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AZ | GA | IN | KY | MD | MN | MO | MT | NE | NEBH
NV | NJ | NM | NY | NC |ND | OH | OK | SC | UT | WA
 
 

AZ

"SECTION D:  PROGRAM REQUIREMENTS
1. SCOPE OF SERVICES…
Dental: …Members under the age of 21 may request dental services without referral and may choose a dental provider from the Contractor's provider network…"  Arizona Contract, pages 10- 11.

GA

"SECTION 3
SCOPE OF SERVICES...
3.010  Offeror Responsibilities
The following identify the responsibilities to be performed by the Offeror...
1.  Evaluate provision of unrestricted access to emergency services and family planning services for recipients enrolled in GBHC…"  Georgia RFP, page 7-8.

IN

"4.4.2.4  Self-Referral Services
Capitation amounts include payment for the following services known as 'self-referral services':

  *  Services rendered for the treatment of an emergency…
  *  Chiropractic services
  *  Podiatric services
  *  Eye Care services (except eye care surgical services)
  *  HIV/AIDS targeted case management services
  *  Diabetes self-management training services…"  Indiana RFP, pages 4-7 -  4-8.

KY

"The Member Services staff shall be responsible for the following services and tasks: ...
  •   Facilitating direct access to primary care vision services; primary care vision services; primary dental and oral surgery services and evaluations by orthodontist and prosthodontists…childhood immunizations; sexually transmitted disease screening, evaluation and treatment; tuberculosis screening, evaluation and treatment; and testing for HIV, HIV-related conditions and other communicable diseases, as described in Attachment VIII of this RFA..."  Kentucky RFA, page 53.

"7.9.3  Direct Access Services
  The Partnership shall ensure direct access and may not restrict the choice of a qualified provider by a Member for the following services within The Partnership's Network:
  •  Primary care vision services, provided by ophthalmologists, optometrists and opticians,
 including the fitting of eye-glasses;
  •  Primary dental and oral surgery services and evaluations by orthodontists and prosthodontists."  Kentucky RFA, page 72.

MD

"Chapter 62  Maryland Medicaid Managed Care Program:  Definitions
.01  Definitions…
(156)  'Self-referral services' are the health care services listed in COMAR 10.09.67.28 for which, under specified circumstances, the MCO is required to pay, without any requirement of referral by the PCP or MCO, when the enrollee accesses the service through a provider other than the enrollee's PCP."  Maryland COMAR 10.09.62.01.

"10.09.64.06...
.06  Access and Capacity:  Benefits and Appointments.
An MCO applicant shall include in its application the following information or descriptions: …
E.  Documentation of the applicant's preparedness to collaborate with providers of self-referral services, and reimburse at the Department's established fee-for-service rate, for permissible self-referred services, including: ...
(2)  School-based clinic services as specified in COMAR 10.09.68...
(4)  Initial medical examination services to children in State-supervised care;
(5)  Annual diagnostic and evaluation services (DES) for individuals diagnosed with HIV/AIDS; and
(6)  Renal dialysis services…"  Maryland COMAR 10.09.64.06.

"10.09.65.20...
(6)  An MCO may require enrollees to utilize in-plan providers for pharmacy and laboratory services ordered by out-of-plan providers of self-referral services, except as provided in §A(7) of this regulation.
(7)  An MCO shall reimburse out-of-plan providers at the Medicaid rate for medically necessary and appropriate pharmacy and laboratory services when the pharmacy or laboratory service is provided:
 (a)  In connection with a self-referred service specified in §A(1) of this regulation; and
 (b)  On-site by the out-of-plan provider at the same location that the self-referred service specified in §A(1) of this regulation was delivered to the MCO's enrollee."  Maryland COMAR 10.09.65.20.

"10.09.67.28...
.28  Benefits-Self-Referral Services...
B.  Services performed by school-based health centers, as provided in COMAR 10.09.68...
D.  Initial medical examination for children in State custody...
F.  Renal dialysis services performed in a Medicare-certified facility;
G.  Initial medical examination of a newborn when the:
 (1)  Examination is performed in a hospital by an on-call physician, and
 (2)  MCO failed to provide for the service before the newborn's discharge from the hospital; and
H.  Medical services directly related to a child's medical condition, such as physical therapy, occupational therapy, or speech therapy for a child with a special health care need who at the time of initial enrollment was receiving these services as part of a current plan of care…"  Maryland COMAR 10.09.67.28.

