{"component": "clause", "props": {"groups": [{"snippet": "The Principal Recipient shall implement the Program as described in the \u201cProgram Implementation Description\u201d included as Annex A of this Agreement. The \u201cPerformance Framework(s)\u201d attached to Annex A of this Agreement set forth the main objectives of the Program, key indicators, intended results, targets and reporting periods of the Program. Unless otherwise indicated, the targets set forth in the Performance Framework(s) attached to Annex A of this Agreement are cumulative and do not include the baseline values.", "size": 5, "samples": [{"hash": "feQhkvFWmu0", "uri": "/contracts/feQhkvFWmu0#program-description-and-objectives", "label": "Funding Agreement", "score": 26.1704312115, "published": true}, {"hash": "ed2KhLuyfFS", "uri": "/contracts/ed2KhLuyfFS#program-description-and-objectives", "label": "Funding Agreement", "score": 22.5222450376, "published": true}, {"hash": "daFzgeChrRV", "uri": "/contracts/daFzgeChrRV#program-description-and-objectives", "label": "Funding Agreement", "score": 18.3374401095, "published": true}], "snippet_links": [{"key": "the-principal", "type": "definition", "offset": [0, 13]}, {"key": "recipient-shall", "type": "clause", "offset": [14, 29]}, {"key": "program-implementation", "type": "clause", "offset": [73, 95]}, {"key": "annex-a", "type": "definition", "offset": [121, 128]}, {"key": "this-agreement", "type": "clause", "offset": [132, 146]}, {"key": "objectives-of-the-program", "type": "clause", "offset": [236, 261]}, {"key": "intended-results", "type": "clause", "offset": [279, 295]}, {"key": "periods-of", "type": "clause", "offset": [319, 329]}, {"key": "unless-otherwise-indicated", "type": "clause", "offset": [343, 369]}, {"key": "the-targets", "type": "clause", "offset": [371, 382]}, {"key": "the-performance", "type": "clause", "offset": [396, 411]}], "hash": "8c5887dcb26b9ee007d76ae93f19b411", "id": 1}, {"snippet": "The state\u2019s goal in implementing the Partnership Plan section 1115(a) demonstration is to improve access to health services and outcomes for low-income New Yorkers by: \u2022 Improving access to health care for the Medicaid population; \u2022 Improving the quality of health services delivered; \u2022 Expanding access to family planning services; and \u2022 Expanding coverage with resources generated through managed care efficiencies to additional low-income New Yorkers. The demonstration is designed to use a managed care delivery system to deliver benefits to Medicaid recipients, create efficiencies in the Medicaid program, and enable the extension of coverage to certain individuals who would otherwise be without health insurance. It was approved in 1997 to enroll most Medicaid recipients into managed care organizations (MCOs) (Medicaid managed care program). As part of the demonstration\u2019s renewal in 2006, authority to require the disabled and aged populations to enroll in mandatory managed care was transferred to a new demonstration, the Federal-State Health Reform Partnership (F-SHRP). In 2001, the Family Health Plus (FHPlus) program was implemented as an amendment to the demonstration, providing comprehensive health coverage to low-income uninsured adults, with and without dependent children, who have income greater than Medicaid state plan eligibility standards. FHPlus was further amended in 2007 to implement an employer-sponsored health insurance (ESHI) component. Individuals eligible for FHPlus who have access to cost-effective ESHI are required to enroll in that coverage, with FHPlus providing any wrap-around services necessary to ensure that enrollees get all FHPlus benefits. FHPlus expires on December 31, 2013 and will become a state- only program. In 2002, the demonstration was expanded to incorporate a family planning benefit under which family planning and family planning-related services are provided to women losing Medicaid eligibility and to certain other adults of childbearing age (family planning expansion program). The family planning expansion program expires on December 31, 2013 and becomes a state plan benefit. In 2010, the Home and Community-Based Services Expansion Program (HCBS expansion program) was added to the demonstration. It provides cost-effective home and community-based services to certain adults with significant medical needs as an alternative to institutional care in a nursing facility. The benefits and program structure mirrors those of existing section 1915(c) waiver programs, and strives to provide quality services for individuals in the community, ensure the well-being and safety of the participants, and increase opportunities for self-advocacy and self-reliance. As part of the 2011 extension, the state is authorized to develop and implement two new initiatives designed to improve the quality of care rendered to Partnership Plan recipients. The first, the Hospital- Medical Home (H-MH) project, will provide funding and performance incentives to hospital teaching programs in order to improve the coordination, continuity, and quality of care for individuals receiving primary care in outpatient hospital settings. By the end of the demonstration extension period, the hospital teaching programs which receive grants under the H-MH project will have received certification by the National Committee for Quality Assurance as patient-centered medical homes and implemented additional improvements in patient safety and quality outcomes. The