Special Rules Governing American Indians and Alaskan Natives Sample Clauses

Special Rules Governing American Indians and Alaskan Natives. Contractor shall comply with applicable laws, rules and regulations relating to the provision of Covered Services to any individual enrolled in Contractor’s QHP in Covered California for the Individual Market who is determined by Covered California to be an eligible American Indian or Alaskan Native as defined in Section 4(d) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b(d). Such requirements include the following: a) Contractor shall cover Covered Services furnished through a health care provider pursuant to a referral under contract for directly furnishing an item or service to an American Indian with no cost-sharing as described in the Affordable Care Act § 1402(d)(2). b) Contractor shall not impose any cost-sharing on such individuals under three hundred (300) percent of federal poverty level (“FPL”) in accordance with the Affordable Care Act § 1401(d)(1). Covered California will have a transparent process to identify Alaskan Natives and American Indians, including a specific identification of those under 300% of FPL so the Contractor has information necessary to comply with Federal law. c) Contractor shall provide monthly Special Enrollment Periods for American Indians or Alaskan Natives enrolled through Covered California. d) Contractor shall comply with other applicable laws, rules and regulations relating to the provision of Covered Services to American Indians, including, the Indian Health Care Improvement Act Sections 206 (25 U.S.C. 1621e) and 408 (25 U.S.C. 1647a).
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Special Rules Governing American Indians and Alaskan Natives. Contractor shall comply with applicable laws, rules and regulations relating to the provision of Covered Services to any individual enrolled in Contractor’s QHP in the Individual Exchange who is determined by the Exchange to be an eligible American Indian or Alaskan Native as defined in Section 4(d) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b(d). Such requirements include the following: a) Contractor shall cover Covered Services furnished through a health care provider pursuant to a referral under contract for directly furnishing an item or service to an American Indian with no cost-sharing as described in the Affordable Care Act § 1402(d)(2). b) Contractor shall not impose any cost-sharing on such individuals under three hundred (300) percent of federal poverty level (“FPL”) in accordance with the Affordable Care Act § 1401(d)(1). The Exchange will have a transparent process to identify Alaskan Natives and American Indians, including a specific identification of those under 300% of FPL so the Contractor has information necessary to comply with Federal law. c) Contractor shall provide monthly Special Enrollment Periods for American Indians or Alaskan Natives enrolled through the Exchange. d) Contractor shall comply with other applicable laws, rules and regulations relating to the provision of Covered Services to American Indians, including, the Indian Health Care Improvement Act Sections 206 (25 U.S.C. 1621e) and 408 (25 U.S.C. 1647a).
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Special Rules Governing American Indians and Alaskan Natives. Contractor shall comply with applicable laws, rules and regulations relating to the provision of Specialized Health Care Services to any individual enrolled in Contractor’s QDP in the Covered California for the Individual Market who is determined by Covered California to be an eligible American Indian or Alaskan Native as defined in § 4(d) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. § 450b(d). Such requirements include the following: (a) Contractor shall provide monthly special enrollment periods for American Indians or Alaskan Natives enrolled through Covered California. (b) Contractor shall comply with other applicable laws, rules and regulations relating to the provision of Health Care Services to American Indians, including the Indian Health Care Improvement Act §§ 206 (25 U.S.C. § 1621e) and 408 (25 U.S.C. § 1647a).
Sample 1Sample 2Sample 3See All (14)
Special Rules Governing American Indians and Alaskan Natives. Contractor shall comply with applicable laws, rules and regulations relating to the provision of Specialized Health Care Services to any individual enrolled in Contractor’s QDP in the Individual Exchange who is determined by the Exchange to be an eligible American Indian or Alaskan Native as defined in § 4(d) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. § 450b(d). Such requirements include the following: (a) Contractor shall provide monthly special enrollment periods for American Indians or Alaskan Natives enrolled through the Exchange. (b) Contractor shall comply with other applicable laws, rules and regulations relating to the provision of Health Care Services to American Indians, including the Indian Health Care Improvement Act §§ 206 (25 U.S.C. § 1621e) and 408 (25 U.S.C. § 1647a).
Sample 1Sample 2See All (6)
Special Rules Governing American Indians and Alaskan Natives. Contractor shall comply with applicable laws, rules and regulations relating to the provision of Specialized Health Care Services to any individual enrolled in Contractor’s QDP in the Covered California for the Individual Market who is determined by Covered California to be an eligible American Indian or Alaskan Native as defined in § 4(d) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. § 450b(d). Such requirements include the following: (a) Contractor shall provide monthly special enrollment periods for American Indians or Alaskan Natives enrolled through Covered California. (b) Contractor shall comply with other applicable laws, rules and regulations relating to the provision of Health Care Services to American Indians, including the Indian Health Care Improvement Act §§ 206 (25 U.S.C. § 1621e) and 408 (25 U.S.C. § 1647a). Participating Providers Provider Contracts‌ (a) Contractor shall include in all of its contracts with Participating Providers the requirement for all Specialized Health Care Services to be provided by duly licensed, certified or accredited Participating Providers consistent with the scope of their license, certification or accreditation and in accordance with applicable laws, rules, regulations, the standards of dental practice in the community, and the terms set forth in agreements entered into by and between Contractor and Participating Providers (“Provider Agreement”). (b) Contractor shall include in each Provider Agreement a requirement that Participating Providers comply with all other applicable laws, rules and regulations. Contractor shall require the following provisions to be included in each: (i) Provider Agreement entered into by and between Contractor and a Participating Provider, and (ii) any subcontracting arrangement entered into by a Participating Provider. Except as expressly set forth herein, capitalized terms set forth herein shall have the same meaning as set forth in the Agreement between Contractor and Covered California; provided that Contractor may use different terminology as necessary to be consistent with the terms used in the Provider Agreement or subcontracting arrangements entered into by Participating Providers so long as such different terminology does not change the meaning set forth herein and the Agreement.
Sample 1
Special Rules Governing American Indians and Alaskan Natives. Contractor shall comply with applicable laws, rules and regulations relating to the provision of Specialized Health Care Services to any individual enrolled in Contractor’s QDP in the Individual Exchange who is determined by the Exchange to be an eligible American Indian or Alaskan Native as defined in §Section 4(d) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b(d). Such requirements include the following:
Sample 1
Special Rules Governing American Indians and Alaskan Natives. Contractor shall comply with applicable laws, rules and regulations relating to the provision of Health Care ServicesCovered Services to any individual enrolled in Contractor’s Certified QHP in the Individual Exchange who is determined by the Exchange to be an eligible American Indian or Alaskan Native as defined in section 4(d) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b(d). Such requirements include the following: (a) Contractor shall cover Health Care ServicesCovered Services furnished through a health care provider pursuant to a referral under contract for directly furnishing an item or service to an American Indian with no cost-sharing as described in the Affordable Care Act Section § 1402(d)(2). (b) Contractor shall not impose any cost-sharing on such individuals under three hundred (300) percent of federal poverty level (“FPL”) in accordance with the Affordable Care Act § 1401(d)(1) . The Exchange will have a transparent process to identify Alaskan Natives and American Indians, including a specific identification of those under 300% of FPL so the Contractor has information necessary to comply with Federal law. (c) Contractor shall provide monthly special enrollment periods for American Indians or Alaskan Natives enrolled through the Exchange. (d) Contractor shall comply with other applicable laws, rules and regulations relating to the provision of Health Care ServicesCovered Services to American Indians, including, the Indian Health Care Improvement Act Sections 206 (25 U.S.C. 1621e) and 408 (25 U.S.C. 1647a)).
Sample 1
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