MN

"B.  Provider Access Changes. The HEALTH PLAN shall not make any substantive changes in its method of provider access during the term of this Contract, unless -approved in advance by the STATE… Examples of methods of provider access include but are not limited to: Enrollee has open access to all Primary Care Providers; Enrollee may self-refer to a physician specialist…"  Minnesota Contract, page 29.

"Section 6.20. Services Received at Indian Health Service and Tribal Providers. This Section applies when the STATE begins enrollment of American Indians under Section 3.1.1.C.(14). American Indian PMAP and PGAMC Enrollees -- living on or off a reservation -- shall have direct access to services provided at Indian Health Service (IHS) facilities and facilities (also known as 638 facilities or providers) operated by a tribe or tribal organization… The HEALTH PLAN shall not require any Prior Approval or impose any condition for an American Indian to access services at such facilities...

Section 6.20.1. Referrals from IHS and 638 Providers. When a physician in a facility described in Section 6.20. refers an American Indian PMAP or PGAMC Enrollee to a Participating Provider for services covered under this Contract, the HEALTH PLAN shall not require the Enrollee to see a Primary Care Provider prior to the referral…"  Minnesota Contract, page 69.

MO

"p.  At a minimum, the member handbook shall include: ...
12)  Notice that a member with a condition which requires ongoing care from a specialist may request a standing referral to such a specialist and the procedure for requesting and obtaining such a standing referral…"  Missouri RFP, pages 42-43.

MT

"2.4.2  Participating Providers:...
B   Providers Contracts Must be Extended to or Contractor Must Allow Access to:...

2)  Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs): ...
At a minimum, the CONTRACTOR must reimburse an FQHC or RHC PARTICIPATING PROVIDER either the Medicaid interim rate for each medically necessary ENROLLEE visit to the FQHC or RHC or the same payment per ENROLLEE or service offered to the CONTRACTOR'S other PRIMARY CARE PROVIDERS.  The DEPARTMENT is responsible for paying the shortfall to the FQH/RHC or recouping the excess from the FQHC/RHC for the difference between the amount reimbursed by the CONTRACTOR and the reasonable cost to the FQHC or the RHC to provide the covered service.

1)  If a recipient is mandated in to an HMO which has no FQHC or RHC on its panel and chooses to go to an FQHC or RHC then the recipient does not have to obtain prior approval, but under the state requirements the recipient must inform their HMO before receiving the FQHC services...

3)  If there is more than one FQHC in the area and one is on the HMO panel and the other is not, then the recipient may only go to the FQHC or RHC on the provider panel without requiring HMO prior authorization.  If the recipient chooses to go to the FQHC or RHC not on the HMO panel then the recipient is responsible to pay for services received from the FQHC or RHC.

3)  Public Health Clinic Access
Give each ENROLLEE, including adolescents, the opportunity to go to any public health clinic for immunizations and blood lead testing (but not well child screens) without requiring a referral...

4)  Indian Health Services (HIS):
If a recipient is eligible for Indian Health Services and chooses to receive services within an HIS clinic then prior approval is not required and HIS is responsible for billing the service fee-for-service to the state."  Montana Contract, pages 36-37.

NE

"4.1.22 The term 'Family Planning Services' means...Treatment for sexually transmitted diseases (STD) pursuant to this contract shall be reimbursed by the plans in the same manner as family planning services, without referral or authorizations by the Primary Care Physician(PCP)/plan…"  Nebraska  Contract, page 9.

"13.22 Provision of Services: The plan shall coordinate activities with the Department, other NHC contractors, and other providers for services outside the Basic Benefits Package, as appropriate, to meet the needs of the client, and ensure that systems are in place to promote well managed patient care, including, but not limited to...
(d) Unrestricted access to 'protected' services such as emergency room services...tribal clinics, etc., according to 471 NAC…"  Nebraska Contract, page 85.