second initiative is intended to reduce the rate of preventable readmissions within the Medicaid population, with the related longer-term goal of developing reimbursement policies that provide incentives to help people stay out of the hospital. Under the Potentially Preventable Readmissions (PPR) project, the state will provide funding, on a competitive basis, to hospitals and/or collaborations of hospitals and other providers for the purpose of developing and implementing strategies to reduce the rate of PPRs for the Medicaid population. Projects will target readmissions related to both medical and behavioral health conditions. Finally, CMS will provide funding for the state\u2019s program to address clinic uncompensated care through its Indigent Care Pool. Prior to this extension period, the state has funded (with state dollars only) this program which provides formula-based grants to voluntary, non-profit, and publicly- sponsored Diagnostic and Treatment Centers (D&TCs) for services delivered to the uninsured throughout the state. In 2012, New York added to the demonstration an initiative to improve service delivery and coordination of long-term care services and supports for individuals through a managed care model. Under the Managed Long-Term Care (MLTC) program, eligible individuals in need of more than 120 days of community-based long-term care are enrolled with managed care providers to receive long- term services and supports as well as other ancillary services. Other covered services are available on a fee-for-service basis to the extent that New York has not exercised its option to include the individual in the Mainstream Medicaid Managed Care Program (MMMC). Enrollment in MLTC may be phased in geographically and by group. The state\u2019s goals specific to managed long-term care (MLTC) are as follows: \u2022 Expanding access to managed long term care for Medicaid enrollees who are in need of long term services and supports (LTSS); \u2022 Improving patient safety and quality of care for enrollees in MLTC plans; \u2022 Reduce preventable inpatient and nursing home admissions; and \u2022 Improve satisfaction, safety and quality of life. In April 2013 New York had three amendments approved. The first amendment was a continuation of the state\u2019s goal for transitioning more Medicaid beneficiaries into managed care. Under this amendment, the Long-Term Home Health Care Program (LTHHCP) participants are transitioned from New York\u2019s 1915(c) waiver into the 1115 demonstration and into managed care. Second, this amendment eliminates the exclusion from MMMC of, both \u2587\u2587\u2587\u2587\u2587\u2587 care children placed by local social service agencies and individuals participating in the Medicaid buy-in program for the working disabled. Additionally the April 2013 amendment approved expenditure authority for New York to claim FFP for expenditures made for certain designated state health programs beginning April 1, 2013 through March 31, 2014. During this period, the state is also required to submit several deliverables to demonstrate that the state is successful in its efforts to transform its health system for individuals with developmental disabilities. Finally, the December 2013 amendment was approved to ensure that it reflected changes to the demonstration that were necessary in order to conform the programs for Affordable Care Act (ACA) implementation beginning January 1, 2014.", "size": 5, "samples": [{"hash": "l69CxXw6290", "uri": "/contracts/l69CxXw6290#program-description-and-objectives", "label": "Special Terms and Conditions", "score": 23.0876112252, "published": true}], "snippet_links": [{"key": "partnership-plan", "type": "definition", "offset": [37, 53]}, {"key": "access-to-health-services", "type": "clause", "offset": [98, 123]}, {"key": "access-to-health-care", "type": "clause", "offset": [180, 201]}, {"key": "medicaid-population", "type": "clause", "offset": [210, 229]}, {"key": "family-planning-services", "type": "definition", "offset": [307, 331]}, {"key": "managed-care-delivery-system", "type": "clause", "offset": [494, 522]}, {"key": "medicaid-recipients", "type": "clause", "offset": [546, 565]}, {"key": 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"affordable-care-act", "type": "definition", "offset": [6830, 6849]}, {"key": "beginning-january", "type": "clause", "offset": [6871, 6888]}], "hash": "b3cd65214362133e8c503af46b22a44d", "id": 2}, {"snippet": "Minnesota\u2019s section 1115 PMAP+ demonstration was initially approved and implemented in July 1995. Minnesota was one of the early States to use health care reform waivers to cover uninsured populations. The PMAP+ demonstration provides health care services through a prepaid, capitated managed care delivery model that operates statewide for both MinnesotaCare Program eligibles and Medicaid State plan groups. The goal of Minnesota\u2019s health care reform effort is to provide organized and coordinated health care that includes pre-established provider networks and payment arrangements, administrative and clinical systems for utilization review, quality improvement, patient and provider services, and management of health services. The Demonstration affects coverage for certain specified mandatory State plan eligibles, and the Demonstration also expands coverage to those that would not traditionally qualify for Medicaid, such as higher income parents/caretaker adults.", "size": 