{"component": "clause", "props": {"groups": [{"samples": [{"hash": "9Ct0e8TOLeU", "uri": "/contracts/9Ct0e8TOLeU#primary-care-providers", "label": "Contract Amendment (Centene Corp)", "score": 25.1396303901, "published": true}, {"hash": "lSgjnkkNFzQ", "uri": "/contracts/lSgjnkkNFzQ#primary-care-providers", "label": "Contract (Centene Corp)", "score": 24.8056125941, "published": true}, {"hash": "7OCCaSFeIWo", "uri": "/contracts/7OCCaSFeIWo#primary-care-providers", "label": "Contract (Centene Corp)", "score": 24.8056125941, "published": true}], "snippet": "The MCO's PCP Network may include Providers from any of the following practice areas: General Practice; Family Practice; Internal Medicine; Pediatrics; Obstetrics/Gynecology (OB/GYN); Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs) (when APRNs and PAs are practicing under the supervision of a physician specializing in Family Practice, Internal Medicine, Pediatrics or Obstetrics/Gynecology who also qualifies as a PCP under this contract); Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and similar community clinics; and specialist physicians who are willing to provide a Medical Home to selected Members with special needs and conditions. Texas Government Code Section 533.005(a)(13) and Texas Health and Safety Code Section 62.1551 require the MCO to use advance practice registered nurses (APRNs) and physician assistants (PAs) practicing under the supervision of a Network physician. The MCO must treat APRNs and PAs in the same manner as other Network PCPs with regard to: (1) selection and assignment as PCPs, (2) inclusion as PCPs in the MCO's Provider Network, and (3) inclusion as a PCP in any Provider Directory maintained by the MCO. An internist or other Provider who provides primary care to adults only is not considered an age-appropriate PCP choice for a Member birth through age 20. An internist or other Provider who provides primary care to adults and children may be a PCP for children if:\n1. the Provider assumes all MCO PCP responsibilities for such child Members in a specific age range from birth through age 20,\n2. the Provider has a history of practicing as a PCP for the specified age range, as evidenced by the Provider's primary care practice including an established patient population within the specified age range, and\n3. the Provider has admitting privileges to a local Hospital that includes admissions to pediatric units. A pediatrician is not considered an age-appropriate choice for a Member age 21 and over. The PCP for a Member with disabilities, Special Health Care Needs, or Chronic or Complex Conditions may be a specialist physician who agrees to provide PCP services to the Member. The specialty physician must agree to perform all PCP duties required in the Contract, and PCP duties must be within the scope of the specialist's license. Any interested person may initiate the request through the MCO for a specialist to serve as a PCP for a Member with disabilities, Special Health Care Needs, or Chronic or Complex Conditions. The MCO must handle such requests in accordance with 28 T.A.C. Part 1, Chapter 11, Subchapter J. PCPs who provide Covered Services for STAR and CHIP newborns must either have admitting privileges at a Hospital that is part of the MCO's Provider Network, or make referral arrangements with a Provider who has admitting privileges to a Network Hospital. STAR+PLUS PCPs must either have admitting privileges at a Network Hospital, or make referral arrangements with a Provider who has admitting privileges to a Network Hospital. The MCO must require, through contract provisions, that PCPs are accessible to Members 24 hours a day, seven (7) days a week. The MCO is encouraged to enter into Network Provider agreements with sites that offer primary care services during evening and weekend hours. The following are acceptable and unacceptable telephone arrangements for contacting PCPs after their normal business hours.