Common use of Medication Therapy Management Clause in Contracts

Medication Therapy Management. A process that promotes safe and effective use of medications, including prescription and over-the-counter drugs, vitamins, and herbal supplements. Member – As defined in OAC rule 5160-26-01, a Medicaid-eligible individual who has selected MCO membership or has been assigned to an MCO for the purpose of receiving health care services. Member Incentive Program – A time-limited monetary or non-monetary reward offered to a member who complies with the intended goals of the MCO's program (e.g., recommended health screenings). Member Materials – Items developed by or on behalf of the MCO to fulfill MCO program requirements or to communicate to all members or a group of members. Member materials include member education, member appreciation, and member incentive program information. Member health education materials produced by a source other than the MCO and which do not include any reference to the MCO are not considered to be member materials. Members with Special Health Care Needs – Individuals, as identified in the MCO's Quality Assurance Performance Improvement (QAPI) program, who have or are at increased risk for chronic, physical, developmental, behavioral, or emotional conditions and who require health and related services of a type or amount beyond that required by individuals generally. Merger – A transaction in which two companies join together to form a single entity, using both companies' assets or stock, or, for non-stock corporations (e.g., non-profit corporations), the conversion of memberships, sponsors, or their voting rights. Both companies cease to exist separately and new stock is issued for the resulting organization or, for non-stock corporations (e.g., non-profit corporations), memberships or sponsors are combined or their voting rights are transferred to the new corporation. Misappropriation – Depriving, defrauding, or otherwise obtaining the money, or real or personal property (including medication) of a member by any means prohibited by law. Mobile Response and Stabilization Services (MRSS) – As provided in OAC rule 5160-27-13, MRSS is a mobile response stabilization service for young people who are experiencing significant behavioral or emotional challenges and their families. The service may be delivered through a face-to-face mobile response to the young person’s home, school, a local emergency department (ED), or another location in the community, including a location preferred by the family. MRSS is available 24 hours a day, 365 days a year. The purpose of MRSS is to provide rapid community-based crisis assessment and stabilization to young people and their families and to build the skills needed to help maintain young people in their homes and communities whenever safe and possible. In addition to the direct provision of crisis intervention and stabilization services, MRSS providers link young people and their families to ongoing clinical and natural supports and services through a facilitated Child and Family Team planning process. MRSS consists of a series of four phases of services including: triage and initial mobile response; assessment and planning; stabilization; and service transition. MRSS provides young people and their caregivers with short-term, flexible services to assist in stabilizing young people in their community setting. Interventions are designed to maintain the young person in their current living arrangement and to stabilize behavioral health needs to improve functioning in all life domains. Neglect – When there is a duty to do so, the failure to provide goods, services, and/or treatment necessary to assure the health, safety, and welfare of a member. Network Provider – Consistent with 42 CFR 438.2, any provider, group of providers, or entity that has a network provider contract with the MCO and receives Medicaid funding directly or indirectly to order, refer, or render covered services as a result of ODM's provider agreement with the MCO. A network provider is not a subcontractor by virtue of the network provider contract.

