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Provider Networks

Sample Contract Language

Here we provide several examples of various contract provisions related to the provider network for a state MLTSS program.

  1. The first example from Arizona’s contract shows how a court mandate can be incorporated into contractor expectations for establishing adequate provider networks.
  2. The second example shows how Hawaii articulated its contractual requirement that the network develop and evolve to meet the LTSS needs of the population.
  3. The third example includes language Pennsylvania used to mandate specific provider training for a target population (in this case, adults with Autism).
  4. And the final sample text, from Texas, provides an example of language related to building a transition period that protects fee-for-service providers.


link to pdf file



Library Resources

Title 42: Public Health, 42 CFR 438

  • 42 CFR 438.206 Availability of Services
  • 42 CFR 438.207 Assurances of Adequate Capacity and Services
  • 42 CRF 438.214 Provider Selection
  • 42 CRF 438.236 Practice Guidelines



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