Service Package III. Service Package III includes Developmental Disability waiver services and ICF/DD services. The Department reserves the right to require Contractor to provide Service Package III services. The Department will provide contractor one-hundred eighty (180) days’ notice, in writing, before requiring the provision of these services.
Service Package III. Upon thirty (30) days’ notice from the Department, Contractor shall provide, or arrange for the provision of, Service Package III, which will include all services in Service Packages I and II, and the additional services described in Attachment III.
Service Package III. Service Package III includes Developmental Disability waiver services and ICF/DD services. The Department reserves the right to require Contractor to provide Service Package III services. The Department will provide contractor one-hundred eighty (180) days’ notice, in writing, before requiring the provision of these services. MLTSS. MLTSS Services include the Behavioral Health and non-emergency transportation services from Service Package I and the Nursing Facility and waiver services from Service Package II that are not covered by Medicare (see Attachment I). Medicare remains the primary payer of Medicare-covered services for MLTSS Enrollees. Crossover claims and other federally approved Medicaid services not covered by Medicare are not covered MLTSS Services and will be billed to Fee-for-Service. Personal Assistant services shall be considered MLTSS Services only if such services can be included in a manner consistent with any existing collective bargaining agreement, or pertinent side letter, between DCMS and SEIU Healthcare Illinois.Contractor must abide by the rules and policies provided in each HCBS Waiver. Institution for Mental Diseases in lieu of Covered Services. Contractor may provide psychiatric and substance use disorder inpatient services in an Institution for Mental Diseases (IMD) that are medically appropriate and cost effective in-lieu of the Covered Services under the State Plan to Enrollees between the ages of twenty-one and sixty-four (21–64) who have inpatient stays in an IMD of no more than fifteen (15) days in a calendar month. Contractor shall not require an Enrollee to use such in lieu of services. The Department represents that Capitation rates paid hereunder for IMD in lieu of services are actuarially sound and based on covered services under the State Plan. Eligibility and length of stay will be determined by IMD admissions status on the first day of every calendar month. Contractor shall obtain Prior Approval from the Department before offering any additional service or benefit to Enrollees not required under this Contract. Contractor shall provide thirty (30) days’ prior written notice to Enrollees and Prospective Enrollees before discontinuing an additional service or benefit. The notice must receive Prior Approval from the Department. Contractor shall implement any Behavioral Health service plan developed by DHS Contractors for an Enrollee who is a class member under the Xxxxxxxx consent decree, unless the Enrollee and the E...
