MCO. On an ongoing basis, if a Recipient was previously enrolled with a MCO and loses eligibility for a period of six (6) months or less, the Recipient will be re- enrolled with that MCO;
MCO. If the Recipient’s MCO is not a Centennial Care 2.0 MCO, then he/she will be auto assigned to a Centennial Care 2.0
MCO. ETO benefits may be used, but will not be considered 5 mandatory, for scheduled work days missed when a nurse is called 6 off, mandated to unschedule his/her shift or part thereof, or given 7 the option to go off the schedule any time within the nurse’s shift 8 due to low census, nursing unit closures (for example, on a holiday) 9 or low acuity. This includes nurses who may also receive stand-by 10 pay.
MCO. A Medicaid managed care organization contracted with HHSC to provide health care services to Medicaid recipients.
MCO. If the Member fails to select a Centennial Care 2.0 MCO by the first auto-assignment cycle that begins December 1, 2018, the Member will default to their Current MCO that is a Centennial Care 2.0
MCO. MassHealth contracts with MCOs that provide comprehensive health coverage including behavioral health services to enrollees. MCO enrollees may receive family planning services from any provider without consulting their PCP or MCO and are not required to obtain prior approval from MassHealth. For family planning services provided by MassHealth providers not participating in the MCO network, MassHealth reimburses the provider on a FFS basis and recoups the funds from the MCO. MassHealth Standard/ABP 1, CommonHealth and Family Assistance members who either choose or are assigned to a health plan may transfer to another available health plan in their geographic service area at any time for any reason. Subject to approval of the Commonwealth’s ABP SPA entitled “CarePlus,” MassHealth CarePlus members may transfer to another available health plan in their geographic service area for any reason, effective on the first of the month following the request to transfer; provided, however, that transfers for cause are effective immediately.
MCO a. Compliance Requirements All MCOs must comply with the Department’s Affirmative Action/Civil Rights Compliance requirements at xxxxx://xxx.xxx.xxxxxxxxx.xxx/civil- rights/index.htm.
MCO. Subcontract
MCO. The requirement to provide or arrange for the provision of medically necessary prenatal care shall include assistance in making a timely appointment for a woman who is presumptively eligible and shall be provided as soon as the CONTRACTOR becomes aware of the enrollment. For a woman in her second or third trimester, the appointment shall occur as required in Section 2.11.4.2. In the event a member enrolling in the CONTRACTOR’s MCO is receiving medically necessary prenatal care services the day before enrollment, the CONTRACTOR shall comply with the requirements in Sections 2.9.2.2 and 2.9.2.3 regarding prior authorization of prenatal care.
