Common use of Referral Process Clause in Contracts

Referral Process. The Parties must work collaboratively to develop policies and procedures that ensure Members are referred to the appropriate LHD program. i. The Parties must facilitate referrals to the relevant LHD program for Members who may potentially meet the criteria of the LHD program and must ensure the LHD program has procedures for accepting referrals from MCP or responding to referrals where LHD programs cannot accept additional Members. Where applicable, such decisions should be made through a patient-centered, shared decision-making process. LHD should facilitate MCP referrals to LHD services or programs by assisting MCP in identifying the appropriate LHD program and/or should provide referral assistance when it is required. ii. MCP must refer Members to LHD for direct service programs as appropriate including, without limitation, those set forth in Section 13. iii. LHD should refer Members to MCP for any Community Supports services or additional care management programs for which they may qualify, such as Enhanced Care Management (“ECM”) or Complex Case Management (“CCM”). However, if LHD is an ECM Provider pursuant to a separate agreement between MCP and LHD for ECM services, this MOU does not govern LHD’s provision of ECM services. iv. LHD should refer Members to MCP for Covered Services.

Referral Process. The Parties must work collaboratively to develop policies and procedures that ensure Members are referred to the appropriate LHD program. i. The Parties must facilitate referrals to the relevant LHD program for Members who may potentially meet the criteria of the LHD program and program. The Parties must ensure the LHD program has procedures for accepting referrals from MCP MCPs or responding to referrals where LHD programs cannot accept additional Members. Where applicable, such decisions should be made through a patient-centered, shared decision-making process. LHD should facilitate MCP MCPs referrals to LHD services or programs by assisting MCP MCPs in identifying the appropriate LHD program and/or should provide referral assistance when it is required. ii. MCP MCPs must refer Members to LHD for direct service programs as appropriate including, without limitation, those set forth in Section 13. iii. LHD should refer Members to MCP MCPs for any Community Supports Support services or additional care management programs for which they may qualify, such as Enhanced Care Management (“ECM”) or Complex Case Management (“CCM”). However, if LHD is an ECM Provider pursuant to a separate agreement between MCP MCPs and LHD for ECM services, this MOU does not govern LHD’s provision of ECM services. iv. LHD should shall refer Members to MCP MCPs for Covered Services.

Referral Process. The Parties must work collaboratively to develop policies and procedures that ensure Members are referred to the appropriate LHD program. i. The Parties must facilitate referrals to the relevant LHD program for Members who may potentially meet the criteria of the LHD program and must ensure the LHD program has procedures for accepting referrals from MCP or responding to referrals where LHD programs cannot accept additional Members. Where applicable, such decisions should be made through a patient-centered, shared decision-making process. LHD should facilitate MCP referrals to LHD services or programs by assisting MCP in identifying the appropriate LHD program and/or should provide referral assistance when it is required. ii. MCP must refer Members to LHD for direct service programs as appropriate including, without limitation, those set forth in Section 13. iii. LHD should refer Members to MCP for any Community Supports services or additional care management programs for which they may qualify, such as Enhanced Care Management (“ECM”) or Complex Case Management (“CCM”). However, if LHD is an ECM Provider pursuant to a separate agreement between MCP and LHD for ECM services, this MOU does not govern LHD’s provision of ECM services. iv. LHD should refer Members to MCP for Covered Services.. DocuSign Envelope ID: F79290DD-ECCE-476E-A29A-E6F42D469B6D