PROVIDER REQUIREMENTS. The MississippiCAN Program, through the State Contract and federal and State statutes and regulations, requires the Agreement to contain certain conditions that Health Plan, Subcontractor and Provider agree to undertake, which include the following: 3.1 Definitions Related to the Provision of Covered Services. Provider shall follow the applicable State Contract’s requirements for the provision of Covered Services. Provider’s decisions affecting the delivery of acute or chronic care services to Covered Persons shall be made on an individualized basis and in accordance with the following definitions: (a) Emergency Medical Condition: A medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in any of the following: (1) placing the health of the individual (or with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy; (2) serious impairment to body functions; or (3) serious dysfunction of any body organ or part.
Appears in 3 contracts
Samples: Provider Agreement, Provider Agreement, Provider Agreement
PROVIDER REQUIREMENTS. The MississippiCAN State Program, through the State Contract contractual requirements and federal and State statutes and regulations, requires the Agreement to contain certain conditions that Health Plan, Subcontractor Subcontractor, and Provider agree to undertake, which include the following:
3.1 Definitions Related to the Provision of Covered Services. Provider shall follow the applicable State Contract’s requirements for the provision of Covered Services. Provider’s decisions affecting the delivery of acute or chronic care services to Covered Persons shall be made on an individualized basis and in accordance with the following definitions:
(a) Emergency Medical Condition: A medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in any of the following: (1) placing the health of the individual (or with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy; (2) serious impairment to body functions; or (3) serious dysfunction of any body organ or part.
Appears in 3 contracts
Samples: Downstream Provider Medicaid Program Regulatory Requirements Appendix, Downstream Provider Medicaid Program Regulatory Requirements Appendix, Downstream Provider Medicaid Program Regulatory Requirements Appendix
