Indian Enrollee Sample Clauses

Indian Enrollee. An individual who is an Indian (as defined in section 4(c) of the Indian Health Care Improvement Act of 1976 (25 U.S.C. 1603(c)).
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Indian Enrollee. An Enrollee who is an Indian (as defined at 25 USC 1603(13), 1603(28), or 1679(a), or who has been determined eligible as an Indian, under 42 C.F.R. § 136.
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Indian Enrollee. An individual who is an Indian (as defined in Section 4(c) of the Indian Health Care Improvement Act of 1976 (25 U.S.C. 1603(c)). Indian Health Care Provider – an Indian Health Care Provider or an Urban Indian Organization as defined in the American Recovery and Reinvestment Act of 2009. Internal Appeal – a request by an Enrollee or the Enrollee’s Appeal Representative made to the Contractor for review of an Adverse Action. Inquiry – any oral or written question by an Enrollee to the Contractor’s Enrollee services department regarding an aspect of Contractor operations that does not express dissatisfaction about the Contractor. Key Contact – Member of Contractor’s staff who liaises with EOHHS and serves as a point of contact for EOHHS for all communications and requests related to this Contract. Long-Term Services and Supports (LTSS) – A wide variety of services and supports that help certain members meet their daily needs for assistance and improve the quality of their lives. Examples include assistance with bathing, dressing and other basic activities of daily life and self-care, as well as support for everyday tasks such as laundry, shopping, and transportation. LTSS are provided over an extended period, predominantly in homes and communities, but also in facility-based settings such as nursing facilities. LTSS CP – Long-Term Services and Supports Community Partner Managed Care Organization (MCO) – any entity that provides, or arranges for the provision of, covered services under a capitated payment arrangement, that is licensed and accredited by the Massachusetts Division of Insurance as a Health Maintenance Organization (HMO), and is organized primarily for the purpose of providing health care services, that (a) meets advance directives requirements of 42 CFR Part 489, subpart I;
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Indian Enrollee. An Enrollee who is an Indian (as defined in the Indian Health Care Improvement Act of 1976 (25 U.S.C. §§ 1603(13), 1603(23), or 1679(a)) or who has been determined as an Indian under 42 C.F.R. § 136.12 and 42 C.F.R. § 447.51. As of September 1, 2017, Indian will be defined as any individual defined at 25 U.S.C. §§ 1603(13), 1603(28), or 1679(a), or who has been determined eligible as an Indian, under 42 C.F.R. § 136.12.
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Indian Enrollee. An Enrollee who is an Indian (as defined in section 4(c) of the Indian Health Care Improvement Act of 1976 (25 U.S.C. 1603(c)). Individualized Care Plan (ICP) — The plan of care developed by an Enrollee and an Enrollee’s Interdisciplinary Care Team. Integrated Care Organization (ICO) — A health plan or provider-based organization contracted to provide and accountable for providing integrated care to Enrollees. All Contractors participating in the Demonstration shall be designated as One Care plans (also known as ICOs). See also One Care plan. Interdisciplinary Care Team (ICT) — A team of Primary Care Provider, Care Coordinator, Independent Living and Long-Term Services and Supports Coordinator and other individuals at the discretion of the Enrollee that work with the Enrollee to develop, implement, and maintain the Individualized Care Plan.
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Indian Enrollee. An individual who is an Indian (as defined in Section 4.2.8 of the Indian Health Care Improvement Act of 1976 (25 U.S.C. 1603(c)) and is enrolled in the Contractor’s SCO plan.
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Indian Enrollee. An individual who is an Indian (as defined in section 4(c) of the Indian Health Care Improvement Act of 1976 (25 U.S.C. 1603(c)). Indian Health Care Provider – an Indian Health Care Provider or an Urban Indian Organization as defined in the American Recovery and Reinvestment Act of 2009. Instrumental Activities of Daily Living (IADLs) – certain basic environmental tasks required for daily living, including the ability to prepare meals, do housework, laundry, and shopping, get around outside, use transportation, manage money, perform care and maintenance of wheelchairs and adaptive devices, and use the telephone. Long-Term Services and Supports (LTSS) – a wide variety of services and supports that help certain members meet their daily needs for assistance and improve the quality of their lives. Examples include assistance with bathing, dressing and other basic activities of daily life and self-care, as well as support for everyday tasks such as laundry, shopping, and transportation. LTSS are provided over an extended period, predominantly in homes and communities, but also in facility-based settings such as nursing facilities. Losses – the amount by which the Contractor’s TCOC Performance exceeds the Contractor’s TCOC Benchmark LTSS – Long-Term Services and Supports. LTSS CPs – Long-Term Services and Supports Community Partners. Managed Care Organizations (MCO) – any entity that provides, or arranges for the provision of, covered services under a capitated payment arrangement, that is licensed and accredited by the Massachusetts Division of Insurance as a Health Maintenance Organization (HMO), and is organized primarily for the purpose of providing health care services, that (a) meets Advance Directives requirements of 42 CFR Part 489, subpart I;
Sample 1Sample 2
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Indian Enrollee. An individual who is an Indian (as defined in section 4(c) of the Indian Health Care Improvement Act of 1976 (25 U.S.C. 1603(c)). Indian Health Care Provider – an Indian Health Care Provider or an Urban Indian Organization as defined in the American Recovery and Reinvestment Act of 2009. Instrumental Activities of Daily Living (IADLs) – certain basic environmental tasks required for daily living, including the ability to prepare meals, do housework, laundry, and shopping, get around outside, use transportation, manage money, perform care and maintenance of wheelchairs and adaptive devices, and use the telephone.
Sample 1
Indian Enrollee. An individual who is an Indian (as defined in section 4(c) of the Indian Health Care Improvement Act of 1976 (25 U.S.C. 1603(c)). Indian Health Care Provider – an Indian Health Care Provider or an Urban Indian Organization as defined in the American Recovery and Reinvestment Act of 2009. Instrumental Activities of Daily Living (IADLs) – certain basic environmental tasks required for daily living, including the ability to prepare meals, do housework, laundry, and shopping, get around outside, use transportation, manage money, perform care and maintenance of wheelchairs and adaptive devices, and use the telephone. Long-Term Services and Supports (LTSS) – a wide variety of services and supports that help certain members meet their daily needs for assistance and improve the quality of their lives. Examples include assistance with bathing, dressing and other basic activities of daily life and self-care, as well as support for everyday tasks such as laundry, shopping, and transportation. LTSS are provided over an extended period, predominantly in homes and communities, but also in facility-based settings such as nursing facilities. LTSS – Long-Term Services and Supports. LTSS CPs – Long-Term Services and Supports Community Partners. Marketing – any communication from the Contractor, its employees, Providers, agents or Material Subcontractors to a Member who is not enrolled with the Contractor that EOHHS can reasonably interpret as influencing the Member to enroll with the Contractor or either not to enroll in, or to disenroll from, another ACO, MCO, or the PCC Plan. Marketing shall not include any personal contact between a Provider and a Member who is a prospective, current or former patient of that Provider regarding the provisions, terms or requirements of MassHealth as they relate to the treatment needs of that particular Member. Marketing Materials – materials that are produced in any medium, by or on behalf of the Contractor and that EOHHS can reasonably interpret as Marketing to Members. This includes the production and dissemination by or on behalf of the Contractor of any promotional material or activities by any medium including, but not limited to, oral presentations and statements, community events, print media, audio visual tapes, radio, television, billboards, online, Yellow Pages, and advertisements that explicitly or implicitly refer to MassHealth Managed Care or Title XIX and Title XXI of the Social Security Act, and are targeted in any way towa...
Sample 1

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