Conditional Provider Network Approval Sample Clauses

Conditional Provider Network Approval. If the Department’s annual network adequacy review of currently certified counties identifies deficiencies per the standards articulated in Article IV, E, the County may be placed on a conditional provider network approval. It is the Department’s expectation that the County will work to address the access issue. The Department will review conditional provider network approvals every six months to ensure adequate access to services for members. The Department has the authority to place the County on a corrective action plan if deficiencies persist.
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Conditional Provider Network Approval. If the Department’s annual network adequacy review of currently certified counties identifies deficiencies per the standards articulated in Article V, E, the HMO may be placed on a conditional provider network approval. It is the Department’s expectation that the HMO will work to address the access issue. The Department will review conditional provider network approvals every six months to ensure adequate access to services for BadgerCare Plus and Medicaid SSI members. The Department has the authority to place the HMO on a corrective action plan or to decertify the HMO in the county if deficiencies persist.
Sample 1

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