\n1. the office telephone is answered after-hours by an answering service that meets language requirements of the Major Population Groups and that can contact the PCP or another designated medical practitioner. All calls answered by an answering service must be returned within 30 minutes;\n2. the office telephone is answered after normal business hours by a recording in the language of each of the Major Population Groups served, directing the patient to call another number to reach the PCP or another provider designated by the PCP. Someone must be available to answer the designated provider's telephone. Another recording is not acceptable; and\n3. the office telephone is transferred after office hours to another location where someone will answer the telephone and be able to contact the PCP, or another designated medical provider, who can return the call within 30 minutes.\n1. the office telephone is only answered during office hours;\n2. the office telephone is answered after-hours by a recording that tells patients to leave a message;\n3. the office telephone is answered after-hours by a recording that directs patients to go to an Emergency Room for any services needed; and\n4. returning after-hours calls outside of 30 minutes. The CHIP MCOs must require PCPs, through contract provisions, to provide children birth through age 20 with preventive services in accordance with the AAP recommendations. Medicaid MCOs must require PCPs, through contract provisions, to provide children birth through age 20 with preventive services in accordance with the Texas Health Steps periodicity schedule. The MCO must require PCPs, through contract provisions, to provide adults with preventive services in accordance with the U.S. Preventive Services Task Force requirements. The MCO must make best efforts to ensure that PCPs follow these periodicity requirements for children and adult Members. Best efforts must include, but not be limited to, Provider education, Provider profiling, monitoring, and feedback activities. The MCO must require PCPs, through contract provisions, to assess the medical needs of Members for referral to specialty care providers and provide referrals as needed. PCPs must coordinate Members' care with specialty care providers after referral. The MCO must make best efforts to ensure that PCPs assess Member needs for referrals and make such referrals. Best efforts must include, but not be limited to, Provider education activities and review of Provider referral patterns.", "snippet_links": [{"key": "practice-areas", "type": "clause", "offset": [70, 84]}, {"key": "general-practice", "type": "clause", "offset": [86, 102]}, {"key": "family-practice", "type": "definition", "offset": [104, 119]}, {"key": "internal-medicine", "type": "clause", "offset": [121, 138]}, {"key": "advanced-practice", "type": "clause", "offset": [184, 201]}, {"key": "registered-nurses", "type": "clause", "offset": [202, 219]}, {"key": "physician-assistants", "type": "clause", "offset": [232, 252]}, {"key": "under-the-supervision-of", "type": "definition", "offset": [294, 318]}, {"key": "under-this-contract", "type": "clause", "offset": [447, 466]}, {"key": "federally-qualified-health-centers", "type": "clause", "offset": [469, 503]}, {"key": "rural-health-clinics", "type": "definition", "offset": [513, 533]}, {"key": "specialist-physicians", "type": "clause", 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5179]}, {"key": "task-force", "type": "clause", "offset": [5201, 5211]}, {"key": "best-efforts", "type": "clause", "offset": [5244, 5256]}, {"key": "to-ensure", "type": "clause", "offset": [5257, 5266]}, {"key": "requirements-for", "type": "clause", "offset": [5302, 5318]}, {"key": "adult-members", "type": "definition", "offset": [5332, 5345]}, {"key": "provider-education", "type": "clause", "offset": [5397, 5415]}, {"key": "provider-profiling", "type": "clause", "offset": [5417, 5435]}, {"key": "feedback-activities", "type": "clause", "offset": [5453, 5472]}, {"key": "medical-needs", "type": "clause", "offset": [5544, 5557]}, {"key": "of-members", "type": "clause", "offset": [5558, 5568]}, {"key": "specialty-care-providers", "type": "clause", "offset": [5585, 5609]}, {"key": "as-needed", "type": "clause", "offset": [5632, 5641]}, {"key": "education-activities", "type": "definition", "offset": [5893, 5913]}, {"key": "review-of", "type": "clause", "offset": [5918, 5927]}], "size": 12, "hash": "fd300bcc60e2c51be0866352233401f4", "id": 1}, {"samples": [{"hash": "jb0qhpmgmUx", "uri": "/contracts/jb0qhpmgmUx#primary-care-providers", "label": "Contract (Centene Corp)", "score": 