Common use of Scope of Covered Services Clause in Contracts

Scope of Covered Services. (A) Except as otherwise provided for by this contract, the Contractor is responsible to arrange for all dental Covered Services listed in the State Plan and as outlined in Attachment C. (B) In accordance with 42 CFR 438.210 the Contractor shall administer Covered Services, when Medically Necessary, in a manner that takes into account the following: (1) services that address the prevention, diagnosis, and treatment of an Enrollee's disease, condition, and/or disorder that results in health impairments and/or disability; (2) the ability for an Enrollee to achieve age-appropriate growth and development; (3) the ability for an Enrollee to attain, maintain, or regain functional capacity (C) The services provided by Contractor shall be delivered in compliance with the requirements of Subpart K of 42 CFR Part 438 insofar as applicable.