Common use of Network Development Clause in Contracts

Network Development. OMPP requires the Contractor to develop and maintain a comprehensive network to provide services to its Hoosier Healthwise members. The network must include providers serving special needs populations, including providers serving children with special health care needs. The Contractor shall develop a comprehensive network prior to the effective date of the Contract. The Contractor shall be required during the readiness review process to demonstrate network adequacy through the submission of Geo Access reports in the manner and timeframe required by OMPP. The Contractor shall be required to have an open network and accept any IHCP provider acting within his or her scope of practice until the Contractor demonstrates that it meets the access requirements. OMPP reserves the right to delay initial member enrollment in the Contractor’s plan if the Contractor fails to demonstrate a complete and comprehensive network. With approval from OMPP, Contractors that can demonstrate that they have met all access, availability and network composition requirements may require members to use in-network providers, with the exception of certain self-referral providers as described in Section 3.2. The Contractor must provide ninety (90) calendar day advance notice to OMPP of changes to the network that may affect access, availability and network composition. OMPP shall regularly and routinely monitor network access, availability and adequacy. OMPP shall impose remedies, as set forth in Exhibit 2, or require the Contractor to maintain an open network, if the Contractor fails to meet the network composition requirements. In accordance with 42 CFR 438.206, the Contractor shall maintain and monitor the provider network. The Contractor shall establish written agreements with all network providers as further described in Section 5.4. In establishing and maintaining the network, the Contractor must consider the following elements:  The anticipated enrollment;  The expected utilization of services, taking into consideration the characteristics and health care needs of the Contractor’s Hoosier Healthwise members;  The numbers and types (in terms of training, experience and specialization) of providers required to furnish the contracted services;  The numbers of network providers who are not accepting new members; and  The geographic location of providers and members, considering distance, travel time, the means of transportation ordinarily used by members and whether the location provides physical access for members with disabilities. OMPP shall assess liquidated damages as set forth in Exhibit 2 and shall impose other authorized remedies, such as requiring the Contractor to maintain an open network, for Contractor’s non-compliance with the network development and network composition requirements. The Contractor shall contract its specialist and ancillary provider network prior to receiving enrollment. OMPP shall have the right to implement corrective actions and shall assess liquidated damages as described in Exhibit 2 if the Contractor fails to meet and maintain the specialist and ancillary provider network access standards. OMPP’s corrective actions may include, but are not limited to, withholding or suspending new member enrollment from the Contractor until the Contractor’s specialist and ancillary provider network is in place. OMPP shall monitor the Contractor’s specialist and ancillary provider network to confirm the Contractor is maintaining the required level of access to specialty care. OMPP shall have the right to increase the number or types of required specialty providers at any time.

Network Development. OMPP requires the Contractor to develop and maintain a comprehensive network to provide services to its Hoosier Healthwise members. The network must include providers serving special needs populations, including providers serving children with special health care needs. The Contractor shall develop a comprehensive network prior to the effective date of the Contract. The Contractor shall be required during the readiness review process to demonstrate network adequacy through the submission of Geo Access reports in the manner and timeframe required by OMPP. The Contractor shall be required to have an open network and accept any IHCP provider acting within his or her scope of practice until the Contractor demonstrates that it meets the access requirements. OMPP reserves the right to delay initial member enrollment in the Contractor’s plan if the Contractor fails to demonstrate a complete and comprehensive network. With approval from OMPP, Contractors that can demonstrate that they have met all access, availability and network composition requirements may require members to use in-network providers, with the exception of certain self-referral providers as described in Section 3.2. The Contractor must provide ninety (90) calendar day advance notice to OMPP of changes to the network that may affect access, availability and network composition. OMPP shall regularly and routinely monitor network access, availability and adequacy. OMPP shall impose remedies, as set forth in Exhibit 2, or require the Contractor to maintain an open network, if the Contractor fails to meet the network composition requirements. In accordance with 42 CFR 438.206, the Contractor shall maintain and monitor the provider network. The Contractor shall establish written agreements with all network providers as