24.5564681725, "published": true}, {"hash": "eR8GIwVMvxY", "uri": "/contracts/eR8GIwVMvxY#primary-care-providers", "label": "Contract (Centene Corp)", "score": 23.559890486, "published": true}, {"hash": "hzEF8q3C07Y", "uri": "/contracts/hzEF8q3C07Y#primary-care-providers", "label": "Contract (Centene Corp)", "score": 23.3107460643, "published": true}], "snippet": "The MCO\u2019s PCP Network may include Providers from any of the following practice areas: General Practice; Family Practice; Internal Medicine; Pediatrics; Obstetrics/Gynecology (OB/GYN); Advanced Practice Nurses (APNs) and Physician Assistants (PAs) (when APNs and PAs are practicing under the supervision of a physician specializing in Family Practice, Internal Medicine, Pediatrics or Obstetrics/Gynecology who also qualifies as a PCP under this contract); Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and similar community clinics; and specialist physicians who are willing to provide a Medical Home to selected Members with special needs and conditions. Section 533.005(a)(13) of the Texas Government Code requires the MCO to use APNs practicing under the supervision of a physician as PCPs in its Provider Network for STAR and STAR+PLUS. An internist or other Provider who provides primary care to adults only is not considered an age-appropriate PCP choice for a Member birth through age 20. An internist or other Provider who provides primary care to adults and children may be a PCP for children if:", "snippet_links": [{"key": "practice-areas", "type": "clause", "offset": [70, 84]}, {"key": "general-practice", "type": "clause", "offset": [86, 102]}, {"key": "family-practice", "type": "definition", "offset": [104, 119]}, {"key": "internal-medicine", "type": "clause", "offset": [121, 138]}, {"key": "advanced-practice-nurses", "type": "clause", "offset": [184, 208]}, {"key": "physician-assistants", "type": "clause", "offset": [220, 240]}, {"key": "under-the-supervision-of", "type": "definition", "offset": [281, 305]}, {"key": "under-this-contract", "type": "clause", "offset": [434, 453]}, {"key": "federally-qualified-health-centers", "type": "clause", "offset": [456, 490]}, {"key": "rural-health-clinics", "type": "definition", "offset": [500, 520]}, {"key": "specialist-physicians", "type": "clause", "offset": [564, 585]}, {"key": "provide-a", "type": "definition", "offset": [605, 614]}, {"key": "medical-home", "type": "clause", "offset": [615, 627]}, {"key": "special-needs", "type": "definition", "offset": [653, 666]}, {"key": "texas-government-code", "type": "clause", "offset": [713, 734]}, {"key": "provider-network", "type": "clause", "offset": [827, 843]}, {"key": "other-provider", "type": "definition", "offset": [884, 898]}, {"key": "primary-care", "type": "clause", "offset": [912, 924]}, {"key": "a-member", "type": "clause", "offset": [992, 1000]}, {"key": "for-children", "type": "clause", "offset": [1116, 1128]}], "size": 8, "hash": "bcb96770d96fece92b4d6ef86120b00e", "id": 2}, {"samples": [{"hash": "3oynYUUK7Ii", "uri": "/contracts/3oynYUUK7Ii#primary-care-providers", "label": "Contract Amendment (Centene Corp)", "score": 21.5667351129, "published": true}, {"hash": "KCi6MUU0IL", "uri": "/contracts/KCi6MUU0IL#primary-care-providers", "label": "Contract Amendment (Centene Corp)", "score": 21.3175906913, "published": true}, {"hash": "keYs9nb9a9x", "uri": "/contracts/keYs9nb9a9x#primary-care-providers", "label": "Contract Amendment (Centene Corp)", "score": 21.0, "published": true}], "snippet": "The HMO\u2019s PCP Network may include Providers from any of the following practice areas: General Practice; Family Practice; Internal Medicine; Pediatrics; Obstetrics/Gynecology (OB/GYN); Certified Nurse Midwives (CNM) and Physician Assistants (PAs) practicing under the supervision of a physician; Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and similar community clinics; and specialist physicians who are willing to provide a Medical Home to selected Members with special needs and conditions. Section 533.005(a)(13), Government Code, requires the HMO to use Advanced Practice Nurses practicing under the supervision of a physician as PCPs in its Provider Network for STAR and STAR+PLUS. CHIP Perinatal HMOs are not required to develop PCP Networks for CHIP Perinates. CHIP Perinatal HMOs may use the same PCP Network for CHIP Members and CHIP Perinatal Newborns. An