Expanded Services. The PH-MCO may provide expanded services subject to advance written approval by the Department. These must be services that are generally considered to have a direct relationship to the maintenance or enhancement of a Member’s health status, and may include various seminars and educational programs promoting healthy living or illness prevention, memberships in health clubs and facilities promoting physical fitness and expanded eyeglass or eye care benefits. These services must be generally available to all Members and must be made available at all appropriate Network Providers. Such services cannot be tied to specific Member performance; however, the Department may grant exceptions when it believes that such performance will produce significant health improvements for Members. Previously approved services will continue to remain in effect under this Agreement, unless the PH- MCO is notified, in writing, by the Department, to discontinue the expanded service. In order for information about expanded services to be included in any Member information provided by the PH-MCO, the PH-MCO must make the expanded services available for a minimum of one full year or until the Member information is revised, whichever is later. Upon sixty (60) days advance notice to the Department, the PH- MCO may modify or eliminate any expanded service. Such services as modified or eliminated shall supersede those specified in the Proposal. The PH-MCO must send written notice to Members and affected Providers at least thirty (30) days prior to the effective date of the change in covered services and must simultaneously amend all written materials describing its covered services or Provider Network. A change in covered services includes any reduction in services or a substantial change to the Provider Network.
Expanded Services f. The PH-MCO may offer Members consumer incentives only if they are directly related to improving health outcomes. The incentive cannot be used to influence a Member to receive any item or service from a particular Provider, practitioner or supplier. In addition, the incentive cannot exceed the total cost of the service being provided. The PH-MCO must receive advance written approval from the Department prior to offering a Member incentive.
Expanded Services. A Health Plan Covered Service for which the Health Plan receives no direct payment from the Agency.
Expanded Services. (See Attachment I)
Expanded Services. The contractor may elect to provide expanded services. If the contractor elects to provide expanded services, the services must be offered to all eligible enrollees following written approval by the Department of Elder Affairs. Expanded services are defined as the following:
Expanded Services. A PSN covered service for which the PSN receives no direct payment from the Agency.
Expanded Services. To allow the State to make payments for services that will be provided that are not normally covered under Part E of title IV of the Act; and to allow the State to use title IV-E funds for these costs and services as described in the Terms and Conditions, Section 2.0.
Expanded Services. 1. The following services are defined as Expanded Services that may be offered by the Health Plan following the Agency’s written approval:
Expanded Services. The Scope of Services in Original Agreement for Phase I is expanded to include the additional work described in “Change Order Request No. 1” attached hereto as Exhibit 3 and made a part of this Addendum. This change order is an addition to the rest of the Scope of Services of Original Agreement.
Expanded Services. The contractor may offer incentive programs for enrollees. The contractor shall receive written approval from the department prior to the use of any special incentives for enrollees. Any incentive program offered must be provided to all eligible individuals and will not be used to direct individuals to select a specific contractor.
