Provider Credentialing. The PIHP shall have written credentialing policies and procedures for ensuring that all providers rendering services to individuals are appropriately credentialed within the state and are qualified to perform their services. Credentialing shall take place every two years. The PIHP must ensure that network providers residing and providing services in bordering states meet all applicable licensing and certification requirements within their state. The PIHP also must have written policies and procedures for monitoring its providers and for sanctioning providers who are out of compliance with the PIHP's standards.
Appears in 6 contracts
Sources: Medicaid Managed Specialty Supports and Services Concurrent Waiver Program Agreement, Michigan Abw Non Pregnant Childless Adults Waiver (Adult Benefits Waiver) Section 1115 Demonstration, Medicaid Managed Specialty Supports and Services Concurrent Waiver Program Agreement