further described in Section 5.4. In establishing and maintaining the network, the Contractor must consider the following elements:  ▪ The anticipated enrollment;  ▪ The expected utilization of services, taking into consideration the characteristics and health care needs of the Contractor’s Hoosier Healthwise members;  ▪ The numbers and types (in terms of training, experience and specialization) of providers required to furnish the contracted services;  ▪ The numbers of network providers who are not accepting new members; and  ▪ The geographic location of providers and members, considering distance, travel time, the means of transportation ordinarily used by members and whether the location provides physical access for members with disabilities. OMPP shall assess liquidated damages as set forth in Exhibit 2 and shall impose other authorized remedies, such as requiring the Contractor to maintain an open network, for Contractor’s non-compliance with the network development and network composition requirements. The Contractor shall contract its specialist and ancillary provider network prior to receiving enrollment. OMPP shall have the right to implement corrective actions and shall assess liquidated damages as described in Exhibit 2 if the Contractor fails to meet and maintain the specialist and ancillary provider network access standards. OMPP’s corrective actions may include, but are not limited to, withholding or suspending new member enrollment from the Contractor until the Contractor’s specialist and ancillary provider network is in place. OMPP shall monitor the Contractor’s specialist and ancillary provider network to confirm the Contractor is maintaining the required level of access to specialty care. OMPP shall have the right to increase the number or types of required specialty providers at any time.

Network Development. OMPP requires the Contractor to develop and maintain a comprehensive network to provide services to its Hoosier Healthwise members. The network must include providers serving special needs populations, including providers serving children with special health care needs. The Contractor shall develop a comprehensive network prior to the effective date of the Contract. The Contractor shall be required during the readiness review process to demonstrate network adequacy through the submission of Geo Access reports in the manner and timeframe required by OMPP. The Contractor shall be required to have an open network and accept any IHCP provider acting within his or her scope of practice until the Contractor demonstrates that it meets the access requirements. OMPP reserves the right to delay initial member enrollment in the Contractor’s plan if the Contractor fails to demonstrate a complete and comprehensive network. With approval from OMPP, Contractors that can demonstrate that they have met all access, availability and network composition requirements may require members to use in-network providers, with the exception of certain self-referral providers as described in Section 3.2. The Contractor must provide ninety (90) calendar day advance notice to OMPP of changes to the network that may affect access, availability and network composition. OMPP shall regularly and routinely monitor network access, availability and adequacy. OMPP shall impose remedies, as set forth in Exhibit 2, or require the Contractor to maintain an open network, network if the Contractor fails to meet the network composition requirements. In accordance with 42 CFR 438.206, the Contractor shall maintain and monitor the provider network. The Contractor shall establish written agreements with all network providers as further described in Section 5.4. In establishing and maintaining the network, the Contractor must consider the following elements:  ▪ The anticipated enrollment;  ▪ The expected utilization of services, taking into consideration the characteristics and health care needs of the Contractor’s Hoosier Healthwise members;  ▪ The numbers and types (in terms of training, experience and specialization) of providers required to furnish the contracted services;  The numbers of network providers who are not accepting new members; and  The geographic location of providers and members, considering distance, travel time, the means of transportation ordinarily used by members and whether the location provides physical access for members with disabilities. OMPP shall assess liquidated damages as set forth in Exhibit 2 and shall impose other authorized remedies, such as requiring the Contractor to maintain an open network, for Contractor’s non-compliance with the network development and network composition requirements. The Contractor shall contract its specialist and ancillary provider network prior to receiving enrollment. OMPP shall have the right to implement corrective actions and shall assess liquidated damages as described in Exhibit 2 if the Contractor fails to meet and maintain the specialist and ancillary provider network access standards. OMPP’s corrective actions may include, but are not limited to, withholding or suspending new member enrollment from the Contractor until the Contractor’s specialist and ancillary provider network is in place. OMPP shall monitor the Contractor’s specialist and ancillary provider network to confirm the Contractor is maintaining the required level of access to specialty care. OMPP shall have the right to increase the number or types of required specialty providers at any time.;

