Demonstration. The program, MyCare Ohio, administered by CMS and the Ohio Department of Medicaid (ODM) for providing integrated care to Medicare-Medicaid Beneficiaries that is the subject of this Contract.
Demonstration. The program, administered by CMS and the Department for providing integrated care to Medicare-Medicaid Enrollees that is the subject of this Contract.
Demonstration. The Bidders may be required to demonstrate the quoted items during the technical evaluation on free of cost, no claim in this regards will be entertained. If required, failing with their bids/offer shall be rejected. The firms are intimated that they should get ready for demonstration and only one-week time will be provided for arrangement of demonstration and no request for extending time for demonstration will be entrained. Financial bids of only those products will be opened samples/specifications of which are found fit for use by the technical bid evaluation committee. However, the committee may call for the samples at any point of time. Failure to demonstrate, their bids/offer will be summarily rejected.
Demonstration. The 1115 Demonstration waiver program in Georgia supported by CMS that expands the delivery of family planning services to uninsured women, ages 18 through 44, who have family income at or below 200 percent of the Federal poverty level (FPL) and who are not otherwise eligible for Medicaid or the Children’s Health Insurance Program (CHIP). Also referred to as the Family Planning Waiver or the P4HB Program.
Demonstration. Phase II of the Rhode Island Integrated Care Initiative, implemented through the Financial Alignment Initiative, a CMS initiative that partners with states, health plans, and coordinated care entities to integrate service delivery and financing for Medicare-Medicaid enrollees. CMS’ Financial Alignment Initiative uses two models to integrate service delivery and financing:
Demonstration. Upon execution of this Agreement, OSI shall provide to BISYS a copy of OSI's demonstration program for sales and demonstration purposes and shall provide BISYS with the most current version of such demonstration program as it may exist from time to time. Unless inappropriate, OSI demonstration systems demonstrating "wrap-around" services, as described in Section 5 hereof, shall demonstrate the "wrap around" services offered by BISYS,
Demonstration. The Client Agency reserves the right to request a demonstration or make an inspection of any Equipment being offered prior to the Contract award. The demonstration must be held within five (5) calendar days of the Client Agency’s request and within the State of Connecticut.
Demonstration. The supervising nurse will explain the skilled procedure to the nurse intern as he or she performs the skill while the nurse intern observes.
Demonstration. The State of Delaware’s Medicaid demonstration project, authorized by CMS pursuant to Section 1115(a) of the Social Security Act. Abuse – For purposes of program integrity, provider practices that are inconsistent with sound fiscal, business, or medical practices, and result in an unnecessary cost to the Medicaid and CHIP program, or in reimbursement for services that are not Medically Necessary or that fail to meet professionally recognized standards for health care. Abuse also includes client/member practices that result in unnecessary cost to the Medicaid and CHIP program (see 42 CFR 455.2). Access (as it pertains to external quality review) – The timely use of services to achieve optimal outcomes, as evidenced by the Contractor successfully demonstrating and reporting on outcome information for the availability and timeliness elements defined under 42 CFR 438.68 (Network adequacy standards) and 42 CFR 438.206 (Availability of services). Adverse Benefit Determination – In accordance with 42 CFR 438.400(b), the denial or limited authorization of a requested service, including determinations based on the type or level of service; requirements for medical necessity (see Section 3.4.5 of this Contract), appropriateness, setting, or effectiveness of a covered service; the reduction, suspension, or termination of a previously authorized service; the denial, in whole or in part, of payment for a service; the failure to provide services in a timely manner, as defined by the State; the failure of the Contractor to act within timeframes provided in this Contract regarding the standard resolution of Grievances and Appeals; and the denial of a member’s request to dispute a financial liability, including cost sharing, copayments, and other member financial liabilities. Activities of Daily Living (ADLs) – A personal or self-care skill performed, with or without the use of assistive devices, on a regular basis that enables the individual to meet basic life needs for food, hygiene, and appearance, including bathing, dressing, personal hygiene, transferring, toileting, skin care, eating and assisting with mobility.
Demonstration. Upon execution of this Agreement, OSI and BISYS agree to review each other's demonstration program for the Licensed Software and Ancillary Products used for sales and demonstration purposes. Upon reasonable request, the other Party shall provide its most-current version of such demonstration program(s) as they may exist from time to time.
