Sufficient Services Sample Clauses
Sufficient Services. Services must be sufficient in amount, duration, or scope to reasonably be expected to achieve the purpose for which the services are furnished. The MCO’s benefit package services that are Medicaid state plan services as defined in Addendum VIII, Section B for Family Care (page 325) and Section C for Partnership and PACE (page 326) must be no more restrictive than the Medicaid fee-for-service coverage. The MCO is responsible for covering services related to the following:
a. The prevention, diagnosis, and treatment of health impairments;
b. The ability to achieve age-appropriate growth and development;
c. The ability to attain, maintain, or regain functional capacity.
Sufficient Services. Services must be sufficient in amount, duration, or scope to reasonably be expected to achieve the purpose for which the services are furnished. The PACE program benefits that are Medicaid state plan services as defined in AddendumVII., Section B must be no more restrictive than the Medicaid fee-for- service coverage.