Network Development. OMPP requires the Contractor to develop and maintain a comprehensive network to provide services to its Hoosier Healthwise members. The network must include providers serving special needs populations, including providers serving children with special health care needs. The Contractor shall develop a comprehensive network prior to the effective date of the Contract. The Contractor shall be required during the readiness review process to demonstrate network adequacy through the submission of Geo Access reports in the manner and timeframe required by OMPP. The Contractor shall be required to have an open network and accept any IHCP provider acting within his or her scope of practice until the Contractor demonstrates that it meets the access requirements. OMPP reserves the right to delay initial member enrollment in the Contractor’s plan if the Contractor fails to demonstrate a complete and comprehensive network. With approval from OMPP, Contractors that can demonstrate that they have met all access, availability and network composition requirements may require members to use in-network providers, with the exception of certain self-referral providers as described in Section 3.2. The Contractor must provide ninety (90) calendar day advance notice to OMPP of changes to the network that may affect access, availability and network composition. OMPP shall regularly and routinely monitor network access, availability and adequacy. OMPP shall impose remedies, as set forth in Exhibit 2, or require the Contractor to maintain an open network, if the Contractor fails to meet the network composition requirements. In accordance with 42 CFR 438.206, the Contractor shall maintain and monitor the provider network. The Contractor shall establish written agreements with all network providers as further described in Section 5.4. In establishing and maintaining the network, the Contractor must consider the following elements:  The anticipated enrollment;  The expected utilization of services, taking into consideration the characteristics and health care needs of the Contractor’s Hoosier Healthwise members;  The numbers and types (in terms of training, experience and specialization) of providers required to furnish the contracted services;  The numbers of network providers who are not accepting new members; and  The geographic location of providers and members, considering distance, travel time, the means of transportation ordinarily used by members and whether the location provides physical access for members with disabilities. OMPP shall assess liquidated damages as set forth in Exhibit 2 and shall impose other authorized remedies, such as requiring the Contractor to maintain an open network, for Contractor’s non-compliance with the network development and network composition requirements. The Contractor shall contract its specialist and ancillary provider network prior to receiving enrollment. OMPP shall have the right to implement corrective actions and shall assess liquidated damages as described in Exhibit 2 if the Contractor fails to meet and maintain the specialist and ancillary provider network access standards. OMPP’s corrective actions may include, but are not limited to, withholding or suspending new member enrollment from the Contractor until the Contractor’s specialist and ancillary provider network is in place. OMPP shall monitor the Contractor’s specialist and ancillary provider network to confirm the Contractor is maintaining the required level of access to specialty care. OMPP shall have the right to increase the number or types of required specialty providers at any time.and

Network Development. OMPP requires the Contractor to develop and maintain a comprehensive network to provide services to its Hoosier Healthwise members. The network must include providers serving special needs populations, including providers serving children with special health care needs. The Contractor shall develop a comprehensive network prior to the effective date of the Contract. The Contractor shall be required during the readiness review process to demonstrate network adequacy through the submission of Geo Access reports in the manner and timeframe required by OMPP. The Contractor shall be required to have an open network and accept any IHCP provider acting within his or her scope of practice until the Contractor demonstrates that it meets the access requirements. OMPP reserves the right to delay initial member enrollment in the Contractor’s plan if the Contractor fails to demonstrate a complete and comprehensive network. With approval from OMPP, Contractors that can demonstrate that they have met all access, availability and network composition requirements may require members to use in-network providers, with the exception of certain self-referral providers as described in Section 3.2. The Contractor must provide ninety (90) calendar day advance notice to OMPP of changes to the network that may affect access, availability and network composition. OMPP shall regularly and routinely monitor network access, availability and adequacy. OMPP shall impose remedies, as set forth in Exhibit 2, or require the Contractor to maintain an open network, if the Contractor fails to meet the network composition requirements. In accordance with 42 CFR 438.206, the Contractor shall maintain and monitor the provider network. The Contractor shall establish written agreements with all network providers as further described in Section 5.4. In establishing and maintaining the network, the