Common use of Nursing Facilities Training Clause in Contracts

Nursing Facilities Training. In addition to Section 8.1.4.6, the MCO must train all Nursing Facility Providers regarding the requirements of the Contract and special needs of STAR+PLUS Members. The MCO must establish ongoing Provider training addressing the following issues at a minimum. • Covered Services and the Provider’s responsibilities for providing services to Members and billing the MCO for the services. The MCO must place special emphasis on Nursing Facility Services and STAR+PLUS requirements, policies, and procedures that vary from Medicaid Fee-for-Service and commercial coverage rules, including payment policies and procedures. • The transition process of up to six (months for the continuation of Nursing Facility for Members receiving those services at the time of program implementation, including provider billing practices for these services and who to contact at the MCO for assistance with this process. • Relevant requirements of the STAR+PLUS Contract, including the role of the Service Coordinator; • Processes for making referrals and coordinating Non-capitated Services; • The MCO’s quality assurance and performance improvement program and the Provider’s role in these programs; and • The MCO’s STAR+PLUS policies and procedures, including those relating to Network and Out-of-Network referrals.