Rules should be applied fairly and consistently across all provider groups, without duplication of oversight. Insurance-Provider Service Agreements. In order to ensure access for consumers managed care networks contracting with providers must have a fair and open process that ensures an opportunity for providers to apply to a network. Eligible providers should be able to obtain information about the process for application to a network and the basic selection criteria. It is in the best interest of all parties to have the selection of network providers focused on the delivery of quality, cost-effective care.
Clinical decisions are an integral part of the relationship between the clinician and the consumer.
Clinical decisions should not be legislated, but should be based on accepted clinical practice. Long-term care services should consider an individual's preference to remain at home whenever appropriate. An integral part of home care is access and coordination with other providers of community-based health and social services. Personal Care Services. In this way, consumers can receive protection from poor care or exploitation, workers can be assured of training and support, and the public is assured that funds are being properly disbursed.