Medicaid Contract Purchasing SpecificationsOverview of User’s GuideThis guide to purchasing specifications for pediatric services is organized into 21 different issues ranging from "access" to "treatment plans." The issues are listed in alphabetical order (see Index ). Because different state purchasers have different policy preferences, no effort is made to rank the 21 issues in order of priority. Using the Index to Pediatric Services Purchasing Issues, purchasers can quickly access the issues of importance to them. Users with access to the on-line version of this document at www.gwhealthpolicy.org/ may go directly to the illustrative language in the particular purchasing specification of interest to them by double clicking on the section citation in boldface. Each issue contains a brief description followed by a citation linkage to the illustrative contract language. The brief description is framed to explain the MCO's duties with respect to the provisions listed. The duties owed by MCOs to Medicaid-eligible children enrolled under the contract have been drafted to show what is expected of the MCO in furnishing services to them. The more clearly an MCO understands what is expected of it by the purchaser, and the more clearly a purchaser understands what the MCO is obligating itself to provide, the more likely it is that any agreement between the two parties will be carried out to the mutual satisfaction of each party and will, in turn, benefit the enrolled children. After each brief description is a table with a listing of citations to the illustrative contract language. The citations may include an entire section (e.g., §201) on a particular issue because all of the language in the section applies, or the citations may be more specific to one of the subsections in the purchasing specifications (e.g., §203(b)) identifying the exact subject matter of the provision. The purchasing specifications included in this User Guide are:
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