Handbook. A. The Contractor shall provide beneficiaries with a copy of the handbook and provider directory when the beneficiary first accesses services and thereafter upon request. (Cal. Code Regs., tit. 9, § 1810.360.)
B. The Contractor shall ensure that the handbook includes the current toll- free telephone number(s) that provides information in threshold languages and is available twenty-four hours a day, seven days a week. (Cal. Code Regs., tit. 9, § 1810.405, subd. (d).)
C. The beneficiary handbook shall include information that enables the beneficiary to understand how to effectively use the managed care program. This information shall include, at a minimum:
1) Benefits provided by the Contractor. (42 C.F.R. § 438.10(g)(2)(i).)
2) How and where to access any benefits provided by the Contractor, including any cost sharing, and how transportation is provided. (42 C.F.R. § 438.10(g)(2)(ii).)
a) The amount, duration, and scope of benefits available under the Contract in sufficient detail to ensure that beneficiaries understand the benefits to which they are entitled. (42 C.F.R. § 438.10(g)(2)(iii).)
b) Procedures for obtaining benefits, including any requirements for service authorizations and/or referrals for specialty care and for other benefits not furnished by the beneficiary’s provider. (42 C.F.R. § 438.10(g)(2)(iv).)
c) Any restrictions on the beneficiary’s freedom of choice among network providers. (42 C.F.R. § 438.10(g)(2)(vi).)
d) The extent to which, and how, beneficiaries may obtain benefits from out-of-network providers. (42 C.F.R. § 438.10(g)(2)(vii).)
e) Cost sharing, if any, consistent with the State Plan. (42 C.F.R. § 438.10(g)(2)(viii); State Plan § 4.18.)
f) Beneficiary rights and responsibilities, including the elements specified in § 438.100 as specified in Section 7 of this Attachment. (42 C.F.R. § 438.10(g)(2)(ix).)
g) The process of selecting and changing the beneficiary’s provider. (42 C.F.R. § 438.10(g)(2)(x).)
h) Grievance, appeal, and fair hearing procedures and timeframes, consistent with 42 C.F.R. §§ 438.400 through 438.424, in a state-developed or state-approved description. Such information shall include:
1) The right to file grievances and appeals;
2) The requirements and timeframes for filing a grievance or appeal;
3) The availability of assistance in the filing process;
4) The right to request a state fair hearing after the Contractor has made a determination on a beneficiary’s appeal which is adverse to the beneficiary;
5) The fa...
Handbook. The guide prepared by Buyer containing additional policies and procedures, as same may be amended from time to time.
Handbook. Employee agrees that the Company Employee Handbook outlines other policies in addition to the terms set forth in this Agreement, which will apply to Employee’s employment with the Company, and Employee acknowledges receipt of such handbook. Employee acknowledges and agrees that the Company retains the right to revise, modify or delete any such policy or any employee benefit plan it deems appropriate.
Handbook. The guide prepared by Buyer containing additional policies and procedures, as same may be amended from time to time. Haircut: With respect to each Transaction, if the Purchase Price is less than par, an amount equal to the difference between par and the Purchase Price, which shall be considered a “settlement payment” as defined in Bankruptcy Code Section 741(8).
Handbook. The policies stated in the custodial handbook shall not contradict an expressed term of this Agreement. The District will forward a copy of the handbook to the Union in advance for its reaction and input.
Handbook.
3.12.3.1 For MSC+ and MSHO, a Handbook must be provided, that has been prior approved by the STATE and for MSHO, by CMS. The Member Handbook or Handbook must be made available annually to MSC+ Enrollees no later than January 1 of the Contract Year, or for MSHO as required by CMS.
(1) For MSHO, the MCO will cooperate with the MSHO Plan Member Materials Workgroup to adjust the CMS Medicare model Member Handbook to incorporate STATE requirements. The MCO will use the model developed by the MSHO Plan Member Materials Workgroup to develop its own Member Handbook, which is then submitted to the STATE and includes information as below in section 3.12.3.1(3)(a) through (y).
(2) For MSC+, the STATE will provide annually to the MCO a model Handbook as the base document. Prior to distribution to the MCO, the model Handbook will be prior approved by MDH to ensure that MDH’s requirements are included. The MCO will not have to subsequently submit the Handbook to MDH after receiving approval from the STATE. After the MCO has incorporated its specific information, the completed Handbook will be submitted to the STATE for prior approval.
(3) For MSHO the Member Handbook and for MSC+ the Handbook must include the following, [42 CFR §438.10(g)]:
(a) Definitions consistent with CMS requirements, as listed in the model Handbook;
(b) A description of the MCO’s medical and remedial care program, including specific information on Covered Services, including amount, duration and scope of benefits available, limitations, and non-covered services;
(c) General descriptions of the coverage for durable medical equipment, including additional equipment and home modifications available to eligible MSHO and MSC+ members through home and community based services, level of coverage available, and criteria and procedures for any Service Authorizations, and also the address and telephone number of an MCO representative whom an Enrollee can contact to obtain (either orally or in writing upon request) specific information about coverage and Service Authorization. The MCO shall provide information that is more specific to a prospective Enrollee upon request;
(d) A description of the Enrollee’s rights and protections as specified in 42 CFR §438.100;
(e) A description of cost-sharing, if applicable;
(f) Notification of the open access of Family Planning Services and services prescribed by Minnesota Statutes, §62Q.14;
(g) Information about providing coverage for prescriptions that are dispen...
Handbook. All newly hired Teacher Assistants will receive a copy of the Teacher Assistants Handbook, and a copy will be available on the district website.
Handbook. The volunteer is obliged to familiarize himself with the "Handbook for Volunteers" for the Winter Festival.
Handbook. The terms of the Handbook are not contractual, and may be unilaterally amended, supplemented, revised or discontinued by Enagic India at any time without my prior consent. The Handbook, together with any amendments, modifications or restatements submitted to me by Enagic India shall constitute the exclusive terms and conditions applicable to my relationsh ip with Enagic India.
Handbook. The Residence Hall Handbook is incorporated by reference into this contract. The Resident is equally responsible for complying with the rules, policies, and regulations contained in this contract and the Handbook. The terms of the Residence Hall Handbook may change from time to time. It is the Resident's responsibility to regularly review the Handbook to ensure awareness of and adherence to the current terms. The Handbook is linked here: xxxxx://xxxxxxx.xxxxxx.xxx/xxxxxxoptions/handbooks/reshall_handbookpages/index.html .
