Network Capacity. 6.1.1 The Contractor shall maintain and monitor an appropriate provider network, supported by written agreements, sufficient to serve enrollees enrolled under this Contract (42 C.F.R. § 438.206(b)(1)).
Network Capacity. Contractor shall maintain a provider network adequate to serve sixty percent (60%) of all Eligible Beneficiaries, including SPD beneficiaries, within Contractor’s Service Area and provide the full scope of benefits. Contractor will increase the capacity of the network as necessary to accommodate enrollment growth beyond the sixty percent (60%). However, after the first twelve months of operation, if Enrollments do not achieve seventy-five percent (75%) of the required network capacity, the Contractor's total network capacity requirement may be renegotiated.
Network Capacity. The Contractor shall maintain and monitor an appropriate and adequate provider network, supported by written agreements, sufficient to provide all Contracted Services under this Contract. The Contractor may provide Contracted Services through Non-Participating Providers, at a cost to the individual that is no greater than if the Contracted Services were provided by Participating Providers, if its network of Participating Providers is insufficient to meet the Behavioral Health needs of Individuals in a manner consistent with this Contract. This provision shall not be construed to require the Contractor to cover such services without authorization. To the extent necessary to provide non-crisis Behavioral Health services covered under this Contract, the Contractor may offer contracts to providers in other RSAs in the state of Washington and to providers in bordering states. The Contractor may not contract for Crisis Services (SUD or Mental Health) or ITA-related services out of Washington State. For non-crisis behavioral health services funded by GFS: The Contractor shall provide non-crisis Behavioral Health services funded by GFS, within Available Resources, to Individuals who meet financial eligibility standards in this Contract and meet one of the following criteria: Are uninsured; Have insurance, but are unable to pay the co-pay or deductible for services; Are using excessive Crisis Services due to inability to access non-crisis behavioral health services; and Have more than five (5) visits over six (6) months to the emergency department, withdrawal management facility, or a sobering center due to a SUD. The Contractor must submit a network of contracted service providers adequate to serve the population in the Contractor’s RSA annually by November 1. If the Contractor fails to provide evidence of or HCA is unable to validate contracts with a sufficient number of providers, HCA may terminate this Contract. The network must have sufficient capacity to serve the RSA and include, at a minimum: 24/7/365 Telephone Crisis Intervention; Designated Crisis Responder (DCR); Evaluation and treatment (E&T) and Secure Withdrawal Management and Stabilization capacity to serve the RSA’s non-Medicaid population; Psychiatric inpatient beds to serve the RSA’s non-Medicaid population, including direct contracts with community hospitals at a rate no greater than that outlined in the HCA Fee-for-Service schedule; Staff to provide mobile crisis outreach in the RSA. The Contrac...
Network Capacity. The Contractor shall maintain and monitor an appropriate and adequate provider network, supported by written agreements, sufficient to provide GFS services under this Contract to its Enrollees; provided that, for purposes of this Contract, Indian Health Care Providers, whether or not they have executed a written agreement with the Contractor, will be treated as in the Contractor’s provider network. Any other changes that result in the Contractor being unable to meet access including a decrease in the number or frequency of a required service, employee strike or other work stoppage related to union activities, or any changes that results in the Contractor being unable to provide timely services. The Contractor shall notify HCA ninety (90) days prior to terminating any of its Subcontracts with entities that provide direct services or entering into new subcontracts with entities that provide direct services. This notification shall occur prior to any public announcement of this change. If a Subcontract is terminated in less than ninety (90) days or a site closure occurs in less than ninety (90) days, the Contractor shall notify HCA as soon as possible and prior to a public announcement. If a subcontract is terminated or a site closes, the Contractor shall submit a plan to HCA that includes at a minimum: Notification to Ombuds services; Individual notification plan; Plan for provision of uninterrupted services; and Any information released to the media. The Contractor shall incorporate the following requirements when developing its network: The Contractor shall, in partnership with the BH-ASO, assist the state to expand community-based alternatives for crisis stabilization, such as mobile crisis or crisis residential and respite beds. The Contractor shall assist the state to expand community-based, recovery‑oriented services and research- and evidence-based practices and Promising Practices. The Contractor shall implement an adequate plan to provide Evaluation and Treatment services, including Culturally Appropriate Care, to Enrollees, which may include the development of less restrictive alternative to involuntary treatment or prevention programs reasonably calculated to reduce the demand for Evaluation and Treatment services. If the Contractor, in HCA’s sole opinion, and in conjunction with recommendations provided by the ACH, fails to maintain an adequate network of Behavioral Health providers in any contracted service area for two (2) consecutive quarters,...
