DOWNSTREAM PROVIDERDownstream Provider Medicaid Program Regulatory Requirements Appendix • August 9th, 2024
The requirements of this Appendix apply to the provision of health care services that Provider provides directly to Covered Persons through Health Plan’s (as defined herein) products or benefit plans, including the State Contracts and related programs (collectively the “State Program”) as governed by the California Department of Health Care Services. Provider has agreed to provide Covered Services to Covered Persons who receive their coverage pursuant to a contract between the State and Health Plan (the “State Contract” as defined herein). The State Contract and applicable State and federal laws require that the provisions contained in this Appendix be part of the Agreement. In the event of a conflict between this Appendix and other appendices or any provision of the Agreement, the provisions of this Appendix shall control except with regard to benefit plans outside the scope of this Appendix or unless otherwise required by law. In the event Health Plan or Subcontractor are required to