Contractor must consider the following elements:  The anticipated enrollment;  The expected utilization of services, taking into consideration the characteristics and health care needs of the Contractor’s Hoosier Healthwise members;  The numbers and types (in terms of training, experience and specialization) of providers required to furnish the contracted services;  The numbers of network providers who are not accepting new members; and  The geographic location of providers and members, considering distance, travel time, the means of transportation ordinarily used by members and whether the location provides physical access for members with disabilities. OMPP shall assess liquidated damages as set forth in Exhibit 2 and shall impose other authorized remedies, such as requiring the Contractor to maintain an open network, for Contractor’s non-compliance with the network development and network composition requirements. The Contractor shall contract its specialist and ancillary provider network prior to receiving enrollment. OMPP shall have the right to implement corrective actions and shall assess liquidated damages as described in Exhibit 2 if the Contractor fails to meet and maintain the specialist and ancillary provider network access standards. OMPP’s corrective actions may include, but are not limited to, withholding or suspending new member enrollment from the Contractor until the Contractor’s specialist and ancillary provider network is in place. OMPP shall monitor the Contractor’s specialist and ancillary provider network to confirm the Contractor is maintaining the required level of access to specialty care. OMPP shall have the right to increase the number or types of required specialty providers at any time.EXHIBIT 1.E

Network Development. OMPP requires the Contractor to develop and maintain a comprehensive network to provide services to its Hoosier Healthwise members. The network must include providers serving special needs populations, including providers serving children with special health care needs. The Contractor shall develop a comprehensive network prior to the effective date of the Contract. The Contractor shall be required during the readiness review process to demonstrate network adequacy through the submission of Geo Access reports in the manner and timeframe required by OMPP. The Contractor shall be required to have an open network and accept any IHCP provider acting within his or her scope of practice until the Contractor demonstrates that it meets the access requirements. OMPP reserves the right to delay initial member enrollment in the Contractor’s plan if the Contractor fails to demonstrate a complete and comprehensive network. With approval from OMPP, Contractors that can demonstrate that they have met all access, availability and network composition requirements may require members to use in-network providers, with the exception of certain self-referral providers as described in Section 3.2. The Contractor must provide ninety (90) calendar day advance notice to OMPP of changes to the network that may affect access, availability and network composition. OMPP shall regularly and routinely monitor network access, availability and adequacy. OMPP shall impose remedies, as set forth in Exhibit 2, or require the Contractor to maintain an open network, if the Contractor fails to meet the network composition requirements. In accordance with 42 CFR 438.206, the Contractor shall maintain and monitor the provider network. The Contractor shall establish written agreements with all network providers as further described in Section 5.4. In establishing and maintaining the network, the Contractor must consider the following elements:  ▪ The anticipated enrollment;  ▪ The expected utilization of services, taking into consideration the characteristics and health care needs of the Contractor’s Hoosier Healthwise members;  ▪ The numbers and types (in terms of training, experience and specialization) of providers required to furnish the contracted services;  ▪ The numbers of network providers who are not accepting new members; and  The geographic location of providers and members, considering distance, travel time, the means of transportation ordinarily used by members and whether the location provides physical access for members with disabilities. OMPP shall assess liquidated damages as set forth in Exhibit 2 and shall impose other authorized remedies, such as requiring the Contractor to maintain an open network, for Contractor’s non-compliance with the network development and network composition requirements. The Contractor shall contract its specialist and ancillary provider network prior to receiving enrollment. OMPP shall have the right to implement corrective actions and shall assess liquidated damages as described in Exhibit 2 if the Contractor fails to meet and maintain the specialist and ancillary provider network access standards. OMPP’s corrective actions may include, but are not limited to, withholding or suspending new member enrollment from the Contractor until the Contractor’s specialist and ancillary provider network is in place. OMPP shall monitor the Contractor’s specialist and ancillary provider network to confirm the Contractor is maintaining the required level of access to specialty care. OMPP shall have the right to increase the number or types of required specialty providers at any time.and