4, "samples": [{"hash": "5jIpP8Twa69", "uri": "/contracts/5jIpP8Twa69#program-description-and-objectives", "label": "Special Terms and Conditions", "score": 25.322303409, "published": true}, {"hash": "jM8MAWAxP7r", "uri": "/contracts/jM8MAWAxP7r#program-description-and-objectives", "label": "Special Terms and Conditions", "score": 19.7460643395, "published": true}], "snippet_links": [{"key": "health-care-reform", "type": "definition", "offset": [143, 161]}, {"key": "health-care-services", "type": "definition", "offset": [235, 255]}, {"key": "care-delivery-model", "type": "clause", "offset": [293, 312]}, {"key": "medicaid-state-plan", "type": "definition", "offset": [382, 401]}, {"key": "to-provide", "type": "definition", "offset": [463, 473]}, {"key": "provider-networks", "type": "clause", "offset": [542, 559]}, {"key": "payment-arrangements", "type": "clause", "offset": [564, 584]}, {"key": "utilization-review", "type": "definition", "offset": [626, 644]}, {"key": "quality-improvement", "type": "definition", "offset": [646, 665]}, {"key": "provider-services", "type": "definition", "offset": [679, 696]}, {"key": "management-of", "type": "clause", "offset": [702, 715]}, {"key": "health-services", "type": "definition", "offset": [716, 731]}, {"key": "coverage-for", "type": "clause", "offset": [759, 771]}], "hash": "eedc6ef13c794b03be19752fbd711d5d", "id": 3}, {"snippet": "This section 1115(a) demonstration provides authority for the state to offer two distinct health care coverage benefit packages to specified populations. The Hoosier Healthwise (HHW) Program supplements state plan benefits for Medicaid eligible children and those otherwise eligible adults who are not aged, blind or disabled. The HIP provides health care coverage for uninsured adults not otherwise eligible for Medicaid through a high deductible managed care health plan and an account styled like a health savings account called a Personal Wellness and Responsibility (POWER) Account. Separate from this demonstration, Indiana offers the Indiana Select Program which includes case management services to supplement state plan benefits offered through Medicaid Select managed care programs for current Medicaid eligible adults who are aged, blind or disabled. Indiana began the Hoosier Healthwise program in 1994, when it initially mandated managed care enrollment for all section 1931 children and adults through a waiver granted by the Secretary under the authority of section 1915(b) of the Social Security Act (the Act). By July 1997, the program was implemented statewide using a combination of managed care organizations (MCOs) and a Primary Care Case Management (PCCM) delivery system. Effective December 2005, all Hoosier Healthwise enrollees are served exclusively by MCOs. Effective January 1, 2008, the authority for the Hoosier Healthwise program was provided solely through this demonstration. The HIP provides a high-deductible health plan and an account styled like a health savings account called a POWER Account to uninsured adults including low-income custodial parents and caretaker relatives of Medicaid and Children\u2019s Health Insurance program (CHIP) children and uninsured non-custodial parents and childless adults. Participation in HIP is voluntary, but all enrollees will be required to receive medical care through the high deductible health plans and POWER Accounts. Enrollees must also make specified contributions to their POWER Accounts as a condition of continued enrollment. These accounts will be used by enrollees to pay for the cost of health care services until the deductible is reached; however, preventive services up to a maximum amount will be exempt from this requirement. Once the deductible has been met, the health plan will provide coverage for medical services up to an annual maximum amount. Eligible individuals who have certain high-risk conditions will be enrolled in the Enhanced Services Plan (ESP), a separate care delivery mechanism managed by the Indiana Comprehensive Health Insurance Association (ICHIA), the state\u2019s high-risk pool. HIP offers the following coverage:\n1) A basic commercial benefits package once annual medical costs exceed $1,100;\n2) A Personal Wellness and Responsibility (POWER) Account valued at $1,100 per adult to pay for initial medical costs. The POWER Accounts provide incentives for participants to utilize services in a cost-efficient manner. HIP members make monthly contributions to their POWER Accounts depending on their income level; and\n3) $500 in \u201cfirst dollar\u201d preventive benefits at no cost to HIP members. Under this demonstration, Indiana expects to achieve the following to promote the objectives of title XIX: \uf0b7 Access: Ensure availability of necessary health services for Medicaid enrollees while offering health coverage to thousands of uninsured individuals; \uf0b7 Prevention: Encourage individuals to stay healthy and seek preventive care; \uf0b7 Personal Responsibility: Give individuals control of their health care decisions and incentivize positive health behaviors; \uf0b7 Cost Transparency: Make individuals aware of the cost of health care services; and \uf0b7 Quality: Encourage provision of quality medical services to all enrollees. Encourage quality, continuity, and appropriate medical care. The following populations will participate in the Hoosier Healthwise (HHW) component of the demonstration. The three populations derive their eligibility through the Medicaid state plan.", "size": 