• Introduction and Learning Objectives
• MLTSS Basics
• Universal Features
• Program Design Choices

• Target Populations
• Enrollment
• Service Coordination
• Options for Including Medicare
• Covered Services
• Provider Networks
• Consumer-Directed Services
• Financial Incentives

• Federal Authorities
• Organizational Capacity & Competencies
• Case Studies

Provider Networks

Sample Contract Language

Here we provide several examples of various contract provisions related to the provider network for a state MLTSS program.

1. The first example from Arizona’s contract shows how a court mandate can be incorporated into contractor expectations for establishing adequate provider networks.
2. The second example shows how Hawaii articulated its contractual requirement that the network develop and evolve to meet the LTSS needs of the population.
3. The third example includes language Pennsylvania used to mandate specific provider training for a target population (in this case, adults with Autism).
4. And the final sample text, from Texas, provides an example of language related to building a transition period that protects fee-for-service providers.

 

 

 

Library Resources Title 42: Public Health, 42 CFR 438 42 CFR 438.206 Availability of Services 42 CFR 438.207 Assurances of Adequate Capacity and Services 42 CRF 438.214 Provider Selection 42 CRF 438.236 Practice Guidelines

 

 

< Back      Next >