Examples of Core Provisions in a sentence
The definitions and acronyms in Core Provisions Section I, Definitions and Acronyms apply to all MMA Managed Care Plans and Comprehensive LTC Managed Care Plans unless specifically noted otherwise in this Exhibit.
In the event the enrollee regains Medicaid eligibility within the SIXT period, the enrollee will be reinstated with the Managed Care Plan in accordance with Core Provisions, Section III.B.1. sub-items h.
When a newborn does not meet the criteria of the mother’s plan, the newborn will be enrolled in a plan in accordance with Attachment II, Core Provisions, Section III, Eligibility and Enrollment, Item B., of this Contract.
Such standards shall be submitted to and approved by the Agency before use, and comply with Attachment II, Core Provisions, Section XII, Special Terms and Conditions, Item L., Communications, of this Contract.
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The Dental Plan shall submit model provider agreement templates to the Agency for review as specified in Attachment II, Scope of Service - Core Provisions, Section VIII., Provider Services.
The Dental Plan shall submit a monthly report to the Agency on the outcome of service authorization decisions as specified in Attachment II, Scope of Service - Core Provisions, Section XVI., Reporting Requirements, and the Statewide Medicaid Managed Care Plan Report Guide.
The Dental Plan shall develop and maintain a provider network that meets the needs of enrollees in accordance with the requirements in Attachment II, Scope of Service- Core Provisions, Section VIII., Provider Services of this Contract.
If the Dental Plan has delegated credentialing and/or recredentialing to a subcontractor, the agreement must ensure that all providers are credentialed in accordance with the Dental Plan’s and the Agency’s credentialing requirements as found in Attachment II, Scope of Service - Core Provisions, Section VIII.C., Provider Credentialing and Contracting.
The Dental Plan shall submit a quarterly report of the results of the inter-rater reliability audit to the Agency as specified in Attachment II, Scope of Service - Core Provisions, Section XVI., Reporting Requirements, and the Statewide Medicaid Managed Care Plan Report Guide.