4, "samples": [{"hash": "edCzP3Py3Y3", "uri": "/contracts/edCzP3Py3Y3#program-description-and-objectives", "label": "Special Terms and Conditions", "score": 21.3195660415, "published": true}, {"hash": "6gppX9udTZ1", "uri": "/contracts/6gppX9udTZ1#program-description-and-objectives", "label": "Special Terms and Conditions", "score": 20.038478014, "published": true}], "snippet_links": [{"key": "for-the-state", "type": "definition", "offset": [54, 67]}, {"key": "to-offer", "type": "definition", "offset": [68, 76]}, {"key": "health-care-coverage", "type": "clause", "offset": [90, 110]}, {"key": "benefit-packages", "type": "clause", "offset": [111, 127]}, {"key": "benefits-for", "type": "clause", "offset": [214, 226]}, {"key": "eligible-children", "type": "definition", "offset": [236, 253]}, {"key": "otherwise-eligible", "type": "definition", "offset": [264, 282]}, {"key": "coverage-for", "type": 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"definition", "offset": [2681, 2690]}, {"key": "benefits-package", "type": "definition", "offset": [2749, 2765]}, {"key": "medical-costs", "type": "definition", "offset": [2778, 2791]}, {"key": "monthly-contributions", "type": "clause", "offset": [3046, 3067]}, {"key": "first-dollar", "type": "definition", "offset": [3141, 3153]}, {"key": "preventive-benefits", "type": "definition", "offset": [3155, 3174]}, {"key": "at-no-cost", "type": "definition", "offset": [3175, 3185]}, {"key": "the-objectives", "type": "clause", "offset": [3280, 3294]}, {"key": "title-xix", "type": "definition", "offset": [3298, 3307]}, {"key": "availability-of", "type": "clause", "offset": [3326, 3341]}, {"key": "services-for", "type": "clause", "offset": [3359, 3371]}, {"key": "health-coverage", "type": "definition", "offset": [3406, 3421]}, {"key": "preventive-care", "type": "clause", "offset": [3522, 3537]}, {"key": "personal-responsibility", "type": "definition", "offset": [3541, 3564]}, {"key": "control-of", "type": "definition", "offset": [3583, 3593]}, {"key": "cost-transparency", "type": "clause", "offset": [3667, 3684]}, {"key": "provision-of", "type": "clause", "offset": [3771, 3783]}, {"key": "participate-in", "type": "definition", "offset": [3919, 3933]}, {"key": "medicaid-state-plan", "type": "definition", "offset": [4054, 4073]}], "hash": "7c2eedcff154b3887c427f3857fce632", "id": 4}, {"snippet": "The State\u201fs goal in implementing the Partnership Plan section 1115(a) Demonstration is to improve access to health services and outcomes for low-income New Yorkers by: \u2022 improving access to health care for the Medicaid population; \u2022 improving the quality of health services delivered; \u2022 expanding access to family planning services; and \u2022 expanding coverage to additional low-income New Yorkers with resources generated through managed care efficiencies. The demonstration is designed to use a managed care delivery system to deliver benefits to Medicaid recipients, create efficiencies in the Medicaid program and enable the extension of coverage to certain individuals who would otherwise be without health insurance. It was approved in 1997 to enroll most Medicaid recipients into managed care organizations (Medicaid managed care program). As part of the Demonstration\u201fs renewal in 2006, authority to require the disabled and aged populations to enroll in mandatory managed care was transferred to a new demonstration, the Federal-State Health Reform Partnership (F-SHRP). In 2001, the Family Health Plus (FHPlus) program was implemented as an amendment to the Demonstration, providing comprehensive health coverage to low-income uninsured adults, with and without dependent children, who have income greater than Medicaid State plan eligibility standards. FHPlus was further amended in 2007 to implement an employer-sponsored health insurance (ESHI) component. Individuals eligible for FHPlus who have access to cost-effective ESHI are required to enroll in that coverage, with FHPlus providing any wrap-around services necessary to ensure that enrollees get all FHPlus benefits. During this extension period, the State will expand Family Health Plus eligibility for low-income adults with children. In 2002, the Demonstration was expanded to incorporate a family planning benefit under which family planning and family planning-related services are provided to women losing Medicaid eligibility and certain other adults of childbearing age (family planning expansion program). In 2010, the Home and Community-Based Services Expansion Program (HCBS expansion program) was added to the Demonstration. It provides cost-effective home and community-based services to certain adults with significant medical needs as an alternative to institutional care in a nursing facility. The benefits and program structure mirrors those of existing 1915(c) waiver programs, and strives to provide quality services for individuals in the community, ensure the well-being and safety of the participants and to increase opportunities for self-advocacy and self-reliance. As part of this extension, the State is authorized to develop and implement two new initiatives designed to improve the quality of care rendered to Partnership Plan recipients. The first, the Hospital- Medical Home (H-MH) project, will provide funding and performance incentives to hospital teaching programs in order to improve the coordination, continuity, and quality of care for individuals receiving primary care in outpatient hospital settings. By the end of the