LTSS standards Sample Clauses

LTSS standards. Unless the State approves an exception, for the first year of the demonstration (October 1, 2013 – December 31, 2014) Demonstration Plans will be required to offer contracts to all nursing facilities and supportive living facilities, as well as any willing LTSS provider in the service area that renders such Covered Services so long as such provider meets all applicable State and federal requirements for participation in the Medicaid program and meets the qualifications of the applicable HCBS waiver. After the first year of the Demonstration, Demonstration Plans may establish quality standards and may contract with only those providers that meet such standards, provided that all of the contracting providers are informed of any such quality standards no later than 90 days after the start of the first year of the Demonstration and that the State has given prior approval of the quality standards. Any such quality standards that are not established within 90 days after the start of the Demonstration must be in effect for 12 months before the Demonstration Plan may terminate a contract of a provider based on a failure to meet such quality standards. The State may grant exceptions to these contracting requirements for reasons other than failure to meet the quality standards. The Demonstration Plan must transition beneficiaries, or have a plan to transition beneficiaries, to new providers prior to terminating the contracts. The following provider specific standards also apply: 1. For Nursing Facilities (NFs) and Supportive Living Facilities (SLFs), Demonstration Plans must maintain the adequacy of its provider network within each county of the service area provided that each provider meets all applicable State and federal requirements for participation in the Medicaid Program. 2. For providers of each of the Covered Services listed below under a HCBS waiver, within each county in the service area, Demonstration Plans must enter into and maintain contracts with a set of providers that provided at least eighty percent (80%) of the fee-for-service services during CY 2012. For counties where there is more than one provider of Covered Services, Demonstration Plans shall enter into contracts with at least two of such providers, even if one served more than eighty percent (80%) of the current clients. HCBS services subject to this standard include: • Adult Day Care • Homemaker • Day Habilitation (BI waiver) • Supported Employment (BI waiver) • Home Delivered Meals • Home...