Common use of All Participants Clause in Contracts

All Participants. For all Participants, the CHC-MCO must comply with continuity of care requirements for continuation of Providers, services, and any ongoing course of treatment outlined in MA Bulletin 99-03-13, Continuity of Care for Recipients Transferring Between and Among Fee-for-Service and Managed Care Organizations. To ensure continuity of services for Participants receiving LTSS, CHC-MCOs must obtain the transitioning Participants’ current PCSP or obtain an electronic record that includes all of the information contained in the current PCSP. CHC-MCOs must contact the providers identified in the service plan from the transferring Fee-for-Service program or CHC-MCO to confirm continuation of service authorization and payment. The term contact means the CHC-MCO provides an authorization of service that includes the type, scope, amount, duration, and frequency of services to be provided. The CHC-MCO must initiate contact within two business days of the date the CHC-MCO receives the PCSP or electronic record.

Appears in 4 contracts

Samples: 2020 Community Healthchoices Agreement, 2023 Community Healthchoices Agreement, 2022 Community Healthchoices Agreement

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