BENEFICIARY ELIGIBILITY Sample Clauses

BENEFICIARY ELIGIBILITY. Contractor shall maintain and implement policies and procedures to ensure a client is a Yolo County Medi-Cal beneficiary, track authorizations, and include only those service units with authorized daily transactions together with the client name for those units eligible for reimbursement. Contractor shall determine Medi-Cal eligibility and report any obligation and payment made of share of cost. Contractor shall provide copies of Medi-Cal swipes documenting beneficiary eligibility with monthly claims. Beneficiaries will be checked weekly by Contractor to verify they are still entitled to Medi-Cal services. If a beneficiary is no longer authorized for service but is in an approved course of treatment, then Contractor shall notify the County in writing immediately. Service may be rendered on a one-time-only basis if the beneficiary’s status has changed since the last service. Additional services may be provided only with the Director’s written authorization based on individual case treatment/service needs.
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BENEFICIARY ELIGIBILITY. This Agreement is not intended to change the determination of Medi-Cal eligibility for beneficiaries in any manner. However, in the event the California State Legislature or Congress of the United States enacts a statute, which redefines Medi-Cal eligibility so as to affect the provision of acute psychiatric inpatient hospital services under this Agreement, this new definition shall apply to the terms of this Agreement.
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BENEFICIARY ELIGIBILITY. County shall maintain and implement policies and procedures to ensure a client is a Yolo County Medi-Cal beneficiary, and will provide copies of clients’ Medi-Cal swipes to Contractor with initial referral information. Contractor shall provide copies of Medi-Cal swipes documenting beneficiary eligibility with monthly claims. If a beneficiary is deemed no longer authorized for service but client is in an approved course of treatment, then service may be rendered as pre- approved by County. These services may be provided only with the Director’s written authorization based on individual case treatment/service needs.
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BENEFICIARY ELIGIBILITY. In the case of a Sub-project under Part B(1), B(2) or B(3)(a) of the Project, the Beneficiary is a household which:
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BENEFICIARY ELIGIBILITY. On a monthly basis, the State will identify which beneficiaries meet the eligibility criteria to receive health home services (See III.B for additional detail).
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BENEFICIARY ELIGIBILITY. Contractor shall maintain and implement policies and procedures to ensure a client is eligible to receive Drug Medi-Cal program services. In order to be eligible, a client (a) must have been determined eligible for Medi-Cal; (b) is not institutionalized; (c) has a substance-related disorder per the “Diagnostic and Statistical Manual of Mental Disorders IV Text Revision (DSM IV-TR) criteria,” and/or DSM IV criteria; and (d) meets the admission criteria to receive DMC services. The requirement as to the use of the specific versions of DSM may be changed during the term of this contract. As changes occur, Contractor shall comply with the changed requirements accordingly. Covered services shall be provided to beneficiaries without regard to the beneficiaries’ county of residence. Contractor shall determine Drug Medi-Cal eligibility and report any obligation and payment made of share of cost. Contractor shall provide copies of Drug Medi-Cal swipes documenting beneficiary eligibility with monthly claims. Beneficiaries will be checked weekly by Contractor to verify they are still entitled to Medi-Cal services. If a beneficiary is no longer authorized for service but is in an approved course of treatment, then Contractor shall notify the County in writing immediately. Service may be rendered on a one-time-only basis if the beneficiary’s status has changed since the last service. Additional services may be provided only with the Director’s written authorization based on individual case treatment/service needs.
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BENEFICIARY ELIGIBILITY. Except as otherwise provided by the Sec- retary, an individual shall only be eligible to receive benefits under the program under sec- tion 1395cc–1 of this title (in this section re- ferred to as the ‘‘demonstration program’’) if such individual— (A) is enrolled under the program under part B of this subchapter and entitled to benefits under part A of this subchapter; and (B) is not enrolled in a Medicare+Choice plan under part C of this subchapter, an xxx- gible organization under a contract under section 1395mm of this title (or a similar or- ganization operating under a demonstration project authority), an organization with an agreement under section 1395l(a)(1)(A) of this title, or a PACE program under section 1395eee of this title.
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BENEFICIARY ELIGIBILITY. In order for a beneficiary to be eligible for the Medicare Part B premium reduction, the beneficiary must be enrolled in an M + C plan that offers the Medicare Part B premium reduction as an addi- tional benefit.
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BENEFICIARY ELIGIBILITY 
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Related to BENEFICIARY ELIGIBILITY

