Common use of Timely Access Clause in Contracts

Timely Access. A. Timely Access. In accordance with 42 C.F.R. § 438.206(c)(1), the Contractor shall: 1) Meet and require its providers to meet standards for timely access to care and services, taking into account the urgency of need for services, pursuant to Welf. & Inst. Code section 14197(d), as specified in BHIN 21-023 and its enclosures, or in subsequent, guidance issued by the Department. 2) Comply with the timeliness standards specified in Cal. Code Regs., tit. 9, section 1810.405(c) and Welf. & Inst. Code § 14717.1. Those standards apply to out-of-plan services, as well as in-plan services. 3) Require subcontracted providers to have hours of operation during which services are provided to Medi-Cal beneficiaries that are no less than the hours of operation during which the provider offers services to non-Medi-Cal beneficiaries. If the provider only serves Medi-Cal beneficiaries, the Contractor shall require that hours of operation are comparable to the hours the provider makes available for Medi-Cal services that are not covered by the Contractor, or another Mental Health Plan. 4) Make services available to beneficiaries 24 hours a day, 7 days a week, when medically necessary. 5) Establish mechanisms to ensure that network providers comply with the timely access requirements; 6) Monitor network providers regularly to determine compliance with timely access requirements; 7) Take corrective action if there is a failure to comply with timely access requirements by a network provider.