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Medicaid Contract Purchasing Specifications

User Guide for Community Health Centers

The sample purchasing specifications include numerous provisions addressing a wide range of issues. In the case of community health centers that own or operate an MCO, all of these provisions are obviously relevant. In the case of other centers, many of these issues directly or indirectly affect them, whether they subcontract with an MCO or not. The following provisions may be of particular interest to these centers. The provisions are listed in alphabetical order.

Covered Benefit

Federally Qualified Health Center (FQHC) Services: §101(c) of Part 1 identifies FQHC and RHC services as covered services under the purchasing document.

Coverage Determinations

Evidence: §101A(b)(6) of Part 1A relates to the use of evidence from providers such as community health centers in connection with Contractor's coverage determinations.

Notice: §102A(c) of Part 1A requires notice of adverse coverage determinations to publicly-supported providers (including community health centers) referring the enrolled child for diagnosis or treatment.

Homeless1

Access to Out-of-Network Primary Care Providers: §511(e) of Part 5 relates to Contractor's duty under certain circumstances to permit a homeless child (or the child's family or caregiver) to select a primary care provider that does not participate in Contractor's provider network.

Assignment of Non-Selecting Children: §403(d) of Part 4 relates to Contractor's duty to assign a homeless child who does not select a primary care provider to a network provider with experience in serving the homeless.

Definition: §1401(n) defines a homeless child.

Service Waiting Time: §603(c)(1)(E) of Part 6 relates to Contractor's duty to ensure that homeless children receive appointments with primary care providers within a specified timeframe.

Information to Enrolled Children

Provider List: §304(a)(1)(B) of Part 3 relates to the inclusion, in the information given to new and potential enrollees, of the name of the community health center with which a physician or other health professional practices.

Involuntary Disenrollment

Children Receiving Treatment: §204(b) of Part 2 relates to Contractor's duty to ensure completion of treatment for children receiving treatment at the time of involuntary disenrollment.

Children Not Receiving Treatment: §205 of Part 2 relates to Contractor's duty to arrange for the transfer of the medical records of a child who is not receiving treatment at the time of involuntary disenrollment to the successor provider assuming responsibility for the care of the child.

Migratory or Seasonal Agricultural Worker Families

Access to Out-of-Network Primary Care Providers: §511(d) of Part 5 relates to Contractor's duty under certain circumstances to permit a migrant child (or the child's family or caregiver) to select a primary care provider that does not participate in Contractor's provider network.

Assignment of Non-Selecting Children: §403(c) of Part 4 relates to Contractor's duty to assign a migrant child who does not select a primary care provider to a network provider with experience in serving migrant or seasonal agricultural worker families.

Definition:

§1401(r) defines a migratory agricultural worker.

§1401(y) defines a seasonal agricultural worker.

Service Waiting Time: §603(c)(1)(D) of Part 6 relates to Contractor's duty to ensure that migratory or seasonal farmworker children receive appointments with primary care providers within a specified timeframe.

Network Providers

Enrollee Access to Network Providers: §501(g) of Part 5 relates to the Contractor's duty to make the services of any provider participating in Contractor's provider network available to an enrolled child.

Certain Providers Identified in Federal Law: §509 of Part 5 relates to the participation of FQHCs in Contractor's provider network and to the reimbursement of such providers.

Traditional Medicaid Provider: §508 of Part 5 relates to participation of traditional Medicaid providers, including federally qualified health centers, in Contractor's provider network, and to the reimbursement of such providers.

Payment: §1301(i) of Part 13 relates to the current federal law requirements regarding Medicaid MCO payments to FQHCs.

Out-of-Network Providers

Payment

§510 of Part 5 relates to Contractor's duty regarding payment for covered services furnished by out-of-network providers, including those with necessary primary care expertise.

§1201(a)(6) of Part 12 relates to Purchaser payment of out-of-network providers and Recoupment of payments from Contractor.

Access

§005(f) of the Overview relates to Contractor's duty with respect to payment for certain public health services (e.g., family planning and STD diagnosis and treatment) received by enrolled children providers such as community health centers, whether or not such providers participate in Contractor's provider network.

§104A of Part 1A relates to Contractor's duty to allow self-referral by adolescent enrollees for certain public health services (e.g., family planning and STD diagnosis and treatment).

§103A of Part 1A relates to Contractor's duty to exempt from prior authorization requirements certain items and services, including immunizations, family planning services and supplies, STD diagnosis and treatment, tuberculosis diagnosis and treatment, and HIV diagnosis and treatment.

Referral by Contractor: §510(a) relates to Contractor's duty to refer enrolled children to out-of-network providers, including community health centers, under certain circumstances and to reimburse for such referrals.

Special Supplemental Food Program for Women, Infants, and Children (WIC)

Coordination by Participating Providers: §501(h) of Part 5 relates to Contractor's duty to ensure that providers in its network coordinate with WIC programs.

Memorandum of Understanding: §704(e) of Part 7 relates to Contractor's duty regarding a memorandum of understanding with an interested State WIC agency.

Referrals: §005(h) of Overview and §704(b) and (c) of Part 7 relate to Contractor's duty regarding referrals of enrolled children under age 5 to local WIC providers.


Endnotes

  1. See also CHSRP's Optional Purchasing Specification: Medicaid Managed Care for Individuals Who Are Homeless (forthcoming).