Mainstreaming. The State considers mainstreaming of Medicaid beneficiaries into the broader health delivery system to be important. The MCO must accept responsibility for ensuring that network providers do not intentionally segregate Medicaid enrollees in any way from other persons receiving services. Examples of prohibited practices include, but are not limited to, the following:
1. Denying or not providing to an enrollee any covered service or availability of a facility;
2. Providing to an enrollee any covered service which is different, or is provided in a different manner or at a different time from that provided to other enrollees, other public or private patients or the public at large;
3. Subjecting an enrollee to segregation or separate treatment in any manner related to the receipt of any covered service; and
4. Assigning times or places for the provision of services on the basis of the race, color, creed, religion, age, sex, national origin, ancestry, marital status, sexual preference, income status, program membership or physical or mental disability of the participants to be served. PCPs will not be permitted to close their panels to Medicaid enrollees alone. If a PCP’s panel is closed, it must be closed to all enrollees. Should a panel reopen, it will be required to admit patients on a first come, first served basis. However, if a PCP has the maximum of 2,000 Medicaid enrollees, the PCP may admit additional, non-Medicaid patients.
Mainstreaming. The State considers mainstreaming of members into the broader health delivery system to be an important program objective. The Contractor agrees that all of its network providers will accept members for treatment. The Contractor agrees to have policies and procedures in place such that any provider in its network who refuses to accept a member for treatment cannot accept non- members for treatment and remain in the network. The Contractor also agrees to accept responsibility for ensuring that network providers do not intentionally segregate members in any way from other persons receiving services. A violation of these terms may be considered a material breach and any such material breach may be grounds for termination of this Agreement under the provisions of Section 3.10.01 (Termination for Default).
Mainstreaming. Special education procedures and forms are available on the intranet to all employees with information on:
Mainstreaming. 4.8.16.1 The Contractor shall encourage that all In-Network Providers accept Members for treatment, unless they have a full panel (2500 members) and are accepting no new GF or commercial patients. The Contractor shall ensure that In-Network Providers do not intentionally segregate Members in any way from other persons receiving services.
4.8.16.2 The Contractor shall ensure that Members are provided services without regard to race, color, creed, sex, religion, age, national origin, ancestry, marital status, sexual preference, health status, income status, or physical or mental disability.
Mainstreaming. The Board will make a sincere effort to make sure that mainstreamed students are equally balanced between sections and teachers. Further, the Board pledges the support of special services personnel to help regular classroom teachers. In the event that there are mainstreamed students who cause more problems than should be expected from such students, action shall be taken to exclude those students from participating in mainstreaming. No child shall be mainstreamed without the knowledge of the classroom teachers.
Mainstreaming. Provider shall accept all Covered Persons for treatment. If Provider refuses to accept a Covered Person for treatment, Provider may not accept non-Covered Persons for treatment and remain in the Subcontractor or Health Plan network. Provider shall not segregate Covered Persons in any way from other persons receiving services from Provider.
Mainstreaming. DVHA’s policies and procedures will ensure that network providers do not intentionally discriminate against Global Commitment to Health Demonstration enrollees in the acceptance of patients into provider panels, or intentionally segregate Global Commitment to Health enrollees in any way from other individuals receiving services.
Mainstreaming. The Contractor must ensure that network Providers do not intentionally segregate their Members in any way from other persons receiving services. The Contractor must investigate Complaints regarding Providers and take affirmative action so that Members are provided covered services without regard to race, color, creed, sex, religion, age, national origin, ancestry, marital status, sexual orientation, language, health status, disease or pre-existing condition (including genetic information), anticipated need for health care or physical or mental handicap, except where medically indicated. Examples of prohibited practices include, but are not limited to, the following:
1. Denying or not providing a Member any Medicaid covered service or availability of a facility within the Contractor’s network. Health care and treatment necessary to preserve life must be provided to all Members who are not terminally ill or permanently unconscious, except where a competent Member objects to such care on his/her own behalf.
2. Subjecting a Member to segregated, separate, or different treatment, including a different place or time from that provided to other Members, public or private patients, in any manner related to the receipt of any Medicaid covered service, except where medically necessary.
3. The assignment of times or places for the provision of services on the basis of the race, color, creed, religion, age, sex, national origin, ancestry, marital status, sexual orientation, income status, program membership, language, health status, disease or pre-existing condition, anticipated need for health care or physical or mental disability of the Members to be served. If the Contractor knowingly executes an agreement with a Provider with the intent of allowing or permitting the Provider to implement barriers to care (e.g., the terms of the Provider agreement are more restrictive than this Contract), the Contractor shall be in breach of this Contract.
Mainstreaming. 4.8.16.1 The Contractor shall encourage that all In-Network Providers accept Members and P4HB Participants for treatment, unless they have a full panel (2500 members and P4HB Participants) and are accepting no new GF or commercial patients. The Contractor shall ensure that In-Network Providers do not intentionally segregate Members and P4HB Participants in any way from other persons receiving services.
4.8.16.2 The Contractor shall ensure that Members and P4HB Participants are provided services without regard to race, color, creed, sex, religion, age, national origin, ancestry, marital status, sexual preference, health status, income status, or physical or mental disability.
Mainstreaming. All special education students are guaranteed access to general education participation to the maximum extent appropriate. For students who require special education instructional support for the majority of their school day (students in special day class placements), the District must define the amount of time they can successfully participate in general education. This “mainstreaming” back into the general education program allows the student access to the general education instruction as well as access to typically developing peers for ongoing development.
