Common use of Provider Network Information Clause in Contracts

Provider Network Information. The Enrollment Packet shall include information on where to find information about the Contractor’s provider network. Additionally, the Contractor shall include a current provider directory and/or information on how to find a network provider near the member’s residence on-line and via the Member Helpline. In accordance with 42 CFR 438.10(h), the provider directory must include the following information for all network providers, including but not limited to, all types of PMPs, specialists, hospitals, pharmacies, behavioral health providers: ▪ Name, group affiliation, location, telephone number and specialty of providers; ▪ Whether PMPs will accept new enrollees; ▪ Cultural and linguistic capabilities, including languages (including ASL) spoken by the provider or the provider’s office personnel (including skilled medical interpreters, if applicable); ▪ Whether the provider has completed cultural competence training; ▪ Provider web sites, if applicable; ▪ If the provider has accommodations for people with physical disabilities, including offices, exam rooms and equipment; ▪ Pharmacies and behavioral health providers; and ▪ Contact information for all brokers contracted with the MCE; and ▪ Identification of providers that are not accepting new patients. A printed copy of the provider directory must also be available to members and FSSA upon request. The Contractor shall include the aforementioned provider network information in an FSSA-approved format (compliant with Section 508 of the US Rehabilitation Act) on its member website. The Contractor shall list provider network information by county on the Contractor’s website and update the information every two (2) weeks. As required by 42 CFR 438.10(h)(3)(i) and 42 CFR 438.10(h)(3)(ii), provider network information on the Contractor’s website must be updated no later than thirty (30) calendar days after the Contractor receives updated provider information. Network provider information shall be available to print from a remote user location and in a machine-readable file and format as specified by the Secretary per 42 CFR 457.1207 and 42 CFR 438.10(h)(4). Paper provider network directories must be updated at least monthly if the Contractor does not have a mobile-enabled, electronic directory; or quarterly if the Contractor has a mobile-enabled electronic directory (42 CFR 438.10(h)(3)).

Provider Network Information. The Enrollment Packet shall include information on where to find information about the Contractor’s provider network. Additionally, the Contractor shall include a current provider directory and/or information on how to find a network provider near the member’s residence on-line and via the Member Helpline. In accordance with 42 CFR 438.10(h), the provider directory must include the following information for all network providers, including but not limited to, all types of PMPs, specialists, hospitals, pharmacies, behavioral health providers: ▪ • Name, group affiliation, location, telephone number and specialty of providers; ▪ • Whether PMPs will accept new enrollees; ▪ • Cultural and linguistic capabilities, including languages (including ASL) spoken by the provider or the provider’s office personnel (including skilled medical interpreters, if applicable)personnel; ▪ Whether the provider has completed cultural competence training; ▪ • Provider web sites, if applicable; ▪ • If the provider has accommodations for people with physical disabilities, including offices, exam rooms and equipment; ▪ • Pharmacies and behavioral health providers; and ▪ • Contact information for all brokers contracted with the MCE; and ▪ Identification of providers that are not accepting new patients. A printed copy of the provider directory must also be available to members and FSSA upon request. The Contractor shall include the aforementioned provider network information in an FSSA-approved format (compliant with Section 508 of the US Rehabilitation Act) on its member website. The Contractor shall list provider network information by county on the Contractor’s website and update the information every two (2) weeks. As required by 42 CFR 438.10(h)(3)(i438.10(h)(3)(i)(A) – (B) and 42 CFR 438.10(h)(3)(ii), provider network information on the Contractor’s website must be updated no later than thirty (30) calendar days after the Contractor receives updated provider information. Network provider information shall be available to print from a remote user location and in a machine-readable file and format as specified by the Secretary per 42 CFR 457.1207 and 42 CFR 438.10(h)(4). Paper provider network directories must be updated at least monthly if the Contractor does not have a mobile-enabled, electronic directory; or quarterly if the Contractor has a mobile-enabled electronic directory (42 CFR 438.10(h)(3))quarterly.