internist or other Provider who provides primary care to adults only is not considered an age-appropriate PCP choice for a Member under age 21. An internist or other Provider who provides primary care to adults and children may be a PCP for children if:", "snippet_links": [{"key": "practice-areas", "type": "clause", "offset": [70, 84]}, {"key": "general-practice", "type": "clause", "offset": [86, 102]}, {"key": "family-practice", "type": "definition", "offset": [104, 119]}, {"key": "internal-medicine", "type": "clause", "offset": [121, 138]}, {"key": "certified-nurse", "type": "definition", "offset": [184, 199]}, {"key": "physician-assistants", "type": "clause", "offset": [219, 239]}, {"key": "under-the-supervision-of", "type": "definition", "offset": [257, 281]}, {"key": "federally-qualified-health-centers", "type": "clause", "offset": [295, 329]}, {"key": "rural-health-clinics", "type": "definition", "offset": [339, 359]}, {"key": "specialist-physicians", "type": "clause", "offset": [403, 424]}, {"key": "provide-a", "type": "definition", "offset": [444, 453]}, {"key": "medical-home", "type": "clause", "offset": [454, 466]}, {"key": "special-needs", "type": "definition", "offset": [492, 505]}, {"key": "government-code", "type": "definition", "offset": [546, 561]}, {"key": "advanced-practice-nurses", "type": "clause", "offset": [587, 611]}, {"key": "provider-network", "type": "clause", "offset": [675, 691]}, {"key": "chip-perinatal-hmos", "type": "clause", "offset": [716, 735]}, {"key": "not-required", "type": "definition", "offset": [740, 752]}, {"key": "to-develop", "type": "definition", "offset": [753, 763]}, {"key": "other-provider", "type": "definition", "offset": [908, 922]}, {"key": "primary-care", "type": "clause", "offset": [936, 948]}, {"key": "a-member", "type": "clause", "offset": [1016, 1024]}, {"key": "age-21", "type": "definition", "offset": [1031, 1037]}, {"key": "for-children", "type": "clause", "offset": [1132, 1144]}], "size": 7, "hash": "b06b0bbc247ef3b6ba0a2e94162904ce", "id": 3}, {"samples": [{"hash": "kmXTPIBDYid", "uri": "/contracts/kmXTPIBDYid#primary-care-providers", "label": "Contract for Services (Amerigroup Corp)", "score": 18.0, "published": true}, {"hash": "gHjw46ughRp", "uri": "/contracts/gHjw46ughRp#primary-care-providers", "label": "Amendment 14 to the Agreement for Health Services to the Medicaid Star Program (Centene Corp)", "score": 18.0, "published": true}, {"hash": "fzsLXsKpDzu", "uri": "/contracts/fzsLXsKpDzu#primary-care-providers", "label": "Amendment 14 to the Agreement for Health Services to the Medicaid Star Program (Centene Corp)", "score": 18.0, "published": true}], "snippet": "Section 7.8.1.1 is added and Sections 7.8.8 and 7.8.11.4 are modified with the following language:", "snippet_links": [{"key": "section-7811", "type": "clause", "offset": [0, 15]}], "size": 6, "hash": "3ada9b1ea3efc9aa2c9b009f49a163c8", "id": 4}, {"samples": [{"hash": "2PRwHQYIukO", "uri": "/contracts/2PRwHQYIukO#primary-care-providers", "label": "Contract for Services (Amerigroup Corp)", "score": 18.0, "published": true}], "snippet": "63 7.9 OB/GYN PROVIDERS .....................................................66 7.10", "snippet_links": [], "size": 5, "hash": "a6b04054296c8676fad1df627b28b23a", "id": 5}, {"samples": [{"hash": "lgWG0W8pvr2", "uri": "/contracts/lgWG0W8pvr2#primary-care-providers", "label": "Standard Contract (Wellcare Health Plans, Inc.)", "score": 21.0, "published": true}, {"hash": "jGwaj8Ti64h", "uri": "/contracts/jGwaj8Ti64h#primary-care-providers", "label": "Standard Contract (Wellcare Health Plans, Inc.)", "score": 21.0, "published": true}], "snippet": "1. The Health Plan shall enter into agreements with a sufficient number of PCPs to ensure adequate accessibility for Enrollees of all ages. The Health Plan shall select and approve its PCPs. The Health Plan shall ensure its approved PCPs agree to the following:\n(a) The PCP\u2019s agreement to accept the associated Case Management responsibilities.