Common use of Necessity or Appropriateness of Services Clause in Contracts

Necessity or Appropriateness of Services. a. Use of Approved Service Authorization Policies The IDT shall use the MCO’s Department-approved service authorization policies and procedures to authorize services. The IDT shall not deny services that are necessary to reasonably and effectively support the member’s long term care outcomes identified in the comprehensive assessment as well as those necessary to assist the member to be as self- reliant and autonomous as possible.

Necessity or Appropriateness of Services. a. Use of Approved Service Authorization Policies The IDT shall use the MCO’s Department-approved service authorization policies and procedures to authorize services. The IDT shall not deny services that are reasonable and necessary to reasonably and cost-effectively support the member’s long term care outcomes identified in the comprehensive assessment as well as those necessary to assist the member to be as self- reliant and autonomous as possible.. Long-term care outcomes for which services are authorized may relate to:

Necessity or Appropriateness of Services. a. Use of Approved Service Authorization Policies The IDT shall use the MCO’s DepartmentDHS-approved service authorization policies and procedures to authorize services. The IDT shall not deny services that are reasonable and necessary to reasonably and effectively support the member’s long term care outcomes identified in the comprehensive assessment as well as those necessary to assist the member to be as self- self-reliant and autonomous as possible.. Long-term care outcomes for which services are authorized may relate to:

Necessity or Appropriateness of Services. a. Use of Approved Service Authorization Policies The IDT shall use the MCO’s Department-approved service authorization policies and procedures to authorize services. The IDT shall not deny services that are necessary to reasonably and effectively support the member’s long term care outcomes identified in the comprehensive assessment as well as those necessary to assist the member to be as self- self-reliant and autonomous as possible.

Necessity or Appropriateness of Services. a. Use of Approved Service Authorization Policies The IDT shall use the MCOPO’s Department-approved service authorization policies and procedures to authorize services. The IDT shall not deny services that are reasonable and necessary to reasonably and cost-effectively support the member’s long term care outcomes identified in the comprehensive assessment as well as those necessary to assist the member to be as self- reliant and autonomous as possible.. Long-term care outcomes for which services are authorized may relate to: