COVERED POPULATIONS Sample Clauses

COVERED POPULATIONS. Medallion 4.0 covers all Medicaid and FAMIS mandatory eligibility groups as well as various optional categorically needy and medically needy groups as defined in this contract. The Contractor agrees to provide services to the general populations as defined and outlined in Federal and State regulations as well as this Contract. In addition, the Contractor agrees to provide services to any additional populations or services that the Department, Governor or General Assembly may deem appropriate. The Department reserves the right to transition populations and services into either CCC Plus or Medallion programs in the future. The Contractor shall work with the Department to ensure services are provided to the populations outlined below as well as ensuring that Departmental goals and focuses are met. Pursuant to 12 VAC30-30-10, the current Medallion 4.0 population includes:
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COVERED POPULATIONS. The MyCare Ohio eligible population includes all “full benefitMedicare and Medicaid enrollees age 18 and over within the selected MyCare demonstration counties. The following describes the populations not eligible to participate in the MyCare program:  Partial Medicare Eligibility  Delayed and Other Spend-down  PACE  Intellectual Disabilities and Other Developmental Disabilities (IDD)  Receives Third-Party Liability (TPL) Benefits  CMS Independence at Home (IAH) Demonstration  Employee Union Coverage and/or Retiree Drug Subsidy  Incarcerated Recipients  Other Exclusion Populations
COVERED POPULATIONS. The following populations will be served by the MCO:  Children and youth who are in xxxxxx care  Individuals receiving adoption assistance  Children ages three (3) up to twenty-one (21) eligible for the CSED waiver and enrolled in the MCO as slots are available  Youth formerly in xxxxxx care up to age twenty-six (26) who aged out of xxxxxx care while enrolled in Medicaid in the state of West Virginia.
COVERED POPULATIONS. Contractor shall provide managed care services on a statewide basis. There will be no regional coverage variations. The populations covered under this Contract are set forth in the Special Contract Exhibit D, Table D.01.
COVERED POPULATIONS. The following populations will be served by the MCO: • Children and youth who are in xxxxxx care (effective March 1, 2020); • Individuals receiving adoption assistance (effective March 1, 2020); • Children from three (3) up to age twenty-one (21) eligible for the SED waiver and enrolled in the MCO as slots are available (effective March 1, 2020);

Related to COVERED POPULATIONS

  • Population The Population shall be defined as all Paid Claims during the 12-month period covered by the Claims Review.

  • Eligible Population 5.1 Program eligibility is determined by applicable law set forth in Program rules and the requirements established in the Program Policy Manual. 5.2 The unduplicated number of Clients for PHC services is 430. This represents the Grantee’s projected number of unduplicated Clients to be served during the Contract period. If during the Contract period it is foreseen that the Grantee might be unable to serve the contracted number of children, HHSC may reduce the Grantee’s grant award amount.

  • Target Population TREATMENT FOR ADULT (TRA) Target Population

  • Study Population ‌ Infants who underwent creation of an enterostomy receiving postoperative care and awaiting enterostomy closure: to be assessed for eligibility: n = 201 to be assigned to the study: n = 106 to be analysed: n = 106 Duration of intervention per patient of the intervention group: 6 weeks between enterostomy creation and enterostomy closure Follow-up per patient: 3 months, 6 months and 12 months post enterostomy closure, following enterostomy closure (12-month follow-up only applicable for patients that are recruited early enough to complete this follow-up within the 48 month of overall study duration).

  • Claims Review Population A description of the Population subject to the Claims Review.

  • Covered Services You will receive Covered Services under the terms and conditions of this Contract only when the Covered Service is: • Medically Necessary; • Provided by a Participating Provider for in-network coverage; • Listed as a Covered Service; • Not in excess of any benefit limitations described in the Schedule of Benefits section of this Contract; and • Received while Your Contract is in force.

  • FLORIDA CONVICTED/SUSPENDED/DISCRIMINATORY COMPLAINTS By submission of an offer, the respondent affirms that it is not currently listed in the Florida Department of Management Services Convicted/Suspended/Discriminatory Complaint Vendor List.

  • Covered Data All instances of "Student Data" should be replaced with "LEA Data". The protections provided within this DPA extend to all data provided to or collected by the Provider.

  • SPECIALIZED SERVICE REQUIREMENTS In the event that the Participating Entity requires service or specialized performance requirements not addressed in this Contract (such as e- commerce specifications, specialized delivery requirements, or other specifications and requirements), the Participating Entity and the Supplier may enter into a separate, standalone agreement, apart from this Contract. Sourcewell, including its agents and employees, will not be made a party to a claim for breach of such agreement.

  • Provider Network The Panel of health service Providers with which the Contractor contracts for the provision of covered services to Members and Out-of-network Providers administering services to Members.

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