Significant Traditional Providers Sample Clauses

Significant Traditional Providers. (No page limit, Respondents should only submit STP tables, not text, with the exception of bidders not meeting the 50 percent threshold described in Section 5.2. These Respondents should provide clear documentation of any problems in meeting this threshold)
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Significant Traditional Providers. (STPS) ---------------------------------------- HMO must seek participation in its provider network from: 7.13.1 Each health care provider in the service area who has traditionally provided care to Medicaid recipients; 7.13.2 Each hospital in the service area that has been designated as a disproportionate share hospital under Medicaid; and 7.13.3 Each specialized pediatric laboratory in the service area, including those laboratories located in children's hospitals. 1999 Renewal Contract Xxxxxx Service Area August 9, 1999 72
Sample 1
Significant Traditional Providers. (STPS) ---------------------------------------- 7.13.1 HMO must include STPs as designated by TDH in its provider network to provide primary care and specialty care services. HMO must include STPs in its provider network for at least three (3) years following the Implementation Date in the service area. 7.13.2 STPs must agree to the contract requirements contained in Article 7.2, unless exempted from a requirement by law or rule. STPs must also agree to the following contract requirements. 7.13.2.1 STP must agree to accept the standard reimbursement rate offered by HMO to other providers for the same or similar services. 7.13.2.2 STP must meet the credentialing requirements of HMO. HMO must not require STPs to meet a different or higher credentialing standard than is required of other providers providing the same or similar services. HMO must not require STP's to contract with a Subcontractor which requires a different or higher credentialing standard than the HMO's if the application of the higher standard results in a disproportionate number of STPs being excluded from the Subcontractor. 7.13.3 HMO must demonstrate a good faith effort to include STPs in its provider network. HMO's compliance with TDH's good faith effort requirement for STPs must be reported using report requirements defined by TDH. HMO must submit quarterly El Paso Service Area HMO Contract reports, in a format provided by TDH, documenting HMO's compliance with TDH's good faith effort requirement for STP's. 7.13.4 Failure to demonstrate a good faith effort to meet TDH's compliance objectives to include STPs in HMO's provider network, or failure to report efforts and compliance as required in Article 7.13.3, are defaults under this contract and may result in any or all of the sanctions and remedies included in Article XVIII of this contract.
Sample 1

Related to Significant Traditional Providers

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