"13.34 Medical Specialists: ...Clients with chronic or severe medical conditions, e.g., HIV/AIDS, may be allowed to go directly to a qualified specialist within the plan’s network pursuant to Section 13.5.3 and 13.5.4."  Nebraska Contract, page 87.

"13.44.3 Unrestricted Services: The plan shall not require authorization for...emergency services, and Native Americans seeking tribal clinic or Indian Health hospital services. The plan shall allow the client to access these services from any Medicaid-enrolled provider s/he chooses, and is not limited to providers within the plan’s network. The plan shall allow the client to access these services without a referral, even if the plan contracts with Medicaid to provide these services.

13.44.4 Emergency Services: The plan shall provide all covered emergency services...The plan shall allow the client to access these services without a referral, even if the plan provides these services."  Nebraska Contract, page 93.

NEBH

"11.26 Coordination of Services:  The PHP shall coordinate activities with the Department, other NHC contractors, other providers for services, and others involved with the client, as appropriate, to meet the needs of the client, and ensure systems are in place to promote well managed patient care, including, but not limited to: ...
(e) Unrestricted access to protected services such as emergency room services, tribal clinics, etc., according to 471 NAC…"  Nebraska Behavioral Health Contract, pages 58-59.

"11.52.4  Native Americans:  The PHP shall ensure that Native Americans seeking tribal clinic or Indian Health hospital services do not require prior authorization or provision by the PHP.
11.52.5  Emergency Services:  The PHP shall ensure that: ...

(c) The client may access these services without a referral, even if the PHP contracts with Medicaid to provide these services."  Nebraska Behavioral Health Contract, pages 64-65.

NV

"H.  Out-of-Plan Services…
   4. Federally Qualified Health Centers and Rural Health Clinics.  The Contractor must pay for services provided by a Federally Qualified Health Center (FQHC) or a rural health clinic…"  Nevada Contract, pages 25-26.

NJ

"1.95  'Referral Services'...
   Exception B:  An enrollee may access services at a Federal Qualified Health Center (FQHC) in a specific enrollment area without the need for a referral when neither the contractor nor any other HMO has a contract with the Federally Qualified Health Center in that enrollment area and the cost of such services will be paid by the Medicaid fee-for-service program."  New Jersey Contract, page 20.

NM

"2.A.1.e.ii  The CONTRACTOR shall provide each member with written information that instructs members about how to obtain primary and specialty care, including:
  (A)  a list of providers, by provider type and specialty, available through the CONTRACTOR and how to access them; such list, at the option of CONTRACTOR, may be limited to primary care providers and those providers to whom members may self-refer, including, but not limited to… urgent and emergency care providers, HIS and other Indian providers, and pharmacies…"  New Mexico Contract, page 5.

"2.C.13 Indian Health Services (HIS) & Tribal Health Centers
The CONTRACTOR shall allow members who are Native American to seek care from any IHS. Tribal Provider or Urban Indian Program Provider defined in the Indian Health Care Improvement Act ... whether or not the provider participates in the CONTRACTOR provider network. The CONTRACTOR may not prevent members who are IHS beneficiaries from seeking care from IHS, Tribal or Urban Indian Providers. and network providers due to their status as Native Americans."  New Mexico Contract, page 33.

NY

"10.  BENEFIT PACKAGE, COVERED AND NON-COVERED SERVICES…
10.16  Services for Which Enrollees Can Self-Refer...
b)  Vision Services
The Contractor will allow its Enrollees to self-refer to any participating provider of vision services (optometrist or opthalmologist) for refractive vision services...

c)  Diagnosis and Treatment of Tuberculosis
Enrollees may self-refer to public health agency facilities for the diagnosis and/or treatment of TB...

e)  Sexually Transmitted Disease (STD) Services
Enrollees may self refer to any qualified Medicaid provider for STD services as described in Section 10.19(c) of this Agreement...

