Common use of Services Outside the Program Clause in Contracts

Services Outside the Program. The following services are excluded by DVHA from Program payments, and will be excluded from the payments by ACO and will be reimbursed by DVHA directly to Participants: 2.4.1 Services Not Covered in the Program. The following services are paid for by DVHA but are not included in the Program: 2.4.1.1 Pharmacy; 2.4.1.2 Nursing Facility Care; 2.4.1.3 Psychiatric Treatment in State Psychiatric Hospital; 2.4.1.4 Level 1 (involuntary placement) Inpatient Psychiatric Stays (in any hospital when paid for by DVHA);

Appears in 4 contracts

Samples: Risk Bearing Participant & Affiliate Agreement, Risk Bearing Participant & Preferred Provider Agreement, Risk Bearing Participant & Preferred Provider Agreement

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