MCO Covered Services Clause Samples
MCO Covered Services those services specified in Appendix C of the Contract which are coordinated by the Contractor, but are provided by EOHHS on an FFS basis.
MCO Covered Services. 2.4.1.1 The Contractor shall provide Members all medically necessary MCO Covered Services specified in Attachment B, MCO Covered Services, as those services are defined in the State Plan and the MCO Manual. The Contractor shall possess the expertise and resources to ensure the delivery of quality healthcare services to its Enrollees in accordance with this Contract and prevailing medical community and national standards.
MCO Covered Services. 2.5.1.1 The Contractor shall provide enrollees all medically necessary MCO covered services specified in Attachment A, MCO Covered Services, as those services are defined in the Louisiana Medicaid State Plan and the MCO Manual. The Contractor shall possess the expertise and resources to ensure the delivery of quality healthcare services to its enrollees in accordance with this Contract and prevailing medical community and national standards.
2.5.1.2 MCO covered services shall be furnished in an amount, duration, and scope that is no less than the amount, duration, and scope for the same services furnished to beneficiaries under fee-for-service (FFS) Medicaid, as set forth in 42 C.F.R. §440.230, and for enrollees under the age of 21, as set forth in 42 C.F.R. Part 441, Subpart B. [42 C.F.R. §438.210(a)(2)]
MCO Covered Services. Those Medicaid covered health care benefits and services that are required to be provided by the Contractor to Medicaid enrollees as specified in Attachment A of the Contract. (In lieu of services and value-added benefits are described in Attachments B and C.)