Network adequacy means access to services by measure of distance, time, and average length of

Network adequacy means a network of providers for the Contractor that is sufficient in numbers and types of providers/facilities to ensure that all services are accessible to Individuals in this Contract and within Available Resources.

Network adequacy means access to services by measure of distance, time, and average length of referral to scheduled visit.

Examples of Network adequacy in a sentence

Network adequacy issues for DPPO customers can also be resolved after the out of network claim has been processed.
The Contractor must comply with federal regulations regarding Provider Network adequacy as stated in 42 C.F.R. §§ 438.68, 438.206, 438.207; and must comply with state regulations regarding reconsideration of inclusion per Miss.
Not employ marketing practices or benefit designs that will have the effect of discour- aging the enrollment of individuals with significant health needs in QHPs.§ 156.230 Network adequacy standards.(a) General requirement.
Network adequacy assurance submitted by plan [Required for MCO/PIHP/PAHP] Programs: The ACC PCCM Entity-PIHP and ACC: MCO Personnel responsible: The ACC PCCM Entity-PIHP and ACC: MCO Strategy: Each ACC PCCM Entity-PIHP is required to create, administer and maintain a network of PCMPs and a network of behavioral health providers in compliance with established state network adequacy standards.
In the absence of a CMS protocol for 42 CFR § 438.358 Activities related to external quality review (b)(1)(iv), IPRO assessed MCO compliance with the standards of 42 CFR § 438.358 Network adequacy standards and Section 7.0 of the state’s Medicaid Services Contract.

More Definitions of Network adequacy

Network adequacy means the adequacy of the provider

Network adequacy means a Medicaid beneficiaries' ability

Network adequacy means the adequacy 1of1 the provider

Network adequacy means the adequacy of a

Network adequacy means the adequacy 1of1 the provider network with respect to the scope and type of health care benefits provided by the managed care plan, the geographic service area covered by the provider network, and access to medical specialists pursuant to the standards in the regulations promulgated pursuant to section 19 of P.L.1997, c.192 (C.26:2S-18) and in the existing contract between a managed care organization and the Division of Medical Assistance and Health Services in the Department of Human Services.

Network adequacy means the adequacy the provider network

Network adequacy means a Medicaid beneficiary's ability