Definitions
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
CCS liaison: California Children Services (CCS) liaison means primary point(s) of contact for the coordination of services between the contractor and county CCS program who ensure the appropriate communication and care coordination are ongoing between the contractor and county CCS program, facilitate quarterly meetings and provide updates to the county CCS program as appropriate.
The contractor must have a CCS liaison(s) that serves as the primary point(s) of contact for the coordination of services between the contractor and county CCS program to ensure the appropriate communication and care coordination are ongoing between the contractor and county CCS program, facilitate quarterly meetings and provide updates to the county CCS program as appropriate.
CCS liaisons must receive training on the full spectrum of rules and regulations pertaining to the CCS program, including referral requirements and processes, annual medical review processes with counties, care management and authorization processes for CCS children.
CCS program: CCS program means a state program administered as a partnership between the county health department and the DHCS to provide medically necessary services to treat CCS-eligible conditions.
CCS provider: CCS provider means any of the following providers when used to treat members for a CCS-eligible condition:
- A medical provider that is paneled by the CCS program, pursuant to Health and Safety Code (H&S), Article 5 (commencing with section 123800) of Chapter 3 of Part 2 of Division 106.
- A licensed acute care hospital approved by the CCS program.
- A special care center approved by the CCS program.
Child/Children and Youth: Child/children and youth, regardless of whether the term is capitalized or not, means a member/members less than 21 years of age unless otherwise specified.
Children and Youth with Special Health Care Needs (CYSHCN): Children and Youth with Special Health Care Needs means children and youth who have or are at increased risk for chronic physical, developmental, behavioral or emotional condition and who also require health or related services of a type or amount beyond that required by children and youth generally. The identification, assessment, treatment and coordination of care for CYSHCN must comply with the requirements of 42 CFR Sections 438.208(b)(3), 438.208(b)(4), and 438.208(c)(2)-(4).