Kaiser Family Foundation Survey on State Medicaid Managed Care ...

5. Benefits. Please indicate in the table below any benefit carve-outs. Under “Comments” please indicate if yourstate has different carve-out policies for different programs or regions, whether a particular benefit is onlypartially carved out or is a non-covered service for adults, and the nature of any planned change in carve-outstatus for any benefit.Benefit Carve-Outs(Check all that apply)i. Outpatient behavioral health v. Prescription drugs ix. Nursing homeii. Inpatient behavioral health vi. Non-emergency transportation x. Home & community-based servicesiii. Outpatient substance abuse vii. Dental xi. Personal care servicesiv. Inpatient detoxification viii. Vision xii. Other :Comments:6. Network Requirements and Access to Carea. Network adequacy: Please briefly describe your state’s network adequacy standards for:i. Primary care:ii. Obstetric care:iii. Specialty care:iv. Hospital care:v. Dental care:b. Primary Care Providers (PCPs): Please indicate in the table below which providers (other than <strong>Family</strong>/GeneralPractitioners, Internists, and Pediatricians) may be primary care providers (PCPs) for enrollees of comprehensiveRB-MCOs. If your state has different policies for different programs or regions, please briefly describe under“Comments.”Comments:Permitted PCP Types(Check all that apply)a. Ob/Gyn e. Nurse practitionerb. Physician specialist f. Physician assistantc. Physician group/clinic g. FQHCd. Nurse midwife h. Other:K A I S E R C O M M I S S I O N O NMedicaid and the Uninsured7HEALTH MANAGEMENT ASSOCIATES