Common Contracts
2 similar Participating Provider Agreement contracts
PREAMBLE AND RECITALSParticipating Provider Agreement • May 23rd, 2013 • New York
to States for Medical Assistance Programs, Section 1396 et seq., as amended from time to time, or any successor program(s) thereto regardless of the name(s) thereof.
PREAMBLE AND RECITALSParticipating Provider Agreement • May 23rd, 2013 • New York
Medically Necessary Services provided must be based on peer-reviewed publications, expert pediatric, psychiatric, and medical opinion, and medical/pediatric community acceptance. In the case of pediatric Members/enrollees, the definition herein shall apply with the additional criteria that the services, including those found to be needed by a pediatric Member as a result of a comprehensive screening visit or an inter-periodic encounter, whether or not they are ordinarily Covered Services for all other Medicaid Members are appropriate for the age and health status of the individual, and the service will aid the overall physical and mental growth and development of the individual, and the service will assist in achieving or maintaining functional capacity.
