Common use of Covered Service Components Clause in Contracts

Covered Service Components. Other Services a. Care Coordination (1) Contractor shall provide Care Coordination to all members consistent with OARs 410- 141-3860, 410-141-3865, and 410-141-3870 and 42 CFR § 438.208. (2) Contractor shall maintain Care Coordination (CC) policies and procedures that comply with OARs 410-141-3860, 410-141-3865, and 410-141-3870. Contractor shall submit its CC policies and procedures to OHA, via Administrative Notice, for review and approval as follows: (i) by January 31 of each Contract Year; (ii) upon any material change to such policies and procedures; and (iii) within five Business Days of request, as made by OHA from time to time. Contractor shall not implement changes in its CC policies and procedures until approved in writing by OHA. If no changes have been made to Contractor’s CC policies and procedures since last approved by OHA, Contractor may, for its annual January 31 submission, submit to OHA via Administrative Notice, an Attestation stating that no changes have been made. OHA will notify Contractor within thirty (30) days from the due date, or within thirty (30) days from the received date if after the due date, of the approval status of its CC policies and procedures; OHA will notify Contractor within the same period if additional time is needed for review. In the event OHA determines Contractor’s CC policies and procedures do not comply with the criteria set forth herein, Contractor shall follow the process set forth in Sec. 5 of Ex. D. (3) Contractor shall submit to OHA, via Administrative Notice, a bi-annual report on its Care Coordination activities no later than forty-five (45) days following the end of each six- month period. The report shall demonstrate Contractor’s ability to fulfill the Care Coordination activities and requirements outlined in OARs 410-141-3860, 410-141-3865, and 410-141-3870. Contractor shall use the reporting template provided by OHA on the CCO Contract Forms Website.