108 Medicaid Waiver Sample Clauses

108 Medicaid Waiver. Generally, a waiver of existing law authorized under Section 1115(a), 1115A, or 1915 of the Social Security Act. A Section 1115(a) waiver is also referred to as a demonstration. 1. 109 Medical Record – A complete record of items and services rendered by all Participating and Non-Participating Providers documenting the specific items and services rendered to the Participant, including but not limited to inpatient, outpatient, emergency care, routine, and LTSS items and services. The record must be kept in accordance with all applicable Federal, State, and local laws, rules and regulations. Such record shall be signed by the Provider rendering the services. 1. 110 Medically Necessary Items and Services (Also Medical Necessity) – Those items and services necessary to prevent, diagnose, correct, or cure conditions in the Participant that cause acute suffering, endanger life, result in illness or infirmity, interfere with such Participant’s capacity for normal activity, or threaten some significant handicap. Notwithstanding this definition, the FIDA Plan will provide coverage in accordance with the more favorable of the current Medicare and NYSDOH coverage rules, as outlined in NYSDOH and Federal rules and coverage guidelines. 1. 111 Medicare-Medicaid Coordination Office – Formally the Federal Coordinated Health Care Office, established by Section 2602 of the Affordable Care Act.