Common use of Network Capacity Clause in Contracts

Network Capacity. The Contractor shall maintain and monitor an appropriate and adequate provider network, supported by written agreements, sufficient to provide GFS services under this Contract to its Enrollees. The Contractor shall incorporate the following requirements when developing its network: The Contractor shall, in partnership with the BH-ASO, assist the state to expand community-based alternatives for crisis stabilization, such as mobile crisis or crisis residential and respite beds. The Contractor shall assist the state to expand community-based, recovery-oriented services and research- and evidence-based practices. The Contractor shall implement an adequate plan to provide Evaluation and Treatment services to Enrollees, which may include the development of less restrictive alternative to involuntary treatment or prevention programs reasonably calculated to reduce the demand for Evaluation and Treatment services. Regional Behavioral Health entities must develop and implement plans for improving access to timely and appropriate treatment for Enrollees with Behavioral Health needs and current or prior criminal justice involvement. If the Contractor, in HCA’s sole opinion, fails to maintain an adequate network of GFS Behavioral Health providers in any contracted service area for two (2) consecutive quarters, and after notification following the first quarter, HCA reserves the right to immediately terminate the Contractor’s services for that service area. The network established under the Contract must complement and support the network of Medicaid providers established by the IAHFC Medicaid Contract. The Contractor shall update and maintain the Contractor’s existing provider manual to include all relevant information regarding GFS services and requirements. The Contractor shall have, maintain, and provide to HCA upon request an up-to- date database of its provider network. The Contractor shall update its existing database to meet the following requirements: A network inventory, including licensure, to quantify the number of providers offering GFS services, including a list of all GFS providers. Includes the providers’ names, locations, telephone numbers, GFS services offered, clinical specialty and areas of expertise. Includes a description of each provider’s language(s) spoken and if appropriate, a brief description of the provider’s skills or experiences that would support the cultural or linguistic needs of its Enrollees when provided by a provider. Indicates whether each provider has capacity to serve new patients and the limits on capacity for each provider. Updates to the provider database shall be made: no less than quarterly or whenever there is a change in the Contractor’s network that would affect adequate capacity in a service area. Contractor program staff shall be available to conduct provider searches based on office or facility location, clinical specialty, provider discipline, provider capacity, available languages and allowable fund sources (e.g., Medicaid, GFS).

Network Capacity. The Contractor shall maintain and monitor an appropriate and adequate provider network, supported by written agreements, sufficient to provide GFS services under this Contract to its Enrollees. The Contractor shall incorporate the following requirements when developing its network: The Contractor shall, in partnership with the BH-ASO, assist the state to expand community-based alternatives for crisis stabilization, such as mobile crisis or crisis residential and respite beds. The Contractor shall assist the state to expand community-based, recovery-oriented services and research- and evidence-based practices. The Contractor shall implement an adequate plan to provide Evaluation and Treatment services to Enrollees, which may include the development of less restrictive alternative to involuntary treatment or prevention programs reasonably calculated to reduce the demand for Evaluation and Treatment services. Regional Behavioral Health entities must develop and implement plans for improving access to timely and appropriate treatment for Enrollees with Behavioral Health needs and current or prior criminal justice involvement. If the Contractor, in HCA’s sole opinion, fails to maintain an adequate network of GFS Behavioral Health providers in any contracted service area for two (2) consecutive quarters, and after notification following the first quarter, HCA reserves the right to immediately terminate the Contractor’s services for that service area. The network established under the Contract must complement and support the network of Medicaid providers established by the IAHFC AH-IMC Medicaid Contract. The Contractor shall update and maintain the Contractor’s existing provider manual to include all relevant information regarding GFS services and requirements. The Contractor shall have, maintain, and provide to HCA upon request an upup- to-to- date database of its provider network. The Contractor shall update its existing database to meet the following requirements: A network inventory, including licensure, to quantify the number of providers offering GFS services, including a list of all GFS providers. Includes the providers’ names, locations, telephone numbers, GFS services offered, clinical specialty and areas of expertise. Includes a description of each provider’s language(s) spoken and if appropriate, a brief description of the provider’s skills or experiences that would support the cultural or linguistic needs of its Enrollees when provided by a provider. Indicates whether each provider has capacity to serve new patients and the limits on capacity for each provider. Updates to the provider database shall be made: no less than quarterly or whenever there is a change in the Contractor’s network that would affect adequate capacity in a service area. Contractor program staff shall be available to conduct provider searches based on office or facility location, clinical specialty, provider discipline, provider capacity, available languages and allowable fund sources (e.g., Medicaid, GFS).

Network Capacity. The Contractor shall maintain and monitor an appropriate and adequate provider network, supported by written agreements, sufficient to provide GFS services under this Contract to its Enrollees. The Contractor shall incorporate the following requirements when developing its network: The Contractor shall, in partnership with the BH-ASO, assist the state to expand community-based based, including Tribal-based, alternatives for crisis stabilization, such as mobile crisis or crisis residential and respite beds. The Contractor shall assist the state to expand community-based, recovery-oriented services and research- and evidence-based practices. The Contractor shall implement an adequate plan to provide Evaluation and Treatment services to Enrollees, which may include the development of less restrictive alternative to involuntary treatment or prevention programs reasonably calculated to reduce the demand for Evaluation and Treatment services. Regional Behavioral Health entities must develop and implement plans for improving access to timely and appropriate treatment for Enrollees with Behavioral Health needs and current or prior criminal justice involvement. If the Contractor, in HCA’s sole opinion, fails to maintain an adequate network of GFS Behavioral Health providers in any contracted service area for two (2) consecutive quarters, and after notification following the first quarter, HCA reserves the right to immediately terminate the Contractor’s services for that service area. The network established under the Contract must complement and support the network of Medicaid providers established by the IAHFC Medicaid Contract. The Contractor shall update and maintain the Contractor’s existing provider manual to include all relevant information regarding GFS services and requirements. The Contractor shall have, maintain, and provide to HCA upon request an up-to- date database of its provider network. The Contractor shall update its existing database to meet the following requirements: A network inventory, including licensure, to quantify the number of providers offering GFS services, including a list of all GFS providers. Includes the providers’ names, locations, telephone numbers, GFS services offered, clinical specialty and areas of expertise. Includes a description of each provider’s language(s) spoken and if appropriate, a brief description of the provider’s skills or experiences that would support the cultural or linguistic needs of its Enrollees when provided by a provider. Indicates whether each provider has capacity to serve new patients and the limits on capacity for each provider. Updates to the provider database shall be made: no less than quarterly or whenever there is a change in the Contractor’s network that would affect adequate capacity in a service area. Contractor program staff shall be available to conduct provider searches based on office or facility location, clinical specialty, provider discipline, provider capacity, available languages and allowable fund sources (e.g., Medicaid, GFS).