  • Student Eligibility The LEA and POSTSECONDARY INSTITUTION shall qualify and advise candidates for dual credit from the pool of eligible high school students. A candidate for dual credit is eligible for consideration for fall, spring, and summer semesters if he or she: a. is enrolled during the fall and spring in a LEA in one-half or more of the minimum course requirements approved by PED for public school students under its jurisdiction or by being in physical attendance at a bureau of Indian education-funded high school at least three documented contact hours per day pursuant to 25 CFR 39.211(c); b. obtains permission from the LEA representative (in consultation with the student’s individualized education program team, as needed), the student’s parent or guardian if the student is under 18 years old, and POSTSECONDARY INSTITUTION representative prior to enrolling in a dual credit course; and c. meets POSTSECONDARY INSTITUTION requirements to enroll as a dual credit student.

  • Dependent Eligibility For all programs covered in this article, eligible dependents are an employee’s lawful spouse or domestic partner (as defined by Section 297 of the California Family Code), and unmarried children (natural, step, adopted, legal guardianship, and/or xxxxxx) of the employee or domestic partner, who are qualified IRS dependents of the employee or domestic partner, up to twenty-three (23) years of age. Disabled dependents may be able to continue coverage beyond the limiting age if the disability occurred while the dependent was covered under a County-sponsored medical plan or prior to the dependent’s 19th birthday, and is certified by a licensed physician.

  • Benefit Eligibility For purposes of the Benefit Plan entitlement, common-law and same sex relationships will apply as defined.

  • Special Eligibility The following employees also receive an Employer Contribution:

  • Vacation Eligibility Subject to the provisions of Sections 3., 4., 8., and 9. hereof, vacations with pay shall be granted during the vacation year to each employee, except upon dismissal for misconduct, who shall have completed a period of six (6)-months’ employment since date of engagement or reengagement, whichever is later, and who has performed work for the Company within the vacation year, as follows: a. One (1) week’s vacation to any such employee who has completed six (6) months or more but less than twelve

  • Funding Eligibility Contractor understands, acknowledges, and agrees that, pursuant to Chapter 2272 (eff. Sept. 1, 2021, Ch. 2273) of the Texas Government Code, except as exempted under that Chapter, HHSC cannot contract with an abortion provider or an affiliate of an abortion provider. Contractor certifies that it is not ineligible to contract with HHSC under the terms of Chapter 2272 (eff. Sept. 1, 2021, Ch. 2273) of the Texas Government Code.

  • Member Eligibility Verify Member eligibility contemporaneous with the rendering of services. BCBS will provide systems and/or methods for verification of eligibility and benefit coverage for Members. This is furnished as a service and not as a guarantee of payment;

  • Employee Eligibility For purposes of this section, “eligible employee” shall be defined by the Public Employees’ Medical and Hospital Care Act.

  • Beneficiary Designation The Participant may, from time to time, name any beneficiary or beneficiaries (who may be named contingently or successively) to whom any benefit under this Agreement is to be paid in case of his or her death before he or she receives any or all of such benefit. Each such designation shall revoke all prior designations by the Participant, shall be in a form prescribed by the Company, and will be effective only when filed by the Participant in writing with the Director of Human Resources of the Company during the Participant’s lifetime. In the absence of any such designation, benefits remaining unpaid at the Participant’s death shall be paid to the Participant’s estate.

  • Contribution Eligibility You are eligible to make a regular contribution to your Xxxx XXX, regardless of your age, if you have compensation and your MAGI is below the maximum threshold. Your Xxxx XXX contribution is not limited by your participation in an employer-sponsored retirement plan, other than a Traditional IRA.

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