Common use of Timely Access to Care Clause in Contracts

Timely Access to Care. The Contractor shall have contracts in place with all subcontractors that meet state standards for access, taking into account the urgency of the need for services (42 C.F.R. § 438.206(b) & (c)(1)(i))). The Contractor shall ensure that: 6.3.1 Network providers offer access comparable to that offered to commercial enrollees or, if the Contractor serves only Medicaid enrollees, comparable to Medicaid fee-for-service (42 C.F.R. § 438.206(b)(1)(iv) & (c)(1)(ii))). 6.3.2 Mechanisms are established to ensure compliance by providers. 6.3.3 Providers are monitored regularly to determine compliance. 6.3.4 Corrective action is initiated and documented if there is a failure to comply.

Timely Access to Care. The Contractor shall have contracts in place with all subcontractors that meet state standards for access, taking into account the urgency of the need for services (42 C.F.R. § CFR 438.206(b) & (c)(1)(i))). The Contractor shall ensure that: 6.3.1 7.4.1. Network providers offer access comparable to that offered to commercial enrollees oror comparable to Medicaid fee-for-service, if the Contractor serves only Medicaid enrollees, comparable to Medicaid fee-for-service enrollees (42 C.F.R. § CFR 438.206(b)(1)(iv) & (c)(1)(ii))). 6.3.2 7.4.2. Mechanisms are established to ensure compliance by providers. 6.3.3 7.4.3. Providers are monitored regularly to determine compliance. 6.3.4 7.4.4. Corrective action is initiated and documented if there is a failure to comply.

Timely Access to Care. The Contractor shall have contracts in place with all subcontractors that meet state standards for access, taking into account the urgency of the need for services (42 C.F.R. § CFR 438.206(b) & (c)(1)(i))). The Contractor shall ensure that: 6.3.1 Network providers offer access comparable to that offered to commercial enrollees or, if the Contractor serves only Medicaid and dual eligible enrollees, comparable to Medicaid fee-for-service (42 C.F.R. § Medicaid and other care options available to Medicare clients(42 CFR 438.206(b)(1)(iv) & (c)(1)(ii))). 6.3.2 Mechanisms are established to ensure compliance by providers. 6.3.3 Providers are monitored regularly to determine compliance. 6.3.4 Corrective action is initiated and documented if there is a failure to comply.

Timely Access to Care. The Contractor shall have contracts in place with all subcontractors that meet state standards for access, taking into account the urgency of the need for services (42 C.F.R. § 438.206(b) & (c)(1)(i))). The Contractor shall ensure that: 6.3.1 Network providers offer access comparable to that offered to commercial enrollees or, if the Contractor serves only Medicaid enrollees, comparable to Medicaid fee-for-service (42 C.F.R. § 438.206(b)(1)(iv) & (c)(1)(ii))). 6.3.2 Mechanisms are established to ensure compliance by providers. 6.3.3 Providers are monitored regularly to determine compliance. 6.3.4 Corrective action is initiated and documented if there is a failure to comply.comply.‌‌

Timely Access to Care. The Contractor shall have contracts in place with all subcontractors that meet state standards for access, taking into account the urgency of the need for services (42 C.F.R. § 438.206(b) & (c)(1)(i))). The Contractor shall ensure that: 6.3.1 Network providers offer access comparable to that offered to commercial enrollees oror comparable to Medicaid fee-for-service, if the Contractor serves only Medicaid enrollees, comparable to Medicaid fee-for-service enrollees (42 C.F.R. § 438.206(b)(1)(iv) & (c)(1)(ii))). 6.3.2 Mechanisms are established to ensure compliance by providers. 6.3.3 Providers are monitored regularly to determine compliance. 6.3.4 Corrective action is initiated and documented if there is a failure to comply.