demonstration extension period, the hospital teaching programs which receive grants under the H-MH project will have received certification by the National Committee for Quality Assurance as a patient-centered medical home and implemented additional improvements in patient safety and quality outcomes. The second initiative is intended to reduce the rate of preventable readmissions within the Medicaid population, with the related longer-term goal of developing reimbursement policies that provide incentives to help people stay out of the hospital. Under the Potentially Preventable Readmissions (PPR) project, the State will provide funding, on a competitive basis, to hospitals and/or collaborations of hospitals and other providers for the purpose of developing and implementing strategies to reduce the rate of PPRs for the Medicaid population. Projects will target readmissions related to both medical and behavioral health conditions. Finally, CMS will provide funding for the State\u201fs program to address clinic uncompensated care through its Indigent Care Pool. Prior to this extension period, the State has funded (with State dollars only) this program which provides formula-based grants to voluntary, non-profit and publicly- sponsored Diagnostic and Treatment Centers (D&TCs) for services delivered to the uninsured throughout the State.", "size": 4, "samples": [{"hash": "lxtNvuFTu4o", "uri": "/contracts/lxtNvuFTu4o#program-description-and-objectives", "label": "Special Terms and Conditions", "score": 21.0, "published": true}], "snippet_links": [{"key": "the-state", "type": "clause", "offset": [0, 9]}, {"key": "partnership-plan", "type": "definition", "offset": [37, 53]}, {"key": "services-and", "type": "clause", "offset": [115, 127]}, {"key": "access-to-health-care", "type": "clause", "offset": [180, 201]}, {"key": "medicaid-population", "type": "clause", "offset": [210, 229]}, {"key": "family-planning-services", "type": "definition", "offset": [307, 331]}, {"key": "managed-care-delivery-system", "type": "clause", "offset": [494, 522]}, 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"performance-incentives", "type": "definition", "offset": [2914, 2936]}, {"key": "teaching-programs", "type": "clause", "offset": [2949, 2966]}, {"key": "in-order-to", "type": "clause", "offset": [2967, 2978]}, {"key": "primary-care", "type": "clause", "offset": [3063, 3075]}, {"key": "outpatient-hospital", "type": "definition", "offset": [3079, 3098]}, {"key": "certification-by", "type": "clause", "offset": [3253, 3269]}, {"key": "national-committee-for-quality-assurance", "type": "definition", "offset": [3274, 3314]}, {"key": "additional-improvements", "type": "definition", "offset": [3366, 3389]}, {"key": "safety-and-quality", "type": "clause", "offset": [3401, 3419]}, {"key": "rate-of", "type": "clause", "offset": [3478, 3485]}, {"key": "reimbursement-policies", "type": "definition", "offset": [3591, 3613]}, {"key": "competitive-basis", "type": "definition", "offset": [3778, 3795]}, {"key": "other-providers", "type": "clause", "offset": [3849, 3864]}, {"key": "for-the-purpose-of", "type": "definition", "offset": [3865, 3883]}, {"key": "related-to", "type": "clause", "offset": [4013, 4023]}, {"key": "health-conditions", "type": "clause", "offset": [4052, 4069]}, {"key": "uncompensated-care", "type": "definition", "offset": [4147, 4165]}, {"key": "indigent-care-pool", "type": "definition", "offset": [4178, 4196]}, {"key": "prior-to", "type": "definition", "offset": [4198, 4206]}, {"key": "with-state", "type": "clause", "offset": [4252, 4262]}, {"key": "for-services", "type": "clause", "offset": [4416, 4428]}], "hash": "2dd6c663abcceb392b95c952a6dd2824", "id": 5}, {"snippet": "The IowaCare Demonstration was originally approved and began implementation on July 1, 2005. Under this renewal, the State will continue to provide health care services to the Expansion Population and Spend-down Pregnant Women populations. During the renewal period, children with serious emotional disorders will be served under a 1915(c) home and community-based services waiver. Under this Demonstration extension, Iowa expects to achieve the following to promote the objectives of title XIX: Deleted: Attachment B \u00b6 IowaCare Special Terms and Conditions\u00b6 Medical Home Requirements\u00b6", "size": 3, "samples": [{"hash": "68Aibi0f6pL", "uri": "/contracts/68Aibi0f6pL#program-description-and-objectives", "label": "Special Terms and Conditions", "score": 29.3390373502, "published": true}], "snippet_links": [{"key": "the-state", "type": "clause", "offset": [113, 122]}, {"key": "continue-to-provide", "type": "clause", "offset": [128, 147]}, {"key": "services-to-the", "type": "clause", "offset": [160, 175]}, {"key": "expansion-population", "type": "definition", "offset": [176, 196]}, {"key": "pregnant-women", "type": "definition", "offset": [212, 226]}, {"key": "the-renewal-period", "type": "definition", "offset": [247, 265]}, {"key": "serious-emotional", "type": "definition", "offset": [281, 298]}, {"key": "home-and-community", "type": "clause", "offset": [340, 358]}, {"key": "the-objectives", "type": "clause", "offset": [467, 481]}, {"key": "title-xix", "type": "definition", "offset": [485, 494]}, {"key": "attachment-b", "type": "definition", "offset": [505, 517]}, {"key": "terms-and", "type": "clause", "offset": [537, 546]}, {"key": "medical-home", "type": "clause", "offset": [559, 571]}], "hash": "53f8aba5c148f57b42515165700673cb", "id": 6}, {"snippet": "The