Common use of Targeted Case Management Services Clause in Contracts

Targeted Case Management Services. Contractor is responsible for determining whether a Member requires Targeted Case Management (TCM) services, and must refer Members who are eligible for TCM services to a Regional Center or local governmental health program as appropriate for the provision of TCM services. If a Member is receiving TCM services as specified in Title 22 CCR Section 51351, Contractor shall be responsible for coordinating the Member's health care with the TCM Provider and for determining the Medical Necessity of diagnostic and treatment services recommended by the TCM Provider that are Covered Services under the Contract. If Members under age 21 are not accepted for TCM services, Contractor shall ensure the Members’ access to services are comparable to EPSDT TCM services per Exhibit A, Attachment 10, Scope of Services, Provision 5. Services for Members under Twenty-One (21) Years of Age.

Appears in 2 contracts

Samples: Service Agreement, Service Agreement

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Targeted Case Management Services. Contractor is responsible for determining whether a Member requires Targeted Case Management (TCM) services, and must refer Members who are eligible for TCM services to a Regional Center or local governmental health program as appropriate for the provision of TCM services. If a Member is receiving TCM services as specified in Title 22 CCR 22, CCR, Section 51351, Contractor shall be responsible for coordinating the Member's ’s health care with the TCM Provider provider and for determining the Medical Necessity of diagnostic and treatment services recommended by the TCM Provider provider that are Covered Services under the Contract. If Members under age 21 are not accepted for TCM services, see Exhibit A, Attachment 10, provision 4, Contractor shall ensure the Members’ access to services are comparable to EPSDT TCM services per Exhibit A, Attachment 10, Scope of Services, Provision 5. Services for Members under Twenty-One (21) Years of Ageservices.

Appears in 1 contract

Samples: Standard Agreement (Molina Healthcare Inc)

Targeted Case Management Services. Contractor is responsible for determining whether a Member requires Targeted Case Management (TCM) services, and must refer Members who are eligible for TCM services to a Regional Center or local governmental health program as appropriate for the provision of TCM services. If a Member is receiving TCM services as specified in Title 22 CCR Section 51351, Contractor shall be responsible for coordinating the Member's health care with the TCM Provider provider and for determining the Medical Necessity of diagnostic and treatment services recommended by the TCM Provider provider that are Covered Services under the Contract. If Members under age 21 are not accepted for TCM services, Contractor shall ensure the Members’ access to services are comparable to EPSDT TCM services per Exhibit A, Attachment 10, Scope of Services, Provision 5. Services for Members under Twenty-One (21) Years of Age.

Appears in 1 contract

Samples: Service Agreement

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Targeted Case Management Services. ‌‌‌ Contractor is responsible for determining whether a Member requires Targeted Case Management (TCM) services, and must refer Members who are eligible for TCM services to a Regional Center or local governmental health program as appropriate for the provision of TCM services. If a Member is receiving TCM services as specified in Title 22 CCR Section 51351, Contractor shall be responsible for coordinating the Member's health care with the TCM Provider and for determining the Medical Necessity of diagnostic and treatment services recommended by the TCM Provider that are Covered Services under the Contract. If Members under age 21 are not accepted for TCM services, Contractor shall ensure the Members’ access to services are comparable to EPSDT TCM services per Exhibit A, Attachment 10, Scope of Services, Provision 5. Services for Members under Twenty-One (21) Years of Age.

Appears in 1 contract

Samples: Service Agreement

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