Common use of Scope of Covered Services Clause in Contracts

Scope of Covered Services. (A) Except as otherwise provided for cases of Emergency Services, the Contractor is responsible to pay for all Covered Services listed in Attachment C. The Contractor shall also be responsible to pay for Covered Services that are, subsequent to the execution of this contract, deemed Covered Services due to amendments, revisions, or additions to the State Plan or to State or Federal regulations, guidelines or policies or made pursuant to court or administrative orders. (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

Scope of Covered Services. (A) Except as otherwise provided for cases of Emergency Services, the Contractor is responsible to pay for all Covered Services listed in Attachment C. The Contractor shall also be responsible to pay for Covered Services that are, subsequent to the execution of this contract, deemed Covered Services due to amendments, revisions, or additions to the CHIP State Plan or to State or Federal regulations, guidelines or policies or made pursuant to court or administrative orders. (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