Provider Network Information. The Enrollment Packet shall include information on where to find information about the Contractor’s provider network. Additionally, the Contractor shall include a current provider directory and/or information on how to find a network provider near the member’s residence on-line and via the Member Helpline. In accordance with 42 CFR 438.10(h), the provider directory must include the following information for all network providers, including but not limited to, all types of PMPs, specialists, hospitals, pharmacies, behavioral health providers: ▪ Name, group affiliation, location, telephone number and specialty of providers; ▪ Whether PMPs will accept new enrollees; ▪ Cultural and linguistic capabilities, including languages (including ASL) spoken by the provider or the provider’s office personnel (including skilled medical interpreters, if applicable); ▪ Whether the provider has completed cultural competence trainingpersonnel; ▪ Provider web sites, if applicable; ▪ If the provider has accommodations for people with physical disabilities, including offices, exam rooms and equipment; ▪ Pharmacies and behavioral health providers; and ▪ Contact information for all brokers contracted with the MCE; and ▪ Identification of providers that are not accepting new patients. A printed copy of the provider directory must also be available to members and FSSA upon request. The Contractor shall include the aforementioned provider network information in an FSSA-approved format (compliant with Section 508 of the US Rehabilitation Act) on its it s member website. The Contractor shall list provider network information by county on the Contractor’s website and update the information every two (2) weeks. As required by 42 CFR 438.10(h)(3)(i438.10(h)(3)(i)(A) – (B) and 42 CFR 438.10(h)(3)(ii), provider network information on the Contractor’s website must be updated no later than thirty (30) calendar days after the Contractor receives updated provider information. Network provider information shall be available to print from a remote user location and in a machine-readable file and format as specified by the Secretary per 42 CFR 457.1207 and 42 CFR 438.10(h)(4). Paper provider network directories must be updated at least monthly if the Contractor does not have a mobile-enabled, electronic directory; or quarterly if the Contractor has a mobile-enabled electronic directory (42 CFR 438.10(h)(3))quarterly.

Provider Network Information. The Enrollment Packet shall include information on where to find information about the Contractor’s provider network. Additionally, the Contractor shall include a current provider directory and/or information on how to find a network provider near the member’s residence on-line and via the Member Helpline. In accordance with 42 CFR 438.10(h), the provider directory must include the following information for all network providers, including but not limited to, all types of PMPs, specialists, hospitals, pharmacies, behavioral health providers: ▪ Name, group affiliation, location, telephone number and specialty of providers; ▪ Whether PMPs will accept new enrollees; ▪ Cultural and linguistic capabilities, including languages (including ASL) spoken by the provider or the provider’s office personnel (including skilled medical interpreters, if applicable); ▪ Whether the provider has completed cultural competence trainingpersonnel; ▪ Provider web sites, if applicable; ▪ If the provider has accommodations for people with physical disabilities, including offices, exam rooms and equipment; ▪ Pharmacies and behavioral health providers; and ▪ Contact information for all brokers contracted with the MCE; and ▪ Identification of providers that are not accepting new patients. A printed copy of the provider directory must also be available to members and FSSA upon request. The Contractor shall include the aforementioned provider network information in an FSSA-approved format (compliant with Section 508 of the US Rehabilitation Act) on its member website. The Contractor shall list provider network information by county on the Contractor’s website and update the information every two (2) weeks. As required by 42 CFR 438.10(h)(3)(i438.10(h)(3)(i)(A) – (B) and 42 CFR 438.10(h)(3)(ii), provider network information on the Contractor’s website must be updated no later than thirty (30) calendar days after the Contractor receives updated provider information. Network provider information shall be available to print from a remote user location and in a machine-readable file and format as specified by the Secretary per 42 CFR 457.1207 and 42 CFR 438.10(h)(4). Paper provider network directories must be updated at least monthly if the Contractor does not have a mobile-enabled, electronic directory; or quarterly if the Contractor has a mobile-enabled electronic directory (42 CFR 438.10(h)(3))quarterly.