At a minimum, the Contractor must provide directly, or through a Subcontractor, all medically necessary Covered Services, Provider types, and service locations described in the MSM or authorized by Nevada’s Section 1115 demonstration, unless specifically excluded under the terms of this Contract. NVHA reserves the right to modify this Contract based on CMS feedback to Nevada’s Section 1115 demonstration, including, for example, updating the Contractor’s responsibilities to manage the health care of justice-involved individuals and to support their transitions from incarceration into the community. The Contractor must comply with all provisions in NRS 695G.162, including, but not limited to: Offering coverage for services provided to an Enrollee via telehealth to the same extent as services provided in person, provided that use of telehealth is medically necessary and clinically appropriate. Providing reimbursement for telehealth services in the same amount as comparable in-person services, including for audio-only interactions relating to behavioral health or substance use disorder (SUD) counseling or treatment. The Contractor must ensure coverage or coordination, as applicable, for services required pursuant to the DOJ Settlement; such services may include, but are not limited to: behavioral health services delivered at home or in the community, in psychiatric residential treatment facilities, and in other acute care settings.
