State Licensure. Prior to the Contract effective date, and as verified in the readiness review described in Section 2.13, the Contractor must be an Indiana licensed accident or sickness insurer or an Indiana licensed health maintenance organization (HMO). The Contractor and all subcontractors shall use clinicians licensed by Indiana and follow all requirements contained within the Contract (e.g., PA/UM criteria; claims processing; encounter data submission; etc.), regardless of geographic location.
Appears in 11 contracts
Sources: Amendment to Contract, Contract for Providing Risk Based Managed Care Services, Contract #0000000000000000000051705
State Licensure. Prior to the Contract effective date, and as verified in the readiness review described in Section 2.13review, the Contractor must be an Indiana be:
1. An Indiana-licensed accident or sickness insurer or an Indiana insurer; or
2. An Indiana-licensed health maintenance organization (HMO). The Contractor and all subcontractors shall use clinicians licensed by Indiana and follow all requirements contained within the Contract (e.g., PA/UM criteria; claims processing; encounter data submission; etc.), regardless of geographic location.
Appears in 3 contracts
Sources: Professional Services, Professional Services, Professional Services