\n(b) The PCP\u2019s agreement to provide or arrange for coverage of services, consultation or approval for referrals twenty four (24) hours per day, seven days per week by Medicaid enrolled providers who will accept Medicaid reimbursement. This coverage must consist of an answering service, call forwarding, provider call coverage or other customary means approved by the Agency. The chosen method of twenty four (24) hour coverage must connect the caller to someone who can render a clinical decision or reach the PCP for a clinical decision. The after hours coverage must be accessible using the medical office\u2019s daytime telephone number. The PCP or covering medical professional must return the call within thirty (30) minutes of the initial contact.\n(c) The PCP\u2019s agreement to arrange for coverage of primary care services during absences due to vacation, illness or other situations which require the PCP to be unable to provide services. Coverage must be provided by a Medicaid enrolled PCP.\n2. The Health Plan shall provide the following:\na. At least one (1) FTE PCP per county including, but not limited to, the following specialties:\n(1) Family Practice;\n(2) General Practice;\n(3) Obstetrics or Gynecology;\n(4) Pediatrics; and", "snippet_links": [{"key": "health-plan", "type": "definition", "offset": [7, 18]}, {"key": "enter-into-agreements", "type": "clause", "offset": [25, 46]}, {"key": "number-of", "type": "clause", "offset": [65, 74]}, {"key": "to-ensure", "type": "clause", "offset": [80, 89]}, {"key": "agree-to", "type": "clause", "offset": [238, 246]}, {"key": "management-responsibilities", "type": "definition", "offset": [316, 343]}, {"key": "agreement-to-provide", "type": "clause", "offset": [359, 379]}, {"key": "arrange-for", "type": "clause", "offset": [383, 394]}, {"key": "coverage-of-services", "type": "clause", "offset": [395, 415]}, {"key": "hours-per-day", "type": "clause", "offset": [473, 486]}, {"key": "days-per-week", "type": "clause", "offset": [494, 507]}, {"key": "medicaid-reimbursement", "type": "definition", "offset": [555, 577]}, {"key": "this-coverage", "type": "definition", "offset": [579, 592]}, {"key": "consist-of", "type": "clause", "offset": [598, 608]}, {"key": "answering-service", "type": "definition", "offset": [612, 629]}, {"key": "call-forwarding", "type": "clause", "offset": [631, 646]}, {"key": "call-coverage", "type": "clause", "offset": [657, 670]}, {"key": "other-customary", "type": "clause", "offset": [674, 689]}, {"key": "by-the-agency", "type": "clause", "offset": [705, 718]}, {"key": "method-of", "type": "definition", "offset": [731, 740]}, {"key": "hour-coverage", "type": "clause", "offset": [758, 771]}, {"key": "coverage-must-be", "type": "clause", "offset": [900, 916]}, {"key": "medical-office", "type": "definition", "offset": [938, 952]}, {"key": "daytime-telephone-number", "type": "definition", "offset": [955, 979]}, {"key": "medical-professional", "type": "clause", "offset": [1001, 1021]}, {"key": "within-thirty", "type": "clause", "offset": [1043, 1056]}, {"key": "initial-contact", "type": "definition", "offset": [1077, 1092]}, {"key": "services-during", "type": "clause", "offset": [1158, 1173]}, {"key": "other-situations", "type": "clause", "offset": [1211, 1227]}, {"key": "require-the", "type": "clause", "offset": [1234, 1245]}, {"key": "to-provide-services", "type": "clause", "offset": [1263, 1282]}, {"key": "provide-the", "type": "clause", "offset": [1363, 1374]}, {"key": "not-limited", "type": "clause", "offset": [1440, 1451]}, {"key": "family-practice", "type": "definition", "offset": [1487, 1502]}, {"key": "general-practice", "type": "clause", "offset": [1508, 1524]}], "size": 4, "hash": "07ff95a65a36e8e97ea4416d0e506dc8", "id": 6}, {"samples": [{"hash": "5UxNCF0awhz", "uri": "/contracts/5UxNCF0awhz#primary-care-providers", "label": "Medicaid Network Participating Provider Contract", "score": 35.935598656, "published": true}, {"hash": "9ao9TioIm5O", "uri": "/contracts/9ao9TioIm5O#primary-care-providers", "label": "Medicaid Network Participating Provider Contract", "score": 27.2149212868, "published": true}], "snippet": "All In-Network Primary Care Providers must perform EPSDT (Early and Periodic Screening, Diagnostic and Treatment) screening for Alliance members less than twenty-one (21) years of age.", "snippet_links": [{"key": "early-and-periodic-screening", "type": "clause", "offset": [58, 86]}, {"key": "years-of-age", "type": "clause", "offset": [171, 183]}], "size": 3, "hash": "595559656a4b2de5f437307acc7e863b", "id": 7}, {"samples": [{"hash": "ecuKM7qPKz9", "uri": "/contracts/ecuKM7qPKz9#primary-care-providers", "label": "Health