Penultimate Saturday Clause Samples

Penultimate Saturday. The Saturday preceding the last Saturday of the month. Penultimate Sunday — The Sunday preceding the last Sunday of the month. Person (entity) — In relation to fraud and abuse requirements, any natural person, corporation, partnership, association, clinic, group, or other entity, whether or not such person is enrolled in the Medicaid program or is a provider of health care. (See Florida Medicaid Provider General Handbook.)

Penultimate Saturday. The Saturday preceding the last Saturday of the month. Person Centered Approach — A nondirective approach to care planning that encourages the maximum participation of an enrollee and the enrollee’s family in the decision making process.

Penultimate Saturday. The Saturday preceeding the last Saturday of the month. Penultimate Sunday — The Sunday preceeding the last Sunday of the month. Pharmacy Benefits Administrator — An entity contracted to or included in a health plan accepting pharmacy prescription claims for enrollees in the plan, assuring these claims conform to coverage policy and determining the allowed payment.

Penultimate Saturday. The Saturday preceding the last Saturday of the month. Person Centered Approach — A nondirective approach to care planning that encourages the maximum participation of an enrollee and the enrollee's family in the decision making process. Person Centered Planning (PCP) – A process to produce a plan of care that includes an enrollee's care needs and includes the enrollee's service needs, personal goals and community activities..

Penultimate Saturday. The Saturday preceding the last Saturday of the month. -- The definition of Penultimate Saturday is hereby amended to read as follows: Penultimate Sunday — The Sunday preceding the last Sunday of the month. -- The definition for Quality Improvement Plan is hereby included as follows: Quality Improvement Plan (QI Plan) — A written document that describes the Health Plan’s Quality Improvement Program (QIP), processes, and current strategy for improving the health care outcomes of its Enrollees. It shall include, at a minimum, all components required in Section VIII, A.2.b.(1) through (10). -- The definition for Risk Adjustment is hereby included as follows: Risk Adjustment (also Risk-Adjusted) - A process to adjust Capitation Rates to reflect the health conditions relative to the health status of the enrolled population. This process includes but is not limited to, risk assessment models, demographics, or population grouping. -- The definition for Specialty Plan is included as follows: Specialty Plan – A Health Plan designed for a specific population and whose Enrollees are primarily composed of Medicaid Recipients, Children with Chronic Conditions or for Medicaid Recipients who have been diagnosed with the human immunodeficiency virus or acquired immunodeficiency syndrome (HIV/AIDS). A Health Plan must be licensed under Chapter 641, Florida Statutes, in order to offer a Specialty Plan for the population with HIV/AIDS.