Common use of Coordination of Care/Letters of Agreement Clause in Contracts

Coordination of Care/Letters of Agreement. The PH-MCO must coordinate the comprehensive in-plan package with entities providing Out-of-Plan Services. To facilitate the efficient administration of the Medical Assistance Program, to enhance the treatment of Members who need Out-of-Plan services and to clearly define the roles of the entities involved in the coordination of services, the PH-MCO must enter into coordination of care letters of agreement with County Children and Youth Agencies (CCYAs), Juvenile Probation Offices (refer to Sample Model Agreement, Exhibit Q), and BH-MCOs (refer to Exhibit R, Coordination with BH- MCOs). In Addition, the PH-MCO must make a good faith effort to enter into coordination of care letters of agreement with school districts and other public, governmental, county, and community- based service providers. Should the PH-MCO be unable to enter into coordination of care letters of agreement as required under this Agreement, the PH-MCO must submit written justification to the Department. Justification must include all the steps taken by the PH-MCO to secure coordination of care letters of agreement, or must demonstrate an existing, ongoing, and cooperative relationship with the entity. The Department will determine whether to waive strict compliance with this requirement. All written coordination documents developed and maintained by the PH-MCO must have advance written approval by the Department and must be reviewed and, if necessary, revised at least annually by the PH-MCO. Coordination documents must be available for review by the Department upon request. The PH-MCO must obtain the Department’s prior written approval of all written coordination documents entered into between a service provider and the PH-MCO. These coordination documents must contain, but should not be limited to, the provisions outlined in Exhibit S, Written Coordination Agreements Between PH-MCO and Service Providers, and must be submitted for final Department review and approval at least thirty (30) days prior to the operational date of Agreement. Under no circumstances may these coordination documents contain a definition of Medically Necessary other than the definition found in this Agreement.

Coordination of Care/Letters of Agreement. The PH-MCO must coordinate the comprehensive in-plan package of services with entities providing Out-of-Plan Services. To facilitate the efficient administration of the Medical Assistance Program, to enhance the treatment of Members who need Out-of-Plan services and to clearly define the roles of the entities involved in the coordination of services, the PH-MCO must enter into coordination of care letters of agreement with County Children and Youth Agencies (CCYAs), ) and Juvenile Probation Offices (refer to Sample Model Agreement, Exhibit QQ of this Agreement), and the BH-MCOs (refer to Exhibit RR of this Agreement, Coordination with BH- BH-MCOs). In Addition, The Department encourages the PH-MCO must to make a good faith effort to enter into coordination of care letters of agreement with school districts and other public, governmental, county, and community- community-based service providers. Should the PH-MCO be unable to enter into coordination of care letters of agreement as required under this Agreement, the PH-PH- MCO must submit written justification to the Department. Justification must include all the steps taken by the PH-MCO to secure coordination of care letters of agreement, or must demonstrate an existing, ongoing, and cooperative relationship with the entity. The Department will then determine whether to waive strict compliance with or not this requirementrequirement will be deemed met. All written coordination documents developed and maintained by the PH-MCO must have advance written approval by the Department and must be reviewed and, if necessary, reviewed/revised at least annually by the PH-MCO. Coordination documents must be available for review by the Department upon request. The PH-MCO must obtain the Department’s prior written approval of all All written coordination documents entered into between a service provider and the PH-MCOMCO must also be approved by the Department. These written coordination documents must containdocuments, but should not be limited toincluding the operational procedures, the provisions outlined in Exhibit S, Written Coordination Agreements Between PH-MCO and Service Providers, and must be submitted for final Department review and approval at least thirty (30) days prior to the operational date of Agreementthe Initial Term of the Contract. Under no circumstances may these Any written coordination documents contain a definition entered into between the PH- MCO and service Providers must contain, but are not limited to, the provisions outlined in Exhibit S of Medically Necessary other than the definition found in this Agreement., Written Coordination Agreements Between PH-MCO and Service

Coordination of Care/Letters of Agreement. The PH-MCO must coordinate the comprehensive in-plan package of services with entities providing Out-of-Plan Services. To facilitate the efficient administration of the Medical Assistance Program, to enhance the treatment of Members who need Out-of-Plan services and to clearly define the roles of the entities involved in the coordination of services, the PH-MCO must enter into coordination of care letters of agreement with County Children and Youth Agencies (CCYAs), ) and Juvenile Probation Offices (refer to Sample Model Agreement, Exhibit QQ of this Agreement), and the BH-MCOs (refer to Exhibit RR of this Agreement, Coordination with BH- BH-MCOs). In Addition, The Department encourages the PH-MCO must to make a good faith effort to enter into coordination of care letters of agreement with school districts and other public, governmental, county, and community- community-based service providers. Should the PH-MCO be unable to enter into coordination of care letters of agreement as required under this Agreement, the PH-PH- MCO must submit written justification to the Department. Justification must include all the steps taken by the PH-MCO to secure coordination of care letters of agreement, or must demonstrate an existing, ongoing, and cooperative relationship with the entity. The Department will then determine whether to waive strict compliance with or not this requirementrequirement will be deemed met. All written coordination documents developed and maintained by the PH-MCO must have advance written approval by the Department and must be reviewed and, if necessary, reviewed/revised at least annually by the PH-MCO. Coordination documents must be available for review by the Department upon request. The PH-MCO must obtain the Department’s prior written approval of all All written coordination documents entered into between a service provider and the PH-MCOMCO must also be approved by the Department. These written coordination documents must containdocuments, but should not be limited toincluding the operational procedures, the provisions outlined in Exhibit S, Written Coordination Agreements Between PH-MCO and Service Providers, and must be submitted for final Department review and approval at least thirty (30) days prior to the operational date of the Initial Term of the Contract. Any written coordination documents entered into between the PH- MCO and service Providers must contain, but are not limited to, the provisions outlined in Exhibit S of this Agreement, Written Coordination Agreements Between PH-MCO and Service Providers. Under no circumstances may these coordination documents contain a any definition of Medically Necessary other than the definition found in this Agreement.

