Time and Distance Standards Clause Samples
The Time and Distance Standards clause sets specific requirements for the timing and spatial parameters within which certain contractual obligations must be performed. Typically, this clause defines acceptable timeframes for delivery or completion and may specify maximum allowable distances for services, transportation, or response times. For example, it might require that goods be delivered within a set number of days and within a certain geographic radius. Its core function is to ensure predictability and fairness by establishing clear benchmarks, thereby reducing disputes over performance timing and location.
Time and Distance Standards. The Contractor shall maintain provider network adequacy time and distance standards to ensure Enrollee access as described in Table 2 for adult and pediatric Covered Services. The standards vary for urban, rural and frontier counties of the State. Table 1 includes the designation of each county as urban, rural, or frontier. The Contractor shall apply the standards in Table 2 according to each of its covered county’s designation in Table 1. The Contractor shall apply the standards as applicable to adult mental health providers, adult substance use disorder providers, pediatric mental health providers and pediatric substance use disorder providers. Table 1 - County Designation Urban Counties Rural Counties Frontier Counties ▇▇▇▇▇ Cache Beaver Salt Lake Carbon Box Elder Utah Iron ▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Sanpete ▇▇▇▇▇ ▇▇▇▇▇▇ Garfield Summit Grand Wasatch Juab Washington ▇▇▇▇ ▇▇▇▇▇▇▇ Piute Rich San ▇▇▇▇ Tooele Uintah ▇▇▇▇▇ Table 2 - Network Adequacy Standards Urban Counties Rural Counties Frontier Counties 90% of members must 80% of members must 75% of members must have access to Network have access to Network have access to Network Providers within 10 miles Providers within 35 miles Providers within 60 miles or 15 minutes or 45 minutes or 70 minutes
Time and Distance Standards. (A) The Contractor shall maintain provider network adequacy time and distance standards to ensure Enrollee access as described in Table 2 for adult and pediatric Covered Services. The standards vary for urban, rural and frontier counties of the State. Table 1 includes the designation of each county as urban, rural, or frontier. The Contractor shall apply the standards in Table 2 according to each of its covered county’s designation in Table 1. The Contractor shall apply the standards as applicable to adult mental health providers, adult substance use disorder providers, pediatric mental health providers and pediatric substance use disorder providers. Table 1 - County Designation Urban Counties Rural Counties Frontier Counties ▇▇▇▇▇ Cache Beaver Salt Lake Carbon Box Elder Utah Iron ▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Sanpete ▇▇▇▇▇ ▇▇▇▇▇▇ Garfield Summit Grand Wasatch Juab Washington ▇▇▇▇ ▇▇▇▇▇▇▇ Piute Rich San ▇▇▇▇ Tooele Uintah ▇▇▇▇▇ Table 2 - Network Adequacy Standards Urban Counties Rural Counties Frontier Counties 90% of members must 80% of members must 75% of members must have access to Network have access to Network have access to Network Providers within 10 miles Providers within 35 miles Providers within 60 miles or 15 minutes or 45 minutes or 70 minutes
(B) If the Contractor is unable to meet the network adequacy standards described in Table 2 above, the Contractor may request an exception to these standards. The Department has sole discretion to allow for any exception to the network adequacy standards. A request for exception to these standards must be in writing and must include:
(1) the specific exemption the Contractor is requesting;
(2) the steps taken by the Contractor to comply with the network adequacy requirements before requesting the exception; and
(3) a description of the Contractor’s plan to adequately provide Covered Services in the area where the exemption is requested.
Time and Distance Standards. (A) The Contractor shall implement the provider network adequacy time and distance standards specified in Table 2 for adult and pediatric Covered Services. The standards vary for urban, rural and frontier counties of the State. Table 1 includes the designation of each county as urban, rural, or frontier. The Contractor shall apply the standards in Table 2 according to each of its covered county’s designation in Table 1. The Contractor shall apply the standards as applicable to adult mental health providers, adult substance use disorder providers, pediatric mental health providers and pediatric substance use disorder providers. ▇▇▇▇▇ Cache Beaver Salt Lake Carbon Box Elder Utah Iron ▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Sanpete ▇▇▇▇▇ ▇▇▇▇▇▇ Garfield Summit Grand Wasatch Juab Washington ▇▇▇▇ ▇▇▇▇▇▇▇ Piute Rich San ▇▇▇▇ Tooele Uintah ▇▇▇▇▇ 90% of members must have access to Network Providers within 10 miles or 15 minutes 80% of members must have access to Network Providers within 35 miles or 45 minutes 75% of members must have access to Network Providers within 60 miles or 70 minutes
(B) If the Contractor is unable to meet the network adequacy standards, the Contractor may request an exception to these standards. The Department has sole discretion to allow for any exception to the network adequacy standards. A request for exception to these standards must be in writing and must include:
(1) the specific exemption the Contractor is requesting;
(2) the steps taken by the Contractor to comply with the network adequacy requirements before requesting the exception; and
(3) a description of the Contractor’s plan to adequately provide Covered Services in the area where the exemption is requested.
