Common use of Medicaid Eligibility Clause in Contracts

Medicaid Eligibility. If applicable, Provider must meet minimum requirements for participation in the State Programs. Provider may meet this requirement either by being enrolled with the State as a Medicaid provider or by demonstrating to Subcontractor and Health Plan that it meets the applicable minimum requirements for Medicaid participation. Subcontractor and Health Plan will exclude from its network any provider who has been suspended from the Medicare or Medicaid program in any state.

Appears in 5 contracts

Samples: Downstream Provider, Downstream Provider, Behavioral Health Individual Participating Provider Agreement

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Medicaid Eligibility. If applicable, Provider must meet minimum requirements for participation in the State ProgramsProgram. Provider may meet this requirement either by being enrolled with the State as a Medicaid provider or by demonstrating to Subcontractor and Health Plan that it meets the applicable minimum requirements for Medicaid participation, including enrollment in Medicare, if applicable. Subcontractor and Health Plan will exclude from its network any provider who has been terminated or suspended from the Medicare or Medicaid program in any state.

Appears in 2 contracts

Samples: Downstream Provider, learn.optumrx.com

Medicaid Eligibility. If applicable, Provider must meet minimum requirements for participation in the State Programs. Provider may meet this requirement either by being enrolled with the State as a Medicaid provider or by demonstrating to Subcontractor and Health Plan that it meets the applicable minimum requirements for Medicaid participation. Subcontractor and Health Plan and/or Subcontractor will exclude from its network any provider who has been suspended from the Medicare or Medicaid program in any state.

Appears in 2 contracts

Samples: www.uhchearing.com, learn.optumrx.com

Medicaid Eligibility. If applicable, Provider must meet minimum requirements for participation in the State Programs. Provider may meet this requirement either by being enrolled with the State as a Medicaid provider or by demonstrating to Subcontractor and Health Plan that it meets the applicable minimum requirements for Medicaid participation. Subcontractor and Health Plan will exclude from its network any provider who has been suspended or terminated from the Medicare or Medicaid program in any state.

Appears in 1 contract

Samples: learn.optumrx.com

Medicaid Eligibility. If applicable, Provider must meet minimum requirements for participation in the State ProgramsProgram. Provider may meet this requirement either by being enrolled with the State as a Medicaid provider or by demonstrating to Subcontractor and and/or Health Plan that it meets the applicable minimum requirements for Medicaid participation, including enrollment in Medicare, if applicable. Subcontractor and and/or Health Plan will exclude from its network any provider who has been terminated or suspended from the Medicare or Medicaid program in any state.

Appears in 1 contract

Samples: learn.optumrx.com

Medicaid Eligibility. If applicable, Provider must meet minimum requirements for participation in the State ProgramsProgram. Provider may meet this requirement either by being enrolled with the State as a Medicaid provider or by demonstrating to Subcontractor and Health Plan and/or Subcontractor that it meets the applicable minimum requirements for Medicaid participation, including enrollment in Medicare, if applicable. Subcontractor Provider acknowledges and agrees that Health Plan and/or Subcontractor will exclude from its network any provider who has been terminated or suspended from the Medicare or Medicaid program in any state.

Appears in 1 contract

Samples: learn.optumrx.com

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Medicaid Eligibility. If applicable, Provider must meet minimum requirements for participation in the State Programs. Provider may meet this requirement either by being enrolled with the State as a Medicaid provider or by demonstrating to Subcontractor and Health Plan Carrier that it meets the applicable minimum requirements for Medicaid participation, including enrollment in Medicare, if applicable. Subcontractor and Health Plan Carrier will exclude from its network any provider who has been terminated or suspended from the Medicare or Medicaid program in any state.

Appears in 1 contract

Samples: learn.optumrx.com

Medicaid Eligibility. If applicable, Provider must meet minimum requirements for participation in the State ProgramsProgram. Provider may meet this requirement either by being enrolled with the State as a Medicaid provider or by demonstrating to Subcontractor and Health Plan and/or Subcontractor that it meets the applicable minimum requirements for Medicaid participation, including enrollment in Medicare, if applicable. Subcontractor and Health Plan and/or Subcontractor will exclude from its network any provider who has been terminated or suspended from the Medicare or Medicaid program in any state.

Appears in 1 contract

Samples: Downstream Provider

Medicaid Eligibility. If applicable, Provider must meet minimum requirements for participation in the State ProgramsProgram. Provider may meet this requirement either by being enrolled with the State as a Medicaid provider or by demonstrating to Subcontractor and Health Plan United that it meets the applicable minimum requirements for Medicaid participation, including enrollment in Medicare, if applicable. Subcontractor and Health Plan United will exclude from its network any provider Provider who has been terminated or suspended from the Medicare or Medicaid program in any state. Providers must meet all applicable credentialing criteria before being listed as a panel Provider.

Appears in 1 contract

Samples: learn.optumrx.com

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