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Provider Networks

Applicable Authorities

Regardless of the managed care authority you use, the program will need to meet the network adequacy provisions in 42 CFR 438. 

In addition, if you include HCBS services in your MLTSS program using a Section 1915(c) waiver or Section 1915(i) authority, you will need to ensure, among other requirements, that the MLTSS contractor understands and can comply with all 1915(c) or 1915(i) assurances and reporting requirements.


We've provided Worksheet 4.6 for you to think through some of the key considerations as you design your program. Worksheet 4.6


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