Time and Distance Standards. (A) The Contractor shall maintain provider network adequacy time and distance standards to ensure patient access. The standards will be different for Frontier, Rural and Urban areas of the State. Wasatch Front Urban, Rural and Frontier areas of Utah are listed in the following table. Table 1 – County Designation Cache Carbon Beaver Davis Iron Box Elder Salt Lake ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Utah Sanpete Duchesne ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ Summit Garfield Wasatch Grand Washington Juab ▇▇▇▇ ▇▇▇▇▇▇▇ Piute Rich San ▇▇▇▇ Tooele Uintah ▇▇▇▇▇
(B) The Contractor shall ensure that Enrollees have access to the following types of providers within the time and distance standards. Table 2 – Time and Distance Standards Primary Care – Adult 90% of members must have access within 10 miles or 15 minutes 90% of members must have access within 35 miles or 45 minutes 90% of members must have access within 60 miles or 70 minutes Primary Care – Pediatric 90% of members must have access within 10 miles or 15 minutes 90% of members must have access within 35 miles or 45 minutes 90% of members must have access within 60 miles or 70 minutes OB/GYN 90% of members must have access within 10 miles or 15 minutes 90% of members must have access within 35 miles or 45 minutes 90% of members must have access within 60 miles or 70 minutes Specialist – Adult 90% of members must have access 90% of members must have access within 80 90% of members must have access within 110 within 30 miles or 45 minutes miles or 100 minutes miles or 125 minutes Specialist – Pediatric 90% of members must have access within 30 miles or 45 minutes 90% of members must have access within 80 miles or 100 minutes 90% of members must have access within 110 miles or 125 minutes Hospital 90% of members must have access within 30 miles or 45 minutes 90% of members must have access within 60 miles or 80 minutes 90% of members must have access within 100 miles or 110 minutes Pharmacy 90% of members must have access within 10 miles or 15 minutes 90% of members must have access within 35 miles or 45 minutes 90% of members must have access within 60 miles or 70 minutes
(C) If the Contractor is unable to meet the network adequacy standards described in this Article 5.1.2, the Contractor may request an exception to these standards. The Department has sole discretion to allow for any exception to the network adequacy standards. A request for exception to these standards must be in writing and must include the following:
(1) the specific exemption th...
Time and Distance Standards. The Contractor shall maintain provider network adequacy time and distance standards to ensure patient access. The standards will be different for Frontier, Rural and Wasatch Front Urban areas of the State. Wasatch Front Urban, Rural and Frontier areas of Utah are listed in the following table. Wasatch Front Urban Counties Non Wasatch Front Rural Counties Non Wasatch Front Frontier Counties ▇▇▇▇▇ Box ▇▇▇▇▇ ▇▇▇▇▇▇ Salt Lake Cache ▇▇▇▇▇▇▇ Utah Carbon Duchesne ▇▇▇▇▇ Iron ▇▇▇▇▇ ▇▇▇▇▇▇ Garfield Sanpete Grand ▇▇▇▇▇▇ Juab Summit ▇▇▇▇ Tooele ▇▇▇▇▇▇▇ Uintah Piute Wasatch ▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇ San ▇▇▇▇ ▇▇▇▇▇
Time and Distance Standards. (A) The Contractor shall maintain provider network adequacy time and distance standards to ensure Enrollee access as described in Table 1 - Time and Distance Standards.
(B) The Contractor shall ensure that Enrollees have access to the following types of providers within the time and distance standards. Provider or Facility Type Standard Primary Care 90% of Enrollees must have access within 10 miles or 15 minutes OB/GYN 90% of Enrollees must have access within 10 miles or 15 minutes Specialist 90% of Enrollees must have access within 30 miles or 45 minutes Hospital 90% of Enrollees must have access within 30 miles or 45 minutes Pharmacy 90% of Enrollees must have access within 10 miles or 15 minutes Behavioral health (mental health and substance use disorder) 90% of Enrollees must have access within 10 miles or 15 minutes
(C) If the Contractor is unable to meet the network adequacy standards described in this Article 5.1.2, the Contractor may request an exception to these standards. The Department has sole discretion to allow for any exception to the network adequacy standards. A request for exception to these standards must be in writing and must include the following:
(1) the specific exemption the Contractor is requesting;
(2) the steps taken by the Contractor to comply with the network adequacy requirements before requesting the exception; and
(3) a description of the Contractor’s plan to adequately provide Covered Services in the area where the exemption is requested.
Time and Distance Standards. The Contractor shall maintain provider network adequacy time and distance standards to ensure Enrollee access. The standards will be different for Frontier, Rural and Urban areas of the State. Wasatch Front Urban, Rural, and Frontier areas of Utah are listed in the following table.. Urban Counties Rural Counties Frontier Counties Cache Summit Tooele ▇▇▇▇▇ Wasatch Salt Lake Utah ▇▇▇▇▇
Time and Distance Standards. The Contractor shall maintain provider network adequacy time and distance standards to ensure Enrollee access as described in Table 2 for adult and pediatric Covered Services. The standards vary for urban, rural and frontier counties of the State. Table 1 includes the designation of each county as urban, rural, or frontier. The Contractor shall apply the standards in Table 2 according to each of its covered county’s designation in Table 1. The Contractor shall apply the standards as applicable to adult mental health providers, and pediatric mental health providers. Table 1 - County Designation Urban Counties Rural Counties Frontier Counties ▇▇▇▇▇ Cache Beaver Salt Lake Carbon Box Elder Utah Iron ▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Sanpete ▇▇▇▇▇ ▇▇▇▇▇▇ Garfield Summit Grand Wasatch Juab Washington ▇▇▇▇ ▇▇▇▇▇▇▇ Piute Rich San ▇▇▇▇ Tooele Uintah ▇▇▇▇▇ Table 2 - Network Adequacy Standards Urban Counties Rural Counties Frontier Counties 90% of members must 80% of members must 75% of members must have access to Network have access to Network have access to Network Providers within 10 miles Providers within 35 miles Providers within 60 miles or 15 minutes or 45 minutes or 70 minutes