Service and Utilization Management. The PIHP shall assure that customers located in the service area have clear and identifiable access to needed supports and services when they are needed, and that supports and services are of high quality and delivered according to established regulations, standards, and practice guidelines. The PIHP shall also perform utilization management functions sufficient to control costs and minimize risk while assuring quality care. Additional requirements are described in the following subsections.
Appears in 6 contracts
Samples: Medicaid Managed Specialty Supports and Services Concurrent Waiver Program Agreement, Michigan Abw Non Pregnant Childless Adults Waiver (Adult Benefits Waiver) Section 1115 Demonstration, Medicaid Managed Specialty Supports and Services Concurrent Waiver Program Agreement
