Common use of Time and Distance Standards Clause in Contracts

Time and Distance Standards. (A) The Contractor shall maintain provider network adequacy time and distance standards to ensure Enrollee access as described in Table 2 for adult and pediatric Covered Services. The standards vary for urban, rural and frontier counties of the State. Table 1 includes the designation of each county as urban, rural, or frontier. The Contractor shall apply the standards in Table 2 according to each of its covered county’s designation in Table 1. The Contractor shall apply the standards as applicable to adult mental health providers, adult substance use disorder providers, pediatric mental health providers and pediatric substance use disorder providers. Table 1 - County Designation Urban Counties Rural Counties Frontier Counties Xxxxx Cache Beaver Salt Lake Carbon Box Elder Utah Iron Xxxxxxx Xxxxx Xxxxxx Xxxxxxxx Sanpete Xxxxx Xxxxxx Garfield Summit Grand Wasatch Juab Washington Xxxx Xxxxxxx Piute Rich San Xxxx Tooele Uintah Xxxxx Table 2 - Network Adequacy Standards Urban Counties Rural Counties Frontier Counties 90% of members must 80% of members must 75% of members must have access to Network have access to Network have access to Network Providers within 10 miles Providers within 35 miles Providers within 60 miles or 15 minutes or 45 minutes or 70 minutes

Time and Distance Standards. (A) The Contractor shall maintain implement the provider network adequacy time and distance standards to ensure Enrollee access as described specified in Table 2 for adult and pediatric Covered Services. The standards vary for urban, rural and frontier counties of the State. Table 1 includes the designation of each county as urban, rural, or frontier. The Contractor shall apply the standards in Table 2 according to each of its covered county’s designation in Table 1. The Contractor shall apply the standards as applicable to adult mental health providers, adult substance use disorder providers, pediatric mental health providers and pediatric substance use disorder providers. Table 1 - – County Designation Urban Counties Rural Counties Frontier Counties Xxxxx Cache Beaver Salt Lake Carbon Box Elder Utah Iron Xxxxxxx Xxxxx Xxxxxx Xxxxxxxx Sanpete Xxxxx Xxxxxx Garfield Summit Grand Wasatch Juab Washington Xxxx Xxxxxxx Piute Rich San Xxxx Tooele Uintah Xxxxx Table 2 - – Network Adequacy Standards Urban Counties Rural Counties Frontier Counties 90% of members must have access to Network Providers within 10 miles or 15 minutes 80% of members must have access to Network Providers within 35 miles or 45 minutes 75% of members must have access to Network have access to Network have access to Network Providers within 10 miles Providers within 35 miles Providers within 60 miles or 15 minutes or 45 minutes or 70 minutes

Time and Distance Standards. (A) The Contractor shall maintain provider network adequacy time and distance standards to ensure Enrollee access as described in Table 2 for adult and pediatric Covered Services. The standards vary for urban, rural and frontier counties of the State. Table 1 includes the designation of each county as urban, rural, or frontier. The Contractor shall apply the standards in Table 2 according to each of its covered county’s designation in Table 1. The Contractor shall apply the standards as applicable to adult mental health providers, adult substance use disorder providers, pediatric mental health providers and pediatric substance use disorder providers. Table 1 - County Designation Urban Counties Rural Counties Frontier Counties Xxxxx Davis Cache Beaver Salt Lake Carbon Box Elder Utah Iron Xxxxxxx Xxxxx Xxxxxx Xxxxxxxx Sanpete Xxxxx Xxxxxx Garfield Summit Grand Wasatch Juab Washington Xxxx Xxxxxxx Piute Rich San Xxxx Tooele Uintah Xxxxx Table 2 - Network Adequacy Standards Urban Counties Rural Counties Frontier Counties 90% of members must 80% of members must 75% of members must have access to Network have access to Network have access to Network Providers within 10 miles Providers within 35 miles Providers within 60 miles or 15 minutes or 45 minutes or 70 minutes