PCMP NETWORK AND NETWORK DEVELOPMENT Clause Samples

PCMP NETWORK AND NETWORK DEVELOPMENT. 4.1.1. The Contractor shall create, administer and maintain a network of PCMPs and other Medicaid providers, building on the current network of Medicaid providers, to serve the needs of its Members. 4.1.1.1. The Contractor shall provide an Internet-based provider directory for Members and other users of the Contractor’s web site. This Internet-based provider directory shall be searchable and allow for Members and other users to search for PCMPs. 4.1.2. The Contractor shall Document its relationship with and requirements for each PCMP in the Contractor’s PCMP Network in a written contract with that PCMP. 4.1.3. The Contractor shall only enter into written contracts with PCMPs that meet the following criteria: 4.1.3.1. The PCMP practice and the individual PCMP are enrolled as a Colorado Medicaid provider. 4.1.3.2. The PCMP practice and the individual PCMP, as applicable, are currently licensed by the Colorado Board of Nursing or Board of Medical Examiners to practice medicine in the State of Colorado. 4.1.3.3. The individual PCMP shall act as the primary care provider for a Member and is capable of providing a majority of that Member’s comprehensive primary, preventative and urgent or sick care. 4.1.3.4. The PCMP practice is certified by the Department as a provider in the Medicaid and CHP+ Medical Homes for Children Program or the PCMP practice is a Federally Qualified Health Center, a Rural Health Clinic, clinic or other group practice with a focus on primary care, general practice, internal medicine, pediatrics, geriatrics or obstetrics and gynecology. 4.1.3.5. The PCMP meets all additional criteria in Exhibit B. 4.1.3.6. The Contractor may not prohibit a PCMP from entering into a contract with another RCCO. 4.1.4. The Contractor shall ensure that its PCMP network is sufficient to meet the requirements for every Member’s Access to Care, to serve all Member’s primary care needs and allow for adequate Member freedom of choice amongst PCMPs and providers during the Initial Phase and Expansion Phase. 4.1.5. The Contractor’s network shall include Essential Community Providers and private for-profit and not-for-profit providers. 4.1.6. The Contractor shall ensure that its network includes providers or PCMPs with the interest and expertise in serving the special populations that include, but are not limited to: 4.1.6.1. The physically or developmentally disabled. 4.1.6.2. Children and ▇▇▇▇▇▇ children. 4.1.6.3. Adults and the aged.