Waived and Inapplicable Federal Requirements. 1. The Contractor is operating as a PIHP. Accordingly, the following provisions of 42 CFR §438 are not applicable to this Intergovernmental Agreement: 42 CFR §438.3(s)(t) – Standard Contract Requirements; 42 CFR §438.4 – Actuarial Soundness; 42 CFR §438.5 – Rate Development Standards; 42 CFR §438.6 – Special Contract Provisions Related to Payment; 42 CFR §438.7 2. Under this DMC-ODS, free choice of providers is restricted. That is, beneficiaries enrolled in this program shall receive DMC-ODS services through the Contractor, operating as a PIHP. Based on this service delivery model, the Department has requested, and Centers for Medicare & Medicaid Services (CMS) has granted
Appears in 6 contracts
Samples: Intergovernmental Agreement, Intergovernmental Agreement, Intergovernmental Agreement
