SERVICE PROVISION AND CONTRACT PERFORMANCE IN ACCORDANCE Sample Clauses

SERVICE PROVISION AND CONTRACT PERFORMANCE IN ACCORDANCE. WITH FIDE SNP STANDARDS The Contractor shall provide FIDE SNP benefits in accordance with the standards set forth in the Medicare Managed Care Manual, Chapter 16B, Article 40.4, restated below and expanded: 40.4.3 - Fully Integrated Dual Eligible (FIDE) SNPs (Rev. 119 , Issued:11-28-14, Effective: 11-28-14, Implementation: 11-28-14) SNPs classified as Fully Integrated Dual Eligible (FIDE) are described in Section 1853(a)(1)(B)(iv) of the Act and at 42 CFR Section 422.2. FIDE SNPs are CMS- approved SNPs that: (1) Enroll special needs individuals entitled to medical assistance under a Medicaid State Plan, as defined in Section 1859(b)(6)(B)(ii) of the Act and 42 CFR Section 422.2 and described in detail in Section 40.5.3 of this chapter; (2) Provide dually-eligible beneficiaries access to Medicare and Medicaid benefits under a single managed care organization; (3) Have a CMS-approved MIPPA compliant contract with a State Medicaid Agency that includes coverage of specified primary, acute, and long-term care benefits and services, consistent with State policy, under risk-based financing; (4) Coordinate the delivery of covered Medicare and Medicaid health and long-term care services, using aligned care management and specialty care network methods for high-risk beneficiaries; and,