Plan Contract", "score": 19.5290896646, "published": true}, {"hash": "gj2IiZ3mfWK", "uri": "/contracts/gj2IiZ3mfWK#primary-care-providers", "label": "Health Plan Contract", "score": 19.3018480493, "published": true}], "snippet": "The Health Plan shall enter into agreements with a sufficient number of PCPs with demonstrated experience in the provision and management of medical and psycho-social health care for persons with HIV/AIDS, to ensure accessibility for enrollees of all ages. The Health Plan shall select and approve its PCPs. PCPs shall practice in one of the following areas: general practice, family practice, pediatrics, internal medicine, infectious disease, hematology, obstetrics, or gynecology. The Health Plan may consider and approve physicians in other areas of specialty as a PCP on a case-by-case basis. The Health Plan shall ensure its approved PCPs agree to the following:\na. The PCP\u2019s agreement to accept the associated case/care management responsibilities.", "snippet_links": [{"key": "health-plan", "type": "definition", "offset": [4, 15]}, {"key": "enter-into-agreements", "type": "clause", "offset": [22, 43]}, {"key": "number-of", "type": "clause", "offset": [62, 71]}, {"key": "demonstrated-experience", "type": "clause", "offset": [82, 105]}, {"key": "management-of", "type": "clause", "offset": [127, 140]}, {"key": "health-care", "type": "definition", "offset": [167, 178]}, {"key": "persons-with-hiv", "type": "clause", "offset": [183, 199]}, {"key": "to-ensure", "type": "clause", "offset": [206, 215]}, {"key": "general-practice", "type": "clause", "offset": [359, 375]}, {"key": "family-practice", "type": "definition", "offset": [377, 392]}, {"key": "internal-medicine", "type": "clause", "offset": [406, 423]}, {"key": "infectious-disease", "type": "definition", "offset": [425, 443]}, {"key": "other-areas", "type": "definition", "offset": [539, 550]}, {"key": "agree-to", "type": "clause", "offset": [645, 653]}, {"key": "agreement-to", "type": "definition", "offset": [682, 694]}, {"key": "management-responsibilities", "type": "definition", "offset": [727, 754]}], "size": 2, "hash": "9e92def3a095ddbe4cb47299633b5cb3", "id": 8}, {"samples": [{"hash": "4FJNnohiPic", "uri": "/contracts/4FJNnohiPic#primary-care-providers", "label": "Contract (Centene Corp)", "score": 25.553045859, "published": true}], "snippet": "The MCO\u2019s PCP Network may include Providers from any of the following practice areas: General Practice; Family Practice; Internal Medicine; Pediatrics; Obstetrics/Gynecology (OB/GYN); Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs) (when APRNs and PAs are practicing under the supervision of a physician specializing in Family Practice, Internal Medicine, Pediatrics or Obstetrics/Gynecology who also qualifies as a PCP under this contract); Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and similar community clinics; physicians serving Members residing in Nursing Facilities effective September 1, 2014;and specialist physicians who are willing to provide a Medical Home to selected Members with special needs and conditions. Texas Government Code Section 533.005(a)(13) and Texas Health and Safety Code Section 62.1551 require the MCO to use advance practice registered nurses (APRNs) and physician assistants (PAs) practicing under the supervision of a Network physician. The MCO must treat APRNs and PAs in the same manner as other Network PCPs with regard to: (1) selection and assignment as PCPs, (2) inclusion as PCPs in the MCO\u2019s Provider Network, and (3) inclusion as a PCP in any Provider Directory maintained by the MCO. An internist or other Provider who provides primary care to adults only is not considered an age-appropriate PCP choice for a Member birth through age 20. An internist or other Provider who provides primary care to adults and children may be a PCP for children if:", "snippet_links": [{"key": "practice-areas", "type": "clause", "offset": [70, 84]}, {"key": "general-practice", "type": "clause", "offset": [86, 102]}, {"key": "family-practice", "type": "definition", "offset": [104, 119]}, {"key": "internal-medicine", "type": "clause", "offset": [121, 138]}, {"key": "advanced-practice", "type": "clause", "offset": [184, 201]}, {"key": "registered-nurses", "type": "clause", "offset": [202, 