Standard IX—Subcontracts and Delegation
The PIHP oversees and is accountable for any functions and responsibilities that it delegates to any subcontractor.
438.230(a)(1)
Standard X—Provider Network
The PIHP maintains and monitors a network of appropriate providers supported by written agreements sufficient to provide adequate access to all services.
§438.206(b)(1)
Standard XI—Credentialing
The PIHP demonstrates that its providers are credentialed as required by Sec. 438.214.
438.206(b)(6)
Each State must establish a uniform credentialing and recredentialing policy that each PIHP must follow.
438.214(b)(1)
Standard XII—Access And Availability
The PIHP meets and requires its providers to meet State standards for timely access to care and services, taking into account the urgency of the need for services.
438.206(c)
Findings were derived from the Michigan Mission-Based Performance Indicator System—Access Domain, Indicators 1 through 4.b.
Standard XIII—Coordination of Care
The PIHP must coordinate the services it furnishes to beneficiaries with other services the beneficiary receives.
438.208(b)(2)i
Standard XIV—Appeals
Each PIHP must have a system that includes an appeal process and access to the State’s fair hearing system.
§438.402