Protective Custody. a. The Health Plan shall provide a physical screening within seventy-two (72) hours, or immediately if required, for all enrolled children/adolescents taken into protective custody, emergency shelter, or the ▇▇▇▇▇▇ care program by DCF. See 65C-29.008, FAC. b. The Health Plan shall provide these required examinations or if unable to do so within the required time frames, approve and process the out-of-network claim. c. For all CHCUP screenings for children/adolescents whose enrollment and Medicaid eligibility are undetermined at the time of entry into the care and custody of DCF, and who are later determined to be enrollees at the time the examinations took place, the Health Plan shall approve and process the claims. 19. Attachment II, Core Contract Provisions, Section V, Covered Services, Item H., Coverage Provisions, is hereby amended to include sub-item 21. as follows:
Appears in 2 contracts
Sources: Medicaid Hmo Non Reform Contract (Wellcare Health Plans, Inc.), Medicaid Hmo Non Reform Contract (Wellcare Health Plans, Inc.)