Timely Access. A. In accordance with 42 CFR 438.206(c)(1), the Contractor shall comply with the following requirements: 1) Meet and require its providers to meet DHCS standards for timely access to care and services, taking into account the urgency of need for services; 2) Require subcontracted providers to have hours of operation during which services are provided to Medi-Cal beneficiaries that are no less than the hours of operation during which the provider offers services to non-Medi-Cal beneficiaries. If the provider only serves Medi-Cal beneficiaries, the Contractor shall require that hours of operation are comparable to the hours the provider makes available for Medi-Cal services that are not covered by the Contractor; 3) Make services available to beneficiaries 24 hours a day, 7 days a week, when medically necessary; 4) Establish mechanisms to ensure that network providers comply with the timely access requirements; 5) Monitor network providers regularly to determine compliance with timely access requirements; and 6) Take corrective action if there is a failure to comply with timely access requirements.
Appears in 9 contracts
Samples: Standard Agreement, Standard Agreement, Intergovernmental Agreement
Timely Access.
A. In accordance with 42 CFR 438.206(c)(1), the Contractor shall comply with the following requirements:requirements:
1) Meet and require its providers to meet DHCS standards for timely access to care and services, taking into account the urgency of need for services;services;
2) Require subcontracted providers to have hours of operation during which services are provided to Medi-Cal beneficiaries that are no less than the hours of operation during which the provider offers services to non-Medi-Cal beneficiaries. If the provider only serves Medi-Cal beneficiaries, the Contractor shall require that hours of operation are comparable to the hours the provider makes available for Medi-Cal services that are not covered by the Contractor;
3) Make services available to beneficiaries 24 hours a day, 7 days a week, when medically necessary;necessary;
4) Establish mechanisms to ensure that network providers comply with the timely access requirements;
5) Monitor network providers regularly to determine compliance with timely access requirements; and
6) Take corrective action if there is a failure to comply with timely access requirements.
Appears in 1 contract
Samples: Intergovernmental Agreement