Network Development. OMPP requires the Contractor to develop and maintain a comprehensive network to provide services to its Hoosier Healthwise members. The network must include providers serving special needs populations, including providers serving children with special health care needs. The Contractor shall develop a comprehensive network prior to the effective date of the Contract. The Contractor shall be required during the readiness review process to demonstrate network adequacy through the submission of Geo Access reports in the manner and timeframe required by OMPP. The Contractor shall be required to have an open network and accept any IHCP provider acting within his or her scope of practice until the Contractor demonstrates that it meets the access requirements. OMPP reserves the right to delay initial member enrollment in the Contractor’s plan if the Contractor fails to demonstrate a complete and comprehensive network. With approval from OMPP, Contractors that can demonstrate that they have met all access, availability and network composition requirements may require members to use in-network providers, with the exception of certain self-referral providers as described in Section 3.2. The Contractor must provide ninety (90) calendar day advance notice to OMPP of changes to the network that may affect access, availability and network composition. OMPP shall regularly and routinely monitor network access, availability and adequacy. OMPP shall impose remedies, as set forth in Exhibit 2, or require the Contractor to maintain an open network, if the Contractor fails to meet the network composition requirements. In accordance with 42 CFR 438.206, the Contractor shall maintain and monitor the provider network. The Contractor shall establish written agreements with all network providers as further described in Section 5.4. In establishing and maintaining the network, the Contractor must consider the following elements:  ▪ The anticipated enrollment;  ▪ The expected utilization of services, taking into consideration the characteristics and health care needs of the Contractor’s Hoosier Healthwise members;  ▪ The numbers and types (in terms of training, experience and specialization) of providers required to furnish the contracted services;  ▪ The numbers of network providers who are not accepting new members; and  ▪ The geographic location of providers and members, considering distance, travel time, the means of transportation ordinarily used by members and whether the location provides physical access for members with disabilities. OMPP shall assess liquidated damages as set forth in Exhibit 2 and shall impose other authorized remedies, such as requiring the Contractor to maintain an open network, for Contractor’s non-compliance with the network development and network composition requirements. The Contractor shall contract its specialist and ancillary provider network prior to receiving enrollment. OMPP shall have the right to implement corrective actions and shall assess liquidated damages as described in Exhibit 2 if the Contractor fails to meet and maintain the specialist and ancillary provider network access standards. OMPP’s corrective actions may include, but are not limited to, withholding or suspending new member enrollment from the Contractor until the Contractor’s specialist and ancillary provider network is in place. OMPP shall monitor the Contractor’s specialist and ancillary provider network to confirm the Contractor is maintaining the required level of access to specialty care. OMPP shall have the right to increase the number or types of required specialty providers at any time.EXHIBIT 1.E

Network Development. OMPP requires the Contractor to develop and maintain a comprehensive network to provide services to its Hoosier Healthwise members. The network must include providers serving special needs populations, including providers serving children with special health care needs. The Contractor shall develop a comprehensive network prior to the effective date of the Contract. The Contractor shall be required during the readiness review process to demonstrate network adequacy through the submission of Geo Access reports in the manner and timeframe required by OMPP. The Contractor shall be required to have an open network and accept any IHCP provider acting within his or her scope of practice until the Contractor demonstrates that it meets the access requirements. OMPP reserves the right to delay initial member enrollment in the Contractor’s plan if the Contractor fails to demonstrate a complete and comprehensive network. With approval from OMPP, Contractors that can demonstrate that they have met all access, availability and network composition requirements may require members to use in-network providers, with the exception of certain self-referral providers as described in Section 3.2. The Contractor must provide ninety (90) calendar day advance notice to OMPP of changes to the network that may affect access, availability and network composition. OMPP shall regularly and routinely monitor network access, availability and adequacy. OMPP shall impose remedies, as set forth in Exhibit 23, or require the Contractor to maintain an open network, if the Contractor fails to meet the network composition requirements. In accordance with 42 CFR 438.206, the Contractor shall maintain and monitor the provider network. The Contractor shall establish written agreements with all network providers as further described in Section 5.4. In establishing and maintaining the network, the Contractor must consider the following elements:   The