Member-To-PCP Ratios. The Contractor agrees to assign no more than fifteen hundred (1,500) members to any single PCP in its network. For PCP teams and PCP sites, the Contractor agrees to assign no more than one thousand (1,000) members per single primary care provider within the team or site, e.g., a PCP team with three (3) providers may be assigned up to three thousand (3,000) members.
Member-To-PCP Ratios. As a means of measuring accessibility, the Contractor must have at least one (1) full-time equivalent (FTE) pediatric PCP, for every 1,500 FAMIS members, and there must be one (1) FTE PCP with pediatric training and/or experience for every 1,500 members under the age of eighteen (18). No PCP may be assigned members in excess of these limits, except where mid- level practitioners are used to support the PCP’s practice. Each contract between the Contractor and any of its network providers who are willing to act as a PCP must indicate the number of open panel slots available to the Contractor for members under this Contract. This standard refers to the total members under enrollment by the Contractor as identified in this Contract. If necessary to meet or maintain appointment availability standards set forth in this Contract, the Contractor shall decrease the number of members assigned to a PCP. When specialists act as PCPs, the duties they perform must be within the scope of their specialist’s license.
