New Medicaid Recipients Sample Clauses

New Medicaid Recipients. Individuals determined eligible for Centennial Care after October 2018 and before January 1, 2019, will select a current Centennial Care MCO at the time of application for Medicaid eligibility. These individuals will also have an opportunity to select a Centennial Care 2.0 MCO prior to January 1, 2019. Recipients eligible on or after January 1, 2019, will have the opportunity to select a Centennial Care 2.0 MCO at the time of application. Recipients who fail to select a Centennial Care 2.0 MCO at such time will be auto assigned in accordance with Section 4.2.4 of this Agreement.
Sample 1Sample 2Sample 3See All (14)
AutoNDA by SimpleDocs
New Medicaid Recipients. Individuals determined eligible for Centennial Care 2.0 after April 2024 and before July 1, 2024, will select a current Centennial Care 2.0 MCO at the time of application for Medicaid eligibility. These individuals will also have an opportunity to select a Turquoise Care MCO prior to July 1, 2024. Recipients eligible on or after July 1, 2024, will have the opportunity to select a Turquoise Care MCO at the time of application. Recipients who do not select a Turquoise Care MCO upon the opportunity to do so will be auto-assigned in accordance with Section 4.2.5 of this Agreement.
Sample 1Sample 2Sample 3See All (10)
New Medicaid Recipients. The effective date of enrollment for Recipients who are enrolled in accordance with Section 4.2.3 of this Agreement is the first day of the month in which the Recipient’s eligibility becomes effective.
Sample 1Sample 2Sample 3
New Medicaid Recipients. Individuals determined eligible for Centennial Care on or after January 1, 2014, and who did not select or were not assigned to an MCO in accordance with Section 4.2.2 of this Agreement, must select an MCO at the time of applying for Medicaid eligibility. Recipients who fail to select an MCO at such time will be auto assigned to an MCO in accordance with Section 4.2.4 of this Agreement.
Sample 1
New Medicaid Recipients. (Revised in RFP A2:) Individuals determined eligible for Centennial Care after October 2018 and before January 1, 2019 will select a current Centennial Care MCO at the time of application for Medicaid eligibility. These individuals will also have an opportunity to select a Centennial Care 2.0 MCO prior to Jan 1, 2019. Recipients eligible on or after January 1, 2019 will have the opportunity to select a Centennial Care 2.0 MCO at the time of application. Recipients who fail to select a Centennial Care 2.0 MCO at such time will be auto assigned in accordance with Section 4.2.4 of this Agreement. Individuals determined eligible for Centennial Care on or after January 1, 2019, and who did not select or were not assigned to a MCO in accordance with Section 4.2.2 of this Agreement, must select a MCO at the time of applying for Medicaid eligibility. Recipients who fail to select a MCO at such time will be auto assigned to a MCO in accordance with Section 4.2.4 of this Agreement.
Sample 1

Related to New Medicaid Recipients

  • Medicaid Program Parties (applicable to any Party providing services and supports paid for under Vermont’s Medicaid program and Vermont’s Global Commitment to Health Waiver):

  • Medicaid Enrollment Treatment Grantees shall enroll as a provider with Texas Medicaid and Healthcare Partnership (TMHP) and all Medicaid Managed Care organizations in Grantee’s service region within the first quarter of this procurement term and maintain through the procurement term.

  • Health Care Operations “Health Care Operations” shall have the same meaning as the term “health care operations” in 45 CFR §164.501.

  • COVERED HEALTHCARE SERVICES This section describes covered healthcare services. This plan covers services only if they meet all of the following requirements: • Listed as a covered healthcare service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered healthcare service under this plan. • Medically necessary, consistent with our medical policies and related guidelines at the time the services are provided. • Not listed in Exclusions Section. • Received while a member is enrolled in the plan. • Consistent with applicable state or federal law. We review medical necessity in accordance with our medical policies and related guidelines. Our medical policies can be found on our website. Our medical policies are written to help administer benefits for the purpose of claims payment. They are made available to you for informational purposes and are subject to change. Medical policies are not meant to be used as a guide for your medical treatment. Your medical treatment remains a decision made by you with your physician. If you have questions about our medical policies, please call Customer Service. When a new service or drug becomes available, when possible, we will review it within six (6) months of one of the events described below to determine whether the new service or drug will be covered: • the assignment of an American Medical Association (AMA) Current Procedural Terminology (CPT) code in the annual CPT publication; • final Food and Drug Administration (FDA) approval; • the assignment of processing codes other than CPT codes or approval by governing or regulatory bodies other than the FDA; • submission to us of a claim meeting the criteria above; and • generally, the first date an FDA approved prescription drug is available in pharmacies (for prescription drug coverage only). During the review period, new services and drugs are not covered. For all covered healthcare services, please see the Summary of Medical Benefits and the Summary of Pharmacy Benefits to determine the amount that you pay and any benefit limits.

  • HEALTH CARE PLANS ‌ Notwithstanding the references to the Pacific Blue Cross Plans in this article, the parties agree that Employers, who are not currently providing benefits under the Pacific Blue Cross Plans may continue to provide the benefits through another carrier providing that the overall level of benefits is comparable to the level of benefits under the Pacific Blue Cross Plans.

  • Child Care The County will continue to support the concept of non-profit child care facilities similar to the “Kid’s at Work” program established in the Public Works Department.

  • Family Care and Medical Leave An unpaid Family Care and Medical Leave shall be granted, to the extent of and subject to the restrictions as set forth below, to an employee who has been employed for at least twelve (12) months and who has served for 130 workdays during the twelve (12) months immediately preceding the effective date of the leave. For purposes of this Section, furlough days and days worked during off-basis time shall count as "workdays". Family Care and Medical Leave absences of twenty (20) consecutive working days or less can be granted by the immediate administrator or designee. Leaves of twenty (20) or more consecutive working days can be granted only by submission of a formal leave application to the Personnel Commission.

  • Medicaid If and when the Resident’s assets/funds have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements and is not entitled to any other third party coverage, the Resident may be eligible for Medicaid (often referred to as the “payor of last resort”). THE RESIDENT, RESIDENT REPRESENTATIVE AND SPONSOR AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS (APPROXIMATELY $50,000) AND/OR INSURANCE COVERAGE TO CONFIRM THAT A MEDICAID APPLICATION HAS OR WILL BE SUBMITTED TIMELY AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, RESIDENT REPRESENTATIVE AND/OR SPONSOR AGREE TO PREPARE AND FILE AN APPLICATION FOR MEDICAID BENEFITS PRIOR TO THE

  • File Management and Record Retention relating to CRF Eligible Persons or Households Grantee must maintain a separate file for every applicant, Eligible Person, or Household, regardless of whether the request was approved or denied. a. Contents of File: Each file must contain sufficient and legible documentation. Documents must be secured within the file and must be organized systematically.

  • Subrecipients when submitting financial reporting packages to DEO for audits done in accordance with 2 CFR 200, Subpart F - Audit Requirements, or Chapters 10.550 (local governmental entities) and 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, should indicate the date that the reporting package was delivered to Subrecipient in correspondence accompanying the reporting package.

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!