Common use of Time and Distance Standards Clause in Contracts

Time and Distance Standards. (A) The Contractor shall implement the provider network adequacy time and distance standards specified in Table 2 for adult and pediatric Covered Services. The standards vary for urban, rural and frontier counties of the State. Table 1 includes the designation of each county as urban, rural, or frontier. The Contractor shall apply the standards in Table 2 according to each of its covered county’s designation in Table 1. The Contractor shall apply the standards as applicable to adult mental health providers, adult substance use disorder providers, pediatric mental health providers and pediatric substance use disorder providers. Xxxxx Cache Beaver Salt Lake Carbon Box Elder Utah Iron Xxxxxxx Xxxxx Xxxxxx Xxxxxxxx Sanpete Xxxxx Xxxxxx Garfield Summit Grand Wasatch Juab Washington Xxxx Xxxxxxx Piute Rich San Xxxx Tooele Uintah Xxxxx 90% of members must have access to Network Providers within 10 miles or 15 minutes 80% of members must have access to Network Providers within 35 miles or 45 minutes 75% of members must have access to Network Providers within 60 miles or 70 minutes (B) If the Contractor is unable to meet the network adequacy standards, the Contractor may request an exception to these standards. The Department has sole discretion to allow for any exception to the network adequacy standards. A request for exception to these standards must be in writing and must include: (1) the specific exemption the Contractor is requesting; (2) the steps taken by the Contractor to comply with the network adequacy requirements before requesting the exception; and (3) a description of the Contractor’s plan to adequately provide Covered Services in the area where the exemption is requested.