Network Capacity. 6.1.1 The Contractor must maintain and monitor an appropriate provider network, supported by written agreements, sufficient to provide adequate access to all services covered under the Contract for all Enrollees, including those with limited English proficiency or physical or mental disabilities (42 C.F.R. § 438.206(b)(1)).
Network Capacity. Report the number and type of all Providers in the network by the type of services rendered.
Network Capacity. I-Link's Network facilities currently have sufficient capacity to handle the traffic currently generated by the Existing and Legacy Customers plus all other existing traffic from other existing customers. I-Link's e-mail and Internet access is sufficient to meet the existing requirements of the Existing and Legacy Customers and currently meets the communication and Web requirements of the I-Link LLC Representative sales force.
Network Capacity. 6.1.1 The Contractor shall maintain and monitor an appropriate and adequate provider network, supported by written agreements, sufficient to provide all Contracted Services under this Contract. The Contractor may provide contracted services through Non-Participating Providers, at a cost to the individual that is no greater than if the contracted services were provided by Participating Providers, if its network of Participating Providers is insufficient to meet the behavioral health needs of individuals in a manner consistent with this Contract. This provision shall not be construed to require the Contractor to cover such services without authorization. To the extent necessary to provide non-crisis behavioral health services covered under this Contract, the Contractor may offer contracts to providers in other RSAs in the state of Washington and to providers in bordering states. The Contractor may not Contract for Crisis Services (SUD or mental health) or ITA-related services out of Washington State.
Network Capacity. The Contractor shall maintain and monitor an appropriate and adequate provider network, supported by written agreements, sufficient to provide GFS services under this Contract to its Enrollees. The Contractor shall incorporate the following requirements when developing its network: The Contractor shall, in partnership with the BH-ASO, assist the state to expand community-based, including Tribal-based, alternatives for crisis stabilization, such as mobile crisis or crisis residential and respite beds. The Contractor shall assist the state to expand community-based, recovery-oriented services and research- and evidence-based practices. The Contractor shall implement an adequate plan to provide Evaluation and Treatment services to Enrollees, which may include the development of less restrictive alternative to involuntary treatment or prevention programs reasonably calculated to reduce the demand for Evaluation and Treatment services. Regional Behavioral Health entities must develop and implement plans for improving access to timely and appropriate treatment for Enrollees with Behavioral Health needs and current or prior criminal justice involvement. If the Contractor, in HCA’s sole opinion, fails to maintain an adequate network of GFS Behavioral Health providers in any contracted service area for two (2) consecutive quarters, and after notification following the first quarter, HCA reserves the right to immediately terminate the Contractor’s services for that service area. The network established under the Contract must complement and support the network of Medicaid providers established by the IAHFC Medicaid Contract. The Contractor shall update and maintain the Contractor’s existing provider manual to include all relevant information regarding GFS services and requirements. The Contractor shall have, maintain, and provide to HCA upon request an up-to- date database of its provider network. The Contractor shall update its existing database to meet the following requirements: A network inventory, including licensure, to quantify the number of providers offering GFS services, including a list of all GFS providers. Includes the providers’ names, locations, telephone numbers, GFS services offered, clinical specialty and areas of expertise. Includes a description of each provider’s language(s) spoken and if appropriate, a brief description of the provider’s skills or experiences that would support the cultural or linguistic needs of its Enrollees when provided by ...
Network Capacity. 4.12 The Lessor represents to the Lessee that Phase 1 and Phase 2 of the Network has a combined total Capacity of approximately 4.5165 million Subscribers.