219]}, {"key": "physician-assistants", "type": "clause", "offset": [232, 252]}, {"key": "under-the-supervision-of", "type": "definition", "offset": [294, 318]}, {"key": "under-this-contract", "type": "clause", "offset": [447, 466]}, {"key": "federally-qualified-health-centers", "type": "clause", "offset": [469, 503]}, {"key": "rural-health-clinics", "type": "definition", "offset": [513, 533]}, {"key": "nursing-facilities", "type": "definition", "offset": [612, 630]}, {"key": "effective-september", "type": "clause", "offset": [631, 650]}, {"key": "specialist-physicians", "type": "clause", "offset": [663, 684]}, {"key": "provide-a", "type": "definition", "offset": [704, 713]}, {"key": "medical-home", "type": "clause", "offset": [714, 726]}, {"key": "special-needs", "type": "definition", "offset": [752, 765]}, {"key": "code-section", "type": "definition", "offset": [799, 811]}, {"key": "health-and-safety-code", "type": "definition", "offset": [837, 859]}, {"key": "require-the", "type": "clause", "offset": [876, 887]}, {"key": "network-physician", "type": "definition", "offset": [1011, 1028]}, {"key": "mco-must", "type": "clause", "offset": [1034, 1042]}, {"key": "in-the-same-manner", "type": "definition", "offset": [1063, 1081]}, {"key": "other-network", "type": "definition", "offset": [1085, 1098]}, {"key": "with-regard-to", "type": "clause", "offset": [1104, 1118]}, {"key": "selection-and-assignment", "type": "clause", "offset": [1124, 1148]}, {"key": "provider-network", "type": "clause", "offset": [1193, 1209]}, {"key": "provider-directory", "type": "clause", "offset": [1245, 1263]}, {"key": "by-the-mco", "type": "clause", "offset": [1275, 1285]}, {"key": "other-provider", "type": "definition", "offset": [1303, 1317]}, {"key": "primary-care", "type": "clause", "offset": [1331, 1343]}, {"key": "a-member", "type": "clause", "offset": [1411, 1419]}, {"key": "for-children", "type": "clause", "offset": [1535, 1547]}], "size": 2, "hash": "1b22a1b8b1a81e2fa15509f9d732a844", "id": 9}, {"samples": [{"hash": "aRS8Kz897M2", "uri": "/contracts/aRS8Kz897M2#primary-care-providers", "label": "Regulatory Compliance Addendum", "score": 26.1704312115, "published": true}], "snippet": "Primary Care Providers are responsible, at a minimum for the following activities:", "snippet_links": [], "size": 1, "hash": "c2de46c8622d66860dddc7a232bc5479", "id": 10}], "next_curs": "Cl8SWWoVc35sYXdpbnNpZGVyY29udHJhY3RzcjsLEhZDbGF1c2VTbmlwcGV0R3JvdXBfdjU2Ih9wcmltYXJ5LWNhcmUtcHJvdmlkZXJzIzAwMDAwMDBhDKIBAmVuGAAgAA==", "clause": {"parents": [["provider-network", "Provider Network"], ["monitoring-access", "Monitoring Access"], ["contract-attachments", "Contract Attachments"], ["obligations-of-the-participating-provider", "OBLIGATIONS OF THE PARTICIPATING PROVIDER"], ["services", "Services"]], "children": [["", ""], ["internal-medicine", "Internal Medicine"], ["supervision", "Supervision"], ["mandatory-members", "Mandatory Members"], ["voluntary-ssi-members", "Voluntary SSI Members"]], "title": "Primary Care Providers", "size": 61, "id": "primary-care-providers", "related": [["outpatient-services", "Outpatient Services", "Outpatient Services"], ["covered-healthcare-services", "COVERED HEALTHCARE SERVICES", "COVERED HEALTHCARE SERVICES"], ["inpatient-services", "Inpatient Services", "Inpatient Services"], ["health-care-operations", "Health Care Operations", "Health Care Operations"], ["pharmacy-services", "Pharmacy Services", "Pharmacy Services"]], "related_snippets": [], "updated": "2025-07-07T12:37:50+00:00", "also_ask": [], "drafting_tip": null, "explanation": "The 'Primary Care Providers' clause defines the designation and responsibilities of healthcare professionals who serve as the main point of contact for a patient\u2019s medical care. This clause typically outlines the qualifications required for a provider to be considered a primary care provider, such as being a licensed physician, nurse practitioner, or physician assistant, and may specify the process for selecting or changing a provider within a healthcare plan. Its core function is to ensure that patients have a clearly identified healthcare professional responsible for coordinating their overall care, thereby promoting continuity, accountability, and effective management of health services."}, "json": true, "cursor": ""}}