Network Adequacy Requirements. The HMO must ensure that its delivery network is sufficient to provide adequate access to all services covered under this contract. In establishing the network, the HMO must consider: a. The anticipated Medicaid and BadgerCare enrollment. b. The expected utilization of services, considering enrollee characteristics and health care needs. c. The number and types of providers (in terms of training experience and specialization) required to furnish the contracted services.
Appears in 2 contracts
Sources: Contract for Medicaid and Badgercare Hmo Services (Centene Corp), Contract for Medicaid and Badgercare Hmo Services (Centene Corp)