Georgia P4HB section 1115(a) Medicaid Demonstration expands the provision of family planning (FP) services to uninsured women, ages 18 through 44, who have family income at or below 200 percent of the Federal poverty level (FPL), and who are not otherwise eligible for Medicaid or the Children\u2019s Health Insurance Program (CHIP). In addition, the Demonstration provides Interpregnancy Care (IPC) services to women who meet the same eligibility requirements above and who deliver a very low birth weight (VLBW) baby (less than 1,500 grams or 3 pounds, 5 ounces) on or after January 1, 2011. Contract #0654 Women, ages 18 through 44, who have family income at or below 200 percent of the FPL, who deliver a VLBW baby on or after January 1, 2011, and who qualify under the Low Income Medicaid Class of Assistance, or the Aged Blind and Disabled Classes of Assistance, under the Georgia Medicaid State plan are also eligible for the Resource Mothers Outreach component of the IPC services which are not otherwise available under the Georgia Medicaid State plan. Under this Demonstration, Georgia expects to achieve the following to promote the objectives of title XIX: \u00b7 Reduce Georgia\u2019s low birth weight (LBW) and VLBW rates; \u00b7 Reduce the number of unintended pregnancies in Georgia; \u00b7 Reduce Georgia\u2019s Medicaid costs by reducing the number of unintended pregnancies by women who otherwise would be eligible for Medicaid pregnancy-related services; \u00b7 Provide access to IPC health services for eligible women who have previously delivered a VLBW baby; and \u00b7 Increase child spacing intervals through effective contraceptive use.", "size": 3, "samples": [{"hash": "hH6wSTIEvu4", "uri": "/contracts/hH6wSTIEvu4#program-description-and-objectives", "label": "Contract No. 0654 (Wellcare Health Plans, Inc.)", "score": 22.3524982888, "published": true}], "snippet_links": [{"key": "provision-of", "type": "clause", "offset": [68, 80]}, {"key": "family-planning", "type": "definition", "offset": [81, 96]}, {"key": "family-income", "type": "definition", "offset": [160, 173]}, {"key": "federal-poverty-level", "type": "definition", "offset": [205, 226]}, {"key": "otherwise-eligible", "type": "definition", "offset": [250, 268]}, {"key": "the-children", "type": "clause", "offset": [285, 297]}, {"key": "health-insurance-program", "type": "clause", "offset": [300, 324]}, {"key": "in-addition", "type": "clause", "offset": [333, 344]}, {"key": "eligibility-requirements", "type": "clause", "offset": [435, 459]}, {"key": "very-low", "type": "clause", "offset": [484, 492]}, {"key": "after-january", "type": "clause", "offset": [570, 583]}, {"key": "class-of", "type": "definition", "offset": [793, 801]}, {"key": "medicaid-state-plan", "type": "definition", "offset": [886, 905]}, {"key": "resource-mothers-outreach", "type": "clause", "offset": [932, 957]}, {"key": "available-under", "type": "clause", "offset": [1012, 1027]}, {"key": "the-objectives", "type": "clause", "offset": [1139, 1153]}, {"key": "title-xix", "type": "definition", "offset": [1157, 1166]}, {"key": "number-of", "type": "clause", "offset": [1239, 1248]}, {"key": "in-georgia", "type": "clause", "offset": [1272, 1282]}, {"key": "related-services", "type": "definition", "offset": [1431, 1447]}, {"key": "access-to", "type": "definition", "offset": [1459, 1468]}, {"key": "services-for", "type": "clause", "offset": [1480, 1492]}, {"key": "child-spacing", "type": "clause", "offset": [1566, 1579]}], "hash": "eaac1cf1a4bb5ae17f312fe7755f8cd9", "id": 7}, {"snippet": "This demonstration had its origins in an earlier demonstration, the Partnership Plan that sought to improve the economy, efficiency, and quality of care by requiring families and children to enroll in managed care entities to receive services. This mandatory managed care is known as Mandatory Mainstream Managed Care (MMMC). The Partnership Plan demonstration is ongoing, but MMMC enrollees in 14 counties are now included instead in this demonstration. New York also has authority under this demonstration to expand MMMC to elderly and disabled populations. In 2004, the state was presented with significant reform opportunities including the aging of New York\u2019s population, the continued shift in care from institutional to outpatient settings, and the quality and efficiency advantages that are available through health information technology. The state created the Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) capital grant program in that year to invest an anticipated $1 billion over a four-year period, to effectively reform and reconfigure New York\u2019s health care delivery system to achieve improvements in patient care and increased efficiency of operation. In 2005, the state asked the federal government to partner with its HEAL NY initiative to implement reform projects that would improve the quality of care and result in long-term savings for both the state and federal government. This demonstration was approved for an initial 5-year period beginning October 1, 2006; under that demonstration authority, the state committed to pursue the following reform initiatives: \u2022 Rightsizing Acute Care Infrastructure. New York\u2019s acute care infrastructure is outdated and oversized, while the facilities are highly leveraged with debt. The inexorable migration of health care services to the outpatient setting has added to the significant excess capacity that exists in the state, estimated