nursing Facilities 2.1.1. except that if only one (1) nursing facility is located within a County, the second nursing facility may be within a fifty (50) mile radius of the Enrollee’s ZIP code of residence. In addition, the Contractor must demonstrate annually that its Provider Network has sufficient providers to ensure that each Enrollee has a choice of at least two (2) outpatient and diversionary Behavioral Health Providers and two (2) community LTSS providers per Covered Service as referenced in Appendix A and defined in Appendix B that are either within a fifteen (15)mile radius or thirty (30) minutes from the Enrollee’s ZIP code of residence, except that with EOHHS prior approval, Contractor may offer Enrollee only one community LTSS provider per Covered Service.

Hospital Services. Enrollees shall have a choice of two (2) hospitals within the applicable time and distance standards set forth in Section 2.8. 2.1.1 except that if only one (1) hospital is located within a County, the second hospital may be within a fifty (50) mile radius of the Enrollee’s Enrollee‘s ZIP code of residence; Nursing Facilities 2.1.1. except that if only one (1) nursing facility is located within a County, the second nursing facility may be within a fifty (50) mile radius of the Enrollee’s Enrollee‘s ZIP code of residence. In addition, the Contractor must demonstrate annually that its Provider Network has sufficient providers to ensure that each Enrollee has a choice of at least two (2) outpatient and diversionary Behavioral Health Providers and two (2) community LTSS providers per Covered Service as referenced in Appendix A and defined in Appendix B that are either within a fifteen (15)mile radius or thirty (30) minutes from the Enrollee’s Enrollee‘s ZIP code of residence, except that with EOHHS prior approval, Contractor may offer Enrollee only one community LTSS provider per Covered Service.