Common use of Eligible Individuals Clause in Contracts

Eligible Individuals. If an eligible individual, as defined in OAC rule 5160-26-01, contacts the MCP, the MCP shall provide any MCP-specific managed care program information requested. The MCP shall not attempt to assess the eligible individual’s health care needs. However, if the eligible individual inquires about continuing/ transitioning health care services, the MCP shall provide an assurance that all MCPs shall cover all medically necessary Medicaid-covered health care services and assist members with transitioning their health care services.

Appears in 19 contracts

Samples: Provider Agreement, Provider Agreement, Provider Agreement

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Eligible Individuals. If an eligible individual, as defined in OAC rule 5160-26-01, individual contacts the MCP, the MCP shall must provide any MCP-specific managed care program information requested. The MCP shall must not attempt to assess the eligible individual’s health care needs. However, if the eligible individual inquires about continuing/ continuing/transitioning health care services, the MCP MCPs shall provide an assurance that all MCPs shall must cover all medically necessary Medicaid-covered health care services and assist members with transitioning their health care services.

Appears in 9 contracts

Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Molina Healthcare Inc), Provider Agreement (Molina Healthcare Inc), Provider Agreement (Wellcare Health Plans, Inc.)

Eligible Individuals. If an eligible individual, as defined in OAC rule 5160-26-01, individual contacts the MCP, the MCP shall must provide any MCP-specific managed care program information requested. The MCP shall must not attempt to assess the eligible individual’s 's health care needs. However, if the eligible individual inquires about continuing/ continuing/transitioning health care services, the MCP MCPs shall provide an assurance that all MCPs shall must cover all medically necessary Medicaid-covered health care services and assist members with transitioning their health care services.

Appears in 3 contracts

Samples: Provider Agreement (Wellcare Health Plans, Inc.), Ohio Medical Assistance Provider Agreement for Managed Care Plan Abd Eligible Population (Wellcare Health Plans, Inc.), Provider Agreement (Wellcare Health Plans, Inc.)

Eligible Individuals. If an eligible individual, as defined in OAC rule 5160-26-01, contacts the MCP, the MCP shall must provide any MCP-specific managed care program information requested. The MCP shall must not attempt to assess the eligible individual’s health care needs. However, if the eligible individual inquires about continuing/ continuing/transitioning health care services, the MCP shall provide an assurance that all MCPs shall must cover all medically necessary Medicaid-covered health care services and assist members with transitioning their health care services.

Appears in 2 contracts

Samples: Provider Agreement, Provider Agreement

Eligible Individuals. If an eligible individual, as defined in OAC rule 5160-26-01, contacts the MCP, the MCP shall provide any MCP-specific managed care program information requested. The MCP shall not attempt to assess the eligible individual’s health care needs. However, if the eligible individual inquires about continuing/ continuing/transitioning health care services, the MCP shall provide an assurance that all MCPs shall cover all medically necessary Medicaid-covered health care services and assist members with transitioning their health care services.

Appears in 2 contracts

Samples: Provider Agreement, Provider Agreement

Eligible Individuals. If an eligible individual, as defined in OAC rule 5160-26-01, individual contacts the MCP, the MCP shall provide mustprovide any MCP-specific managed care program information requested. The MCP shall must not attempt to assess the eligible individual’s health care needs. However, if the eligible individual inquires about continuing/ continuing/transitioning health care services, the MCP MCPs shall provide an assurance that all MCPs shall must cover all medically necessary Medicaid-covered health care services and assist members with transitioning their health care services.

Appears in 1 contract

Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.)

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Eligible Individuals. If an eligible individual, as defined in OAC rule 5160-26-01, individual contacts the MCP, the MCP shall must provide any MCP-specific managed care program information requested. The MCP shall must not attempt to assess the eligible individual’s 's health care needs. However, if the eligible individual inquires about continuing/ continuing/transitioning health care services, the MCP MCPs shall provide an assurance that all MCPs shall must cover all medically necessary Medicaid-covered health care services and assist members with transitioning their health care services.. Appendix C Covered Families and Children (CFC) population Page 12

Appears in 1 contract

Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Molina Healthcare Inc)

Eligible Individuals. If an eligible individual, as defined in OAC rule 5160-26-01, individual contacts the MCP, the MCP shall must provide any MCP-specific managed care program information requested. The MCP shall must not attempt to assess the eligible individual’s 's health care needs. However, if the eligible individual inquires about continuing/ transitioning continuing/transition ing health care services, the MCP shall MCPs must provide an assurance that all MCPs shall must cover all medically necessary Medicaid-covered health care services and assist members with transitioning their health care services.. Appendix C

Appears in 1 contract

Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.)

Eligible Individuals. If an eligible individual, as defined in OAC rule 5160-26-01, individual contacts the MCP, the MCP shall provide mustprovide any MCP-specific managed care program information requested. The MCP shall TheMCP must not attempt to assess the eligible individual’s health care needs. However, if the eligible individual inquires about continuing/ continuing/transitioning health care services, the MCP MCPs shall provide an assurance that all MCPs shall must cover all medically necessary Medicaid-covered health care services and assist members with transitioning their health care services.

Appears in 1 contract

Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.)

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