Coordination of Care/Letters of Agreement. The PH-MCO must coordinate the comprehensive in-plan package with entities providing Out-of-Plan Services. To facilitate the efficient administration of the Medical Assistance Program, to enhance the treatment of Members who need Out-of-Plan services and to clearly define the roles of the entities involved in the coordination of services, the PH-MCO must enter into coordination of care letters of agreement with County Children and Youth Agencies (CCYAs), Juvenile Probation Offices (refer to Sample Model Agreement, Exhibit Q), and BH-MCOs (refer to Exhibit R, Coordination with BH- BH-MCOs). In Addition, the PH-MCO must make a good faith effort to enter into coordination of care letters of agreement with school districts and other public, governmental, county, and community- community-based service providers. Should the PH-MCO be unable to enter into coordination of care letters of agreement as required under this Agreement, the PH-PH- MCO must submit written justification to the Department. Justification must include all the steps taken by the PH-MCO to secure coordination of care letters of agreement, or must demonstrate an existing, ongoing, and cooperative relationship with the entity. The Department will determine whether to waive strict compliance with this requirement. All written coordination documents developed and maintained by the PH-MCO must have advance written approval by the Department and must be reviewed and, if necessary, revised revisd at least annually by the PH-MCO. Coordination documents must be available for review by the Department upon request. The PH-MCO must obtain the Department’s prior written approval of all written coordination documents entered into between a service provider and the PH-MCO. These coordination documents must contain, but should not be limited to, the provisions outlined in Exhibit S, Written Coordination Agreements Between PH-MCO and Service Providers, and must be submitted for final Department review and approval at least thirty (30) days prior to the operational date of Agreement. Under no circumstances may these coordination documents contain a definition of Medically Necessary other than the definition found in this Agreement.

Coordination of Care/Letters of Agreement. ‌ The PH-MCO must coordinate the comprehensive in-plan package with entities providing Out-of-Plan Services. To facilitate the efficient administration of the Medical Assistance Program, to enhance the treatment of Members who need Out-of-Plan services and to clearly define the roles of the entities involved in the coordination of services, the PH-MCO must enter into coordination of care letters of agreement with County Children and Youth Agencies (CCYAs), Juvenile Probation Offices (refer to Sample Model Agreement, Exhibit Q), and BH-MCOs (refer to Exhibit R, Coordination with BH- BH-MCOs). In Addition, the PH-MCO must make a good faith effort to enter into coordination of care letters of agreement with school districts and other public, governmental, county, and community- community-based service providers. Should the PH-MCO be unable to enter into coordination of care letters of agreement as required under this Agreement, the PH-PH- MCO must submit written justification to the Department. Justification must include all the steps taken by the PH-MCO to secure coordination of care letters of agreement, or must demonstrate an existing, ongoing, and cooperative relationship with the entity. The Department will determine whether to waive strict compliance with this requirement. All written coordination documents developed and maintained by the PH-MCO must have advance written approval by the Department and must be reviewed and, if necessary, revised revisd at least annually by the PH-MCO. Coordination documents must be available for review by the Department upon request. The PH-MCO must obtain the Department’s prior written approval of all written coordination documents entered into between a service provider and the PH-MCO. These coordination documents must contain, but should not be limited to, the provisions outlined in Exhibit S, Written Coordination Agreements Between PH-MCO and Service Providers, and must be submitted for final Department review and approval at least thirty (30) days prior to the operational date of Agreement. Under no circumstances may these coordination documents contain a definition of Medically Necessary other than the definition found in this Agreement.

Coordination of Care/Letters of Agreement. The PH-MCO must coordinate the comprehensive in-plan package with entities providing Out-of-Plan Services. To facilitate the efficient administration of the Medical Assistance Program, to enhance the treatment of Members who need Out-of-Plan services and to clearly define the roles of the entities involved in the coordination of services, the PH-MCO must enter into coordination of care letters of agreement with County Children and Youth Agencies (CCYAs), Juvenile Probation Offices (refer to Sample Model Agreement, Exhibit Q), and BH-MCOs (refer to Exhibit R, Coordination with BH- MCOs). In Addition, the PH-MCO must make a good faith effort to enter into coordination of care letters of agreement with school districts and other public, governmental, county, and community- based service providers. Should the PH-MCO be unable to enter into coordination of care letters of agreement as required under this Agreement, the PH-MCO must submit written justification to the Department. Justification must include all the steps taken by the PH-MCO to secure coordination of care letters of agreement, or must demonstrate an existing, ongoing, and cooperative relationship with the entity. The Department will determine whether to waive strict compliance with this requirement. All written coordination documents developed and maintained by the PH-MCO must have advance written approval by the Department and must be reviewed and, if necessary, revised at least annually by the PH-MCO. Coordination documents must be available for review by the Department upon request. The PH-MCO must obtain the Department’s 's prior written approval of all written coordination documents entered into between a service provider and the PH-MCO. These coordination documents must contain, but should not be limited to, the provisions outlined in Exhibit S, Written Coordination Agreements Between PH-MCO and Service Providers, and must be submitted for final Department review and approval at least thirty (30) days prior to the operational date of Agreement. Under no circumstances may these coordination documents contain a definition of Medically Necessary other than the definition found in this Agreement.