AHCCCS Health Plans Required to Operate Companion Sample Clauses

AHCCCS Health Plans Required to Operate Companion. D-SNP(s) As required by its AHCCCS Complete Care (ACC), ALTCS DD, or RBHA health plan contract, each State-contracted Medicaid health plan is required to also operate an MAO offering a D-SNP product(s) in all Service Areas in which it holds an AHCCCS Complete Care (ACC), ALTCS DD, or RBHA health plan contract. AHCCCS shall execute this Agreement only when XXX holds a CMS D-SNP contract, beginning on the Effective Date of this Agreement, which covers the same service area(s) as its AHCCCS Complete Care (ACC), ALTCS DD, or RBHA health plan. Each contracted AHCCCS Complete Care (ACC), ALTCS DD, or RBHA health plan shall have, and assure AHCCCS that it does have, the legal and actual authority to direct, manage, and control the operations of both the corporation operating its AHCCCS Complete Care (ACC), ALTCS DD, or RBHA health plan contract and its contracted companion MAO to the extent necessary to ensure integration of Medicare and Medicaid services for individuals enrolled for both programs.
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Related to AHCCCS Health Plans Required to Operate Companion

  • Medical Examination Where the Employer requires an employee to submit to a medical examination or medical interview, it shall be at the Employer's expense and on the Employer's time.

  • Health Care Operations Health Care Operations shall have the meaning set out in its definition at 45 C.F.R. § 164.501, as such provision is currently drafted and as it is subsequently updated, amended or revised.

  • Office Visits (other than Preventive Care Services) This plan covers office and clinic visits to diagnose or treat a sickness or injury. Office visit copayments differ depending on the type of provider you see. This plan covers physician visits in your home if you have an injury or illness that: • confines you to your home; or • requires special transportation; and • because of this injury or illness, you are physically unable to travel to the provider’s

  • Outpatient Dental Anesthesia Services This plan covers anesthesia services received in connection with a dental service when provided in a hospital or freestanding ambulatory surgical center and: • the use of this is medically necessary; and • the setting in which the service is received is determined to be appropriate. This plan also covers facility fees associated with these services.

  • Medical Exams 18.1: The Sheriff's Department may require a physical and/or psychological exam by a doctor, at the Employer's expense, to determine the employee's ability to perform his/her regular duties, if deemed appropriate. The employee may obtain a second opinion, at the employee's expense, and in the event there is a dispute between the Employer's doctor and the employee's doctor, both of these doctors shall select a third doctor, whose decision shall be final and binding on the parties. The expense for the third doctor's opinion shall be split 50-50 by the Employer and the employee if not covered by the employee's insurance.

  • Health Examination 27-1 When the District determines that a MBU's health condition (mental or physical) may be impairing his/her job performance, the immediate supervisor, site administrator, or Regional Assistant Superintendent, with the concurrence of the Human Resources Department may, with just cause, direct the MBU to have a health examination at District expense. The MBU will be given a copy of the directive which will state the reason(s) for such examination. Following the examination, results will be sent by the Human Resources Department to the MBU and immediate supervisor. All communication which results from the implementation of this Article shall be handled in a confidential manner. ARTICLE TWENTY-EIGHT

  • Patient Care Resident shall participate in safe, effective, and compassionate patient care, under supervision, commensurate with Resident's level of advancement and responsibility.

  • Coverage Under the Minnesota Advantage Health Plan From July 1, 2019 through December 31, 2019, health coverage under the SEGIP will continue at the level in effect on June 30, 2019. Effective January 1, 2020, Advantage will cover eligible services subject to the copayments, deductibles and coinsurance coverage limits stated. Services provided through Advantage are subject to the managed care procedures and principles, including standards of medical necessity and appropriate practice, of the plan administrators. Coverage details are provided in the Advantage Summary of Benefits.

  • Professional Growth and Improvement Plans A. Professional growth and improvement plans shall be developed as follows:

  • Indiana Veteran’s Business Enterprise Compliance Award of this Contract was based, in part, on the Indiana Veteran’s Business Enterprise (“IVBE”) participation plan. The following IVBE subcontractors will be participating in this Contract: VBE PHONE COMPANY NAME SCOPE OF PRODUCTS and/or SERVICES UTILIZATION DATE PERCENT _____________________________________________________________________________________ _____________________________________________________________________________________ A copy of each subcontractor agreement shall be submitted to IDOA within thirty (30) days of the request. Failure to provide any subcontractor agreement may also be considered a material breach of this Contract. The Contractor must obtain approval from IDOA before changing the IVBE participation plan submitted in connection with this Contract. The Contractor shall report payments made to IVBE subcontractors under this Contract on a monthly basis. Monthly reports shall be made using the online audit tool, commonly referred to as “Pay Audit.” IVBE subcontractor payments shall also be reported to IDOA as reasonably requested and in a format to be determined by IDOA.

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