The particular format used in these sample specifications is NOT intended as a substitute for each state's own format. Instead, it is intended simply to divide each suggested provision into the smallest practicable policy elements. This division and subdivision format is designed to enable a user to identify quickly the policy choices contained in each provision and to identify which, if any, of the elements the user wishes to adopt. This format also serves as a detailed checklist for those users who wish to compare portions of their current purchasing documents with the relevant portions of these sample specifications. The Contractor will provide the full array of family planning services covered under the Contract without Prior Authorization.
Members have the right to access family planning services through any family planning provider.
Issues Not Addressed in this Technical Assistance Document These purchasing specifications do not include language addressing cultural competence standards. Access to covered services within an MCO is not solely a function of the staffing or configuration of an MCO, or the performance standards to which it is held. A recent survey of Medicaid capitation rates found substantial variation in payment rates among the states and concluded that this variation could affect beneficiary access to services. These specifications do not speak to the issue of payment, either to the MCO or to providers delivering services to MCO enrollees. Upon issuance of final rules, these specifications will be updated.