at over 19,000 beds. As a result, state law was enacted in 2005 establishing the Commission on Health Care Facilities in the 21st Century (Commission) which is charged with recommending reconfiguration measures, including downsizing, restructuring, and/or facility closures. Such measures will reduce future Medicaid inpatient hospital costs.", "size": 3, "samples": [{"hash": "8irNUHYfZk0", "uri": "/contracts/8irNUHYfZk0#program-description-and-objectives", "label": "Special Terms and Conditions", "score": 23.0876112252, "published": true}], "snippet_links": [{"key": "partnership-plan", "type": "definition", "offset": [68, 84]}, {"key": "quality-of-care", "type": "definition", "offset": [137, 152]}, {"key": "families-and-children", "type": "clause", "offset": [166, 187]}, {"key": "managed-care", "type": "clause", "offset": [201, 213]}, {"key": "to-receive", "type": "definition", "offset": [223, 233]}, {"key": "elderly-and-disabled", "type": "clause", "offset": [526, 546]}, {"key": "of-new-york", "type": "definition", "offset": [651, 662]}, {"key": "in-care", "type": "definition", "offset": [697, 704]}, {"key": "health-information-technology", "type": "definition", "offset": [817, 846]}, {"key": "grant-program", "type": "clause", "offset": [949, 962]}, {"key": "to-invest", "type": "clause", "offset": [976, 985]}, {"key": "year-period", "type": "definition", "offset": [1024, 1035]}, {"key": "health-care-delivery-system", "type": "definition", "offset": [1086, 1113]}, {"key": "in-patient-care", "type": "definition", "offset": [1138, 1153]}, {"key": "efficiency-of-operation", "type": "clause", "offset": [1168, 1191]}, {"key": "the-federal-government", "type": "clause", "offset": [1218, 1240]}, {"key": "state-and-federal", "type": "definition", "offset": [1393, 1410]}, {"key": "period-beginning", "type": "definition", "offset": [1477, 1493]}, {"key": "october-1", "type": "definition", "offset": [1494, 1503]}, {"key": "demonstration-authority", "type": "clause", "offset": [1522, 1545]}, {"key": "acute-care", "type": "clause", "offset": [1625, 1635]}, {"key": "the-facilities", "type": "clause", "offset": [1722, 1736]}, {"key": "services-to-the", "type": "clause", "offset": [1809, 1824]}, {"key": "outpatient-setting", "type": "definition", "offset": [1825, 1843]}, {"key": "excess-capacity", "type": "definition", "offset": [1873, 1888]}, {"key": "in-the-state", "type": "definition", "offset": [1901, 1913]}, {"key": "state-law", "type": "clause", "offset": [1959, 1968]}, {"key": "the-commission", "type": "clause", "offset": [2002, 2016]}, {"key": "health-care-facilities", "type": "clause", "offset": [2020, 2042]}, {"key": "facility-closures", "type": "clause", "offset": [2181, 2198]}, {"key": "hospital-costs", "type": "clause", "offset": [2252, 2266]}], "hash": "3ad22a9cf92e5cc532f3fc167e2e3dc6", "id": 8}, {"snippet": "The DSHP section 1115(a) demonstration is designed to use a managed care delivery system to create efficiencies in the Medicaid program and enable the extension of coverage to certain individuals who would otherwise be without health insurance. The initial demonstration was approved in 1995 to mandatorily enroll most Medicaid recipients into managed care organizations (MCOs) beginning January 1, 1996. Using savings achieved under managed care, Delaware expanded Medicaid health coverage to uninsured Delawareans with incomes up to 100 percent of the federal poverty level (FPL) and provides family planning coverage to women losing Medicaid pregnancy coverage at the end of 60 days postpartum or losing DSHP comprehensive benefits and have a family income at or below 200 percent of the FPL. The demonstration was previously renewed on June 29, 2000, December 12, 2003, December 21, 2006, and January 31, 2011. Through an amendment approved by CMS in 2012, the state was authorized to expand the demonstration to create the Diamond State Health Plan Plus (DSHP-Plus) to mandate care through MCOs for additional state plan populations, including (1) individuals receiving care at nursing facilities (NF) other than intermediate care facilities for the mentally retarded (ICF/MR);", "size": 2, "samples": [{"hash": "dy8WdejPXjv", "uri": "/contracts/dy8WdejPXjv#program-description-and-objectives", "label": "Special Terms and Conditions", "score": 23.3195660415, "published": true}, {"hash": "hQXdiyaLqqT", "uri": "/contracts/hQXdiyaLqqT#program-description-and-objectives", "label": "Special Terms and Conditions", "score": 22.9835728953, "published": true}], "snippet_links": [{"key": "managed-care-delivery-system", "type": "clause", "offset": [60, 88]}, {"key": "medicaid-program", "type": "clause", "offset": [119, 135]}, {"key": "extension-of-coverage", "type": "clause", "offset": [151, 172]}, {"key": "health-insurance", "type": "clause", "offset": [227, 243]}, {"key": "medicaid-recipients", "type": "clause", "offset": [319, 338]}, {"key": "managed-care-organizations", "type": "clause", "offset": [344, 370]}, {"key": "beginning-january", "type": "clause", "offset": [378, 395]}, {"key": "medicaid-health-coverage", "type": "definition", "offset": [466, 490]}, {"key": "federal-poverty-level", "type": "definition", "offset": [554, 575]}, {"key": "family-planning", "type": "definition", "offset": [595, 610]}, {"key": "at-the-end-of", "type": "clause", "offset": [664, 677]}, {"key": "comprehensive-benefits", "type": "definition", "offset": [712, 734]}, {"key": "family-income", "type": "definition", "offset": [746, 