anticipated enrollment;   The expected utilization of services, taking into consideration the characteristics and health care needs of the Contractor’s Hoosier Healthwise members;   The numbers and types (in terms of training, experience and specialization) of providers required to furnish the contracted services;   The numbers of network providers who are not accepting new members; and   The geographic location of providers and members, considering distance, travel time, the means of transportation ordinarily used by members and whether the location provides physical access for members with disabilities. OMPP shall assess liquidated damages as set forth in Exhibit 2 3 and shall impose other authorized remedies, such as requiring the Contractor to maintain an open network, for Contractor’s non-non- compliance with the network development and network composition requirements. The Contractor shall contract its specialist and ancillary provider network prior to receiving enrollment. OMPP shall have the right to implement corrective actions and shall assess liquidated damages as described in Exhibit 2 3 if the Contractor fails to meet and maintain the specialist and ancillary provider network access standards. OMPP’s corrective actions may include, but are not limited to, withholding or suspending new member enrollment from the Contractor until the Contractor’s specialist and ancillary provider network is in place. OMPP shall monitor the Contractor’s specialist and ancillary provider network to confirm the Contractor is maintaining the required level of access to specialty care. OMPP shall have the right to increase the number or types of required specialty providers at any time.

Network Development. OMPP requires the Contractor to develop and maintain a comprehensive network to provide services to its Hoosier Healthwise HIP members. The network must shall include providers serving special needs populations. For its HIP population, including providers serving children with special health care needsthe provider network shall not be any more restrictive for HIP Basic members than for HIP Plus members. The Contractor shall develop a comprehensive network prior to the effective date of the Contract. The Contractor shall be required during the readiness review process to demonstrate network adequacy through the submission of Geo Access reports in the manner and timeframe required by OMPP. The Contractor shall be required to have an open network and accept any IHCP provider acting within his or her scope of practice until the Contractor demonstrates that it meets the access requirements. OMPP reserves the right to delay initial member enrollment in the Contractor’s plan if the Contractor fails to demonstrate a complete and comprehensive network. With approval from OMPP, Contractors that can demonstrate that they have met all access, availability and network composition requirements may require members to use in-network providers, with the exception of certain self-referral providers as described in Section 3.26.2. The Contractor must shall provide ninety (90) calendar day advance notice to OMPP of changes to the network that may affect access, availability and network composition. OMPP shall regularly and routinely monitor network access, availability and adequacy. OMPP shall impose remedies, as set forth in Exhibit 24, or require the Contractor to maintain an open network, if the Contractor fails to meet the network composition requirements. In accordance with 42 CFR 438.206, the Contractor shall maintain and monitor the provider network. The Contractor shall establish written agreements with all network providers as further described in Section 5.48.4. In establishing and maintaining the network, the Contractor must shall consider the following elements:   The anticipated enrollment;   The expected utilization of services, taking into consideration the characteristics and health care needs of the Contractor’s Hoosier Healthwise and HIP members;   The numbers and types (in terms of training, experience and specialization) of providers required to furnish the contracted services;   The numbers of network providers who are not accepting new members; and   The geographic location of providers and members, considering distance, travel time, the means of transportation ordinarily used by members and whether the location provides physical access for members with disabilities. OMPP shall assess liquidated damages as set forth in Exhibit 2 4 and shall impose other authorized remedies, such as requiring the Contractor to maintain an open network, for Contractor’s non-non- compliance with the network development and network composition requirements. The Contractor shall contract its specialist and ancillary provider network prior to receiving enrollment. OMPP shall have the right to implement corrective actions and shall assess liquidated damages as described in Exhibit 2 4 if the Contractor fails to meet and maintain the specialist and ancillary provider network access standards. OMPP’s corrective actions may include, but are not limited to, withholding or suspending new member enrollment from the Contractor until the Contractor’s specialist and ancillary provider network is in place. OMPP shall monitor the Contractor’s specialist and ancillary provider network to confirm the Contractor is maintaining the required level of access to specialty care. OMPP shall have the right to increase the number or types of required specialty providers at any time.