Publicly Supported Providers Sample Clauses

Publicly Supported Providers. Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) Federally Qualified Health Centers (FQHCs) are federally-funded Community Health Centers, Migrant Health Centers and Health Care for the Homeless Projects that receive grants under sections 329, 330 and 340 of the US Public Health Service Act.10 Current federal regulations specify that states must guarantee access to FQHCs and RHCs under Medicaid managed care programs; therefore, MCOs must provide access to FQHCs and RHCs to the extent that access is required under federal law. If federal law is amended to revise these access requirements, BMS may alter the requirements imposed on MCOs. The MCO must contract with as many FQHCs and RHCs as necessary to permit beneficiary access to participating FQHCs and RHCs without having to travel a significantly greater distance past a non-participating FQHC or RHC. The MCO must contract with the FQHC or RHC – contracts with individual physicians at FQHCs and RHCs do not suffice for this requirement. The MCO must contract with FQHCs and RHCs in accordance with the 30-minute travel time standards for routinely-used delivery sites as specified in this contract. An MCO with an FQHC or RHC on its panel that has no capacity to accept new patients will not satisfy these requirements. If an MCO cannot satisfy the standard for FQHC and RHC access at any time while the MCO holds a Medicaid contract, the MCO must allow its Medicaid members to seek care from non-contracting FQHCs and RHCs and must reimburse these providers at Medicaid fees. The MCO must offer FQHCs and RHCs terms and conditions, including reimbursement, that are at least equal to those offered to other providers of comparable services. The MCO cannot sign exclusive contracts with any publicly supported providers that prevent the providers from signing contracts with other MCOs. Upon BMS notification to the MCO of any changes to the FQHC/RHC reimbursement rates, with proper documentation from CMS, the MCOs shall update payment rates to FQHC/RHC effective the date of notification. The MCO must pay the new rate for claims not yet paid with a date of service on or after the effective date of change. The new payment rate must be loaded into the MCO’s claims payment system within 30 days of notification of the payment rate change. BMS will reconcile reasonable costs with FQHCs and RHCs.
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Publicly Supported Providers. 4.8.9.1 Federally Qualified Health Centers and Rural Health Clinics
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Publicly Supported Providers 
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Related to Publicly Supported Providers

  • Lead Hand Employee who performs hands-on work in a group or small section of a department (usually four or fewer employees) and directs work assignments and is responsible for its completion. Employees providing work direction or supervision must be layered over (i.e. placed at a higher classification than) all employees to whom direction or supervision is provided. The resulting classification will be determined by the classification levels of the applicable job family.

  • Contracted Services The Employer agrees that all work coming under the jurisdiction of this Union, in the certified area, performed by anyone, on behalf of, or at the instance of the Employer, directly or indirectly under contract or sub-contract, shall be performed by employees who are members of this Union or who shall become members in accordance with the terms and conditions as set out in this Agreement.

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