180 Day SNF Nf Benefit for MSC Sample Clauses

180 Day SNF Nf Benefit for MSC. (A) For any Recipient who is enrolled into MSC+ while in a community setting (i.e. Community EW and Community Non-EW payment categories), the MCO shall have financial responsibility for Nursing Facility services for one hundred eighty (180) days. The 180 days begin at the time of the MSC+ Enrollee’s date of admission to a Skilled Nursing Facility (SNF) or Nursing Facility (NF) on or after the first effective date of enrollment. Both Medical Assistance and Medicare covered days shall be counted toward the 180-day Benefit Period, except that the MCO shall not pay for Nursing Facility services for new admits to a facility that occurs during Denial of Payment for New Admissions (DOPNA) violation periods, since these days are not covered under the STATE’s fee-for-service program. The 180 days shall be counted cumulatively. The MCO shall be responsible for paying any coinsurance for Medicare covered days during the 180-day Benefit Period. The 180-day Benefit Period may be applied to an Enrollee more than once if the requirements of the 180-day Separation Period are met as specified in section 4.21.8.
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180 Day SNF Nf Benefit for MSC 
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