Common use of Evidentiary standards Clause in Contracts

Evidentiary standards. At a minimum, the supporting documentation must demonstrate the following to the satisfaction of both RI EOHHS and CMS staff with appropriate clinical or medical expertise: 2.3.6.2.4.1. The Enrollee is presently engaging in a pattern of disruptive conduct that is seriously impairing the Contractor’s ability to furnish Covered Services to the Enrollee and/or other Enrollees. 2.3.6.2.4.2. The Contractor took reasonable efforts to address the disruptive conduct including at a minimum: 2.3.6.2.4.2.1. A documented effort to understand and address the Enrollee’s underlying interests and needs reflected in his/her disruptive conduct and provide reasonable accommodations as defined by the Americans with Disabilities Act, including those for individuals with mental and/or cognitive conditions. An accommodation is reasonable if it is efficacious in providing equal access to services and proportional to costs. RI EOHHS and CMS will determine whether the reasonable accommodations offered are sufficient. 2.3.6.2.4.2.2. A documented provision of information to the individual of his or her right to use the Contractor’s Grievance procedures. 2.3.6.2.4.3. The Contractor provided the Enrollee with a reasonable opportunity to cure his/her disruptive conduct. 2.3.6.2.4.4. The Contractor must provide evidence that the Enrollee’s behavior is not related to the use, or lack of use, of medical services. 2.3.6.2.4.5. The Contractor may also provide evidence of other extenuating circumstances that demonstrate the Enrollee’s disruptive conduct.

Evidentiary standards. At a minimum, the supporting documentation must demonstrate the following to the satisfaction of both RI EOHHS DHCS and CMS staff with appropriate clinical or medical expertise: 2.3.6.2.4.12.3.2.5.3.1. The Enrollee is presently engaging in a pattern of disruptive conduct that is seriously impairing the Contractor’s ability to furnish Covered Items and Services to the Enrollee and/or other Enrollees. 2.3.6.2.4.22.3.2.5.3.2. The Contractor took reasonable efforts to address the disruptive conduct including at a minimum: 2.3.6.2.4.2.12.3.2.5.3.2.1. A documented effort to understand and address the Enrollee’s underlying interests and needs reflected in his/her disruptive conduct and provide reasonable accommodations as defined by the Americans with Disabilities Act, Act including those for individuals with mental and/or cognitive conditions. An accommodation is reasonable if it is efficacious in providing equal access to services and proportional to costs. RI EOHHS DHCS and CMS will determine whether the reasonable accommodations offered are sufficient. 2.3.6.2.4.2.22.3.2.5.3.2.2. A documented provision of information to the individual of his or her right to use the Contractor’s Grievance procedures. 2.3.6.2.4.32.3.2.5.3.2.3. The Contractor provided the Enrollee with a reasonable opportunity to cure his/her disruptive conduct. 2.3.6.2.4.42.3.2.5.3.3. The Contractor must provide evidence that the Enrollee’s behavior is not related to the use, or lack of use, of medical services. 2.3.6.2.4.52.3.2.5.3.4. The Contractor may also provide evidence of other extenuating circumstances that demonstrate the Enrollee’s disruptive conduct.;

Evidentiary standards. At a minimum, the supporting documentation must demonstrate the following to the satisfaction of both RI EOHHS and CMS staff with appropriate clinical or medical expertise: 2.3.6.2.4.1. The Enrollee is presently engaging in a pattern of disruptive conduct that is seriously impairing the Contractor’s ability to furnish Covered Services to the Enrollee and/or other Enrollees. 2.3.6.2.4.2. The Contractor took reasonable efforts to address the disruptive conduct including at a minimum: 2.3.6.2.4.2.1. A documented effort to understand and address the Enrollee’s underlying interests and needs reflected in his/her their disruptive conduct and provide reasonable accommodations as defined by the Americans with Disabilities Act, including those for individuals with mental and/or cognitive conditions. An accommodation is reasonable if it is efficacious in providing equal access to services and proportional to costs. RI EOHHS and CMS will determine whether the reasonable accommodations offered are sufficient. 2.3.6.2.4.2.2. A documented provision of information to the individual of his or her right to use the Contractor’s Grievance procedures. 2.3.6.2.4.3. The Contractor provided the Enrollee with a reasonable opportunity to cure his/her cease their disruptive conduct. 2.3.6.2.4.4. The Contractor must provide evidence that the Enrollee’s behavior is not related to the use, or lack of use, of medical services. 2.3.6.2.4.5. The Contractor may also provide evidence of other extenuating circumstances that demonstrate the Enrollee’s disruptive conduct.