759]}, {"key": "approved-by", "type": "definition", "offset": [936, 947]}, {"key": "the-state", "type": "clause", "offset": [961, 970]}, {"key": "state-health-plan", "type": "definition", "offset": [1036, 1053]}, {"key": "state-plan", "type": "definition", "offset": [1115, 1125]}, {"key": "nursing-facilities", "type": "definition", "offset": [1183, 1201]}, {"key": "intermediate-care", "type": "definition", "offset": [1218, 1235]}, {"key": "mentally-retarded", "type": "definition", "offset": [1255, 1272]}], "hash": "54566a9610a3184c1be87e280468802a", "id": 9}, {"snippet": "In this extension of the demonstration, the Commonwealth and CMS have agreed to implement major new demonstration components to support a value-based restructuring of MassHealth\u2019s health care delivery and payment system, including a new Accountable Care Organization (ACO) initiative and Delivery System Reform Incentive Program (DSRIP) to transition the Massachusetts delivery system into accountable care models. The Safety Net Care Pool (SNCP) has been redesigned to align SNCP funding with MassHealth\u2019s broader accountable care strategies and expectations and to establish a more sustainable structure for necessary and ongoing funding support to safety net providers. During the new extension period approved for state fiscal year (SFY) 2018-2022, the goals of the demonstration are:\n(1) Enact payment and delivery system reforms that promote integrated, coordinated care; and hold providers accountable for the quality and total cost of care;\n(2) Improve integration of physical, behavioral and long term services;\n(3) Maintain near-universal coverage;\n(4) Sustainably support safety net providers to ensure continued access to care for Medicaid and low- income uninsured individuals; and\n(5) Address the opioid addiction crisis by expanding access to a broad spectrum of recovery-oriented substance use disorder services; and,\n(6) Increase and strengthen overall coverage of former \u2587\u2587\u2587\u2587\u2587\u2587 care youth and improve health outcomes for this population.", "size": 2, "samples": [{"hash": "17kDAdyoEYD", "uri": "/contracts/17kDAdyoEYD#program-description-and-objectives", "label": "Special Terms & Conditions", "score": 25.2422997947, "published": true}, {"hash": "9AEQgS2X3pJ", "uri": "/contracts/9AEQgS2X3pJ#program-description-and-objectives", "label": "Special Terms & Conditions", "score": 23.5174537988, "published": true}], "snippet_links": [{"key": "extension-of-the-demonstration", "type": "clause", "offset": [8, 38]}, {"key": "the-commonwealth", "type": "clause", "offset": [40, 56]}, {"key": "agreed-to", "type": "clause", "offset": [70, 79]}, {"key": "payment-system", "type": "clause", "offset": [205, 219]}, {"key": "accountable-care-organization", "type": "definition", "offset": [237, 266]}, {"key": "delivery-system", "type": "clause", "offset": [288, 303]}, {"key": "incentive-program", "type": "definition", "offset": [311, 328]}, {"key": "safety-net-care-pool", "type": "definition", "offset": [419, 439]}, {"key": "to-establish", "type": "clause", "offset": [564, 576]}, {"key": "funding-support", "type": "clause", "offset": [632, 647]}, {"key": "safety-net-providers", "type": "clause", "offset": [651, 671]}, {"key": "extension-period", "type": "definition", "offset": [688, 704]}, {"key": "state-fiscal-year", "type": "clause", "offset": [718, 735]}, {"key": "payment-and-delivery", "type": "clause", "offset": [799, 819]}, {"key": "coordinated-care", "type": "definition", "offset": [860, 876]}, {"key": "total-cost-of-care", "type": "definition", "offset": [929, 947]}, {"key": "long-term-services", "type": "clause", "offset": [1001, 1019]}, {"key": "to-ensure", "type": "clause", "offset": [1104, 1113]}, {"key": "continued-access-to-care", "type": "definition", "offset": [1114, 1138]}, {"key": "opioid-addiction", "type": "definition", "offset": [1211, 1227]}, {"key": "broad-spectrum", "type": "definition", "offset": [1260, 1274]}, {"key": "substance-use-disorder-services", "type": "definition", "offset": [1296, 1327]}, {"key": "coverage-of", "type": "clause", "offset": [1370, 1381]}, {"key": "health-outcomes", "type": "definition", "offset": [1419, 1434]}], "hash": "11ace436cb8939efc381092f1b504182", "id": 10}], "next_curs": "CmsSZWoVc35sYXdpbnNpZGVyY29udHJhY3RzckcLEhZDbGF1c2VTbmlwcGV0R3JvdXBfdjU2Iitwcm9ncmFtLWRlc2NyaXB0aW9uLWFuZC1vYmplY3RpdmVzIzAwMDAwMDBhDKIBAmVuGAAgAA==", "clause": {"title": "PROGRAM DESCRIPTION AND OBJECTIVES", "parents": [["of-the-program", "Of the Program"], ["budget-neutrality-aggregate-cap", "Budget Neutrality Aggregate Cap"], ["implementation-of-the-program", "Implementation of the Program"]], "children": [["", ""], ["cms-right-to-terminate-or-suspend", "CMS Right to Terminate or Suspend"], ["extension-of-the-demonstration", "Extension of the Demonstration"], ["adequacy-of-infrastructure", "Adequacy of Infrastructure"], ["demonstration-phase-out", "Demonstration Phase-Out"]], "size": 59, "id": "program-description-and-objectives", "related": [["scope-and-objectives", "Scope and Objectives", "Scope and Objectives"], ["purpose-and-objectives", "Purpose and Objectives", "Purpose and Objectives"], ["background-and-objectives", "BACKGROUND AND OBJECTIVES", "BACKGROUND AND OBJECTIVES"], ["aims-and-objectives", "Aims and Objectives", "Aims and Objectives"], ["program-objectives", "Program Objectives", "Program Objectives"]], "related_snippets": [], "updated": "2025-07-07T12:37:48+00:00"}, "json": true, "cursor": ""}}