"10.19  Public Health Services
a)  Tuberculosis Screening, Diagnosis and Treatment; Directly Observed Therapy(TB\DOT):
 i) ...It is the State's preference that the Contractor's Enrollees receive TB diagnosis and treatment through the Contractor's plan, to the extent that providers experienced in this type of care are available in the Contractor's network of Participating Providers, although Enrollees may self-refer to public health agency facilities for the diagnosis and/or treatment of TB... "  New York Contract, pages 10-1-10-10.

NC

"6.19  Payment to Out-of-Plan Providers
The Plan shall reimburse Out-of-Plan Providers for Covered Services, which may be obtained by Members without prior authorization from the Plan for the following: ...

c.  Services provided by a Public Health Department for the screening, diagnosis, counseling, or treatment of STD's, TB, HIV…"  North Carolina Contract, page 13.

ND

"2.5  Public Health Clinic Access
The Contractor shall give each enrollee, including adolescents, the opportunity to go to any public health clinic for immunizations and blood lead testing, but not well-child screens, without requiring a referral…"  North Dakota Contract, Attachment C, page 11.

OH

"Certified Nurse Midwives (CNMs) and Certified Nurse Practitioners (CNPs)…
MCPs would be permitted to require a referral from the enrollee's PCP if they so desired, however, MCPs must allow enrollee's whose pregnancy has been confirmed by their PCP's office to self-refer to CNMs…"  Ohio RFP, pages 28-29.

OK

"2.8.7  Self-Referral for Designated Services
2.8.7.1  General
Except for the categories described below, Health Plan may require members to obtain authorization prior to receiving any non-emergent, non-primary care services included in the pre-paid benefit package...

2.8.7.3  Dental Services
Health Plan must allow its members who are eligible for dental services to self refer to a network dental provider for non-emergent dental services, subject to the Plan's standard utilization management mechanisms.

2.8.7.4  Eye Care Services
Health Plan must allow its members who are eligible for eye care services to self refer to any network ophthalmologist or optometrist for non-emergent services both refractive services and treatment of diseases/injuries of the eye, subject to the Plan's standard utilization management mechanisms...

2.8.7.6  Immunizations and EPSDT Screens
The Health Plan must allow the member to self-refer for immunizations and EPSDT screenings, if the following occurs:
  1) a school-based clinic or health department notifies the Plan that a member is due for an immunization or EPSDT screen; and
  2) the Plan fails to schedule an immunization or EPSDT screen within three weeks of notification…"  Oklahoma RFP, pages 44-45.

SC

"COMMUNICABLE DISEASE SERVICES...
A.  Communicable Disease...
Eligible recipients should be encouraged to receive family planning, TB, STD, and HIV services through their primary care provider or by appropriate referral to promote the integration/coordination of these services with heir total medical care.  However, eligible recipients have the freedom to receive family planning services from any appropriate Medicaid providers without any restrictions.  Eligible recipients have the freedom to receive TB, STD and HIV testing and counseling services from any public health agency without any restrictions to services."  South Carolina Contract, Appendix C, Tab 1, page 3.

UT

"E.  Clarification of Covered Services
  1.  Emergency Services
  a.  In General
  The Health Plan must provide coverage for Emergency Services without regard to prior authorizations or the emergency care provider's contractual relationship with the MCO.  MCOs must inform their enrollees that access to emergency services is not restricted and that if an enrollee experiences a medical emergency, he or  she may obtain services from a non-plan physician or other qualified provider, without penalty... The CONTRACTOR must comply with Medicare guidelines for post-stabilization of care. "  Utah Contract, Attachment B, page 13.

WA

"4.9  Self-Referral to Family Planning Clinics and Health Departments: …  Members may self-refer to health departments for the following services: immunizations, sexually transmitted disease screening and follow-up, human immunodeficiency virus (HIV) screening, tuberculosis screening and follow-up… ...In addition, members may self-refer to family planning clinics for… sexually transmitted disease screening and treatment services."  Washington Contract, pages 17-18.

"COVERED SERVICES...
Vision Care:  The Contractor shall cover eye examination for visual acuity and refraction once every twenty-four (24) months for adults and once every twelve (12) months for children under age twenty-one (21)…Members may self-refer to participating providers for these services."  Washington Contract,  Exhibit 6, Attachment 1, page 2.