Common use of Restricted Medicaid Coverage Periods Clause in Contracts

Restricted Medicaid Coverage Periods. The MCOP must ensure accurate claims payment to nursing facility (NF) and home and community-based services (HCBS) waiver providers by appropriately modifying payment when a member has patient liability obligations, lump sum amount(s) pursuant to 5160-3-39.1, and/or restricted Medicaid coverage periods (RMCP). The MCOP is prohibited from paying for NF services and LTSS during an RMCP. The MCOP must utilize HIPAA compliant enrollment files for patient liability obligations and RMCPs.

Restricted Medicaid Coverage Periods. The MCOP must shall ensure accurate claims payment to nursing facility (NF) and home and community-based services (HCBS) waiver providers by appropriately modifying payment when a member has patient liability obligations, lump sum amount(s) pursuant to 5160-3-39.1, and/or restricted Medicaid coverage periods (RMCP). The MCOP is prohibited from paying for NF services and LTSS during an RMCP. The MCOP must shall utilize HIPAA compliant enrollment files for patient liability obligations and RMCPs.

Restricted Medicaid Coverage Periods. The MCOP must shall ensure accurate claims payment to nursing facility (NF) and home and community-based community‐based services (HCBS) waiver providers by appropriately modifying payment when a member has patient liability obligations, lump sum amount(s) pursuant to 5160-3-39.15160‐3‐39.1, and/or restricted Medicaid coverage periods (RMCP). The MCOP is prohibited from paying for NF services and LTSS during an RMCP. The MCOP must shall utilize HIPAA compliant enrollment files for patient liability obligations and RMCPs.

Restricted Medicaid Coverage Periods. The MCOP must ensure accurate claims payment to nursing facility (NF) and home and community-based community‐based services (HCBS) waiver providers by appropriately modifying payment when a member has patient liability obligations, lump sum amount(s) pursuant to 5160-3-39.15160‐3‐39.1, and/or restricted Medicaid coverage periods (RMCP). The MCOP is prohibited from paying for NF services and LTSS during an RMCP. The MCOP must utilize HIPAA compliant enrollment files for patient liability obligations and RMCPs.