Medication Therapy Management. A process that promotes safe and effective use of medications, including prescription and over-the-counter drugs, vitamins, and herbal supplements. Member – As defined in OAC rule 5160-26-01, a Medicaid-eligible individual who has selected MCO membership or has been assigned to an MCO for the purpose of receiving health care services. Member Incentive Program – A time-limited monetary or non-monetary reward offered to a member who complies with the intended goals of the MCO's program (e.g., recommended health screenings). Member Materials – Items developed by or on behalf of the MCO to fulfill MCO program requirements or to communicate to all members or a group of members. Member materials include member education, member appreciation, and member incentive program information. Member health education materials produced by a source other than the MCO and which do not include any reference to the MCO are not considered to be member materials. Members with Special Health Care Needs – Individuals, as identified in the MCO's Quality Assurance Performance Improvement (QAPI) program, who have or are at increased risk for chronic, physical, developmental, behavioral, or emotional conditions and who require health and related services of a type or amount beyond that required by individuals generally. Merger – A transaction in which two companies join together to form a single entity, using both companies' assets or stock, or, for non-stock corporations (e.g., non-profit corporations), the conversion of memberships, sponsors, or their voting rights. Both companies cease to exist separately separately, and new stock is issued for the resulting organization or, for non-stock corporations (e.g., non-profit corporations), memberships or sponsors are combined or their voting rights are transferred to the new corporation. Misappropriation – Depriving, defrauding, or otherwise obtaining the money, or real or personal property (including medication) of a member by any means prohibited by law. Mobile Response and Stabilization Services (MRSS) – As provided in OAC rule 5160-27-13, MRSS is a mobile response stabilization service for young people who are experiencing significant behavioral or emotional challenges and their families. The service may be delivered through a face-to-face mobile response to the young person’s home, school, a local emergency department (ED), or another location in the community, including a location preferred by the family. MRSS is available 24 hours a day, 365 days a year. The purpose of MRSS is to provide rapid community-based crisis assessment and stabilization to young people and their families and to build the skills needed to help maintain young people in their homes and communities whenever safe and possible. In addition to the direct provision of crisis intervention and stabilization services, MRSS providers link young people and their families to ongoing clinical and natural supports and services through a facilitated Child and Family Team planning process. MRSS consists of a series of four phases of services including: triage and initial mobile response; assessment and planning; stabilization; and service transition. MRSS provides young people and their caregivers with short-term, flexible services to assist in stabilizing young people in their community setting. Interventions are designed to maintain the young person in their current living arrangement and to stabilize behavioral health needs to improve functioning in all life domains. Neglect – When there is a duty to do so, the failure to provide goods, services, and/or treatment necessary to assure the health, safety, and welfare of a member. Network Provider – Consistent with 42 CFR 438.2, any provider, group of providers, or entity that has a network provider contract with the MCO and receives Medicaid funding directly or indirectly to order, refer, or render covered services as a result of ODM's provider agreement with the MCO. A network provider is not a subcontractor by virtue of the network provider contract.

Medication Therapy Management. A process that promotes safe and effective use of medications, including prescription and over-the-counter drugs, vitamins, and herbal supplements. Member – As defined in OAC rule 5160-26-01, a Medicaid-eligible individual who has selected MCO membership or has been assigned to an MCO for the purpose of receiving health care services. Member Incentive Program – A time-limited monetary or non-monetary reward offered to a member who complies with the intended goals of the MCO's program (e.g., recommended health screenings). Member Materials – Items developed by or on behalf of the MCO to fulfill MCO program requirements or to communicate to all members or a group of members. Member materials include member education, member appreciation, and member incentive program information. Member health education materials produced by a source other than the MCO and which do not include any reference to the MCO are not considered to be member materials. Members with Special Health Care Needs – Individuals, as identified in the MCO's Quality Assurance Performance Improvement (QAPI) program, who have or are at increased risk for chronic, physical, developmental, behavioral, or emotional conditions and who require health and related services of a type or amount beyond that required by individuals generally. Merger – A transaction in which two companies join together to form a single entity, using both companies' assets or stock, or, for non-stock corporations (e.g., non-profit corporations), the conversion of memberships, sponsors, or their voting rights. Both companies cease to exist separately and new stock is issued for the resulting organization or, for non-stock corporations (e.g., non-profit corporations), memberships or sponsors are combined or their voting rights are transferred to the new corporation. Misappropriation – Depriving, defrauding, or otherwise obtaining the money, or real or personal property (including medication) of a member by any means prohibited by law. Mobile Response and Stabilization Services (MRSS) – As provided in OAC rule 5160-27-13, MRSS is a mobile response stabilization service for young people who are experiencing significant behavioral or emotional challenges and their families. The service may be delivered through a face-to-face mobile response to the young person’s home, school, a local emergency department (ED), or another location in the community, including a location preferred by the family. MRSS is available 24 hours a day, 365 days a year. The purpose of MRSS is to provide rapid community-based crisis assessment and stabilization to young people and their families and to build the skills needed to help maintain young people in their homes and communities whenever safe and possible. In addition to the direct provision of crisis intervention and stabilization services, MRSS providers link young people and their families to ongoing clinical and natural supports and services through a facilitated Child child and Family Team family team planning process. MRSS consists of a series of four phases of services including: triage and initial mobile response; assessment and planning; stabilization; and service transition. MRSS provides young people and their caregivers with short-term, flexible services to assist in stabilizing young people in their community setting. Interventions are designed to maintain the young person in their current living arrangement and to stabilize behavioral health needs to improve functioning in all life domains. Neglect – When there is a duty to do so, the failure to provide goods, services, and/or treatment necessary to assure the health, safety, and welfare of a member. Network Provider – Consistent with 42 CFR 438.2, any provider, group of providers, or entity that has a network provider contract with the MCO and receives Medicaid funding directly or indirectly to order, refer, or render covered services as a result of ODM's provider agreement with the MCO. A network provider is not a subcontractor by virtue of the network provider contract.