Directed Payment means an Excess Payment that is:
Directed Payment means Provider payments as directed by HCA and approved by CMS in accordance with 42 C.F.R. § 438.6(c). Dual Eligible(s) means individuals who – by reason of age, income, and/or disability – qualify for Medicare and full Medicaid benefits under Section 1902(a)(10)(A) or 1902(a)(10)(C) of the Social Security Act, under Section 1902(f) of the Social Security Act or under any other category of eligibility (XXX) for medical assistance for full benefits. Dual Eligible Special Needs Plans (D-SNP) means plans that enroll Members who are entitled to both Medicare (Title XVIII) and Medical Assistance from a State Plan under Title XIX (Medicaid), and offer the opportunity of enhanced benefits by combining those available through Medicare and Medicaid. Durable Medical Equipment (DME) means equipment and supplies that are primarily used to serve a medical purpose, that are medically necessary to individuals with an illness, physical disability, or injury and that are commonly used at home. Early and Periodic Screening, Diagnostic and Treatment (EPSDT) means the federally required Early and Periodic Screening, Diagnostic and Treatment program, as defined in Section 1905(r) of the Social Security Act and 42 C.F.R. § 441, Subpart B for Members under the age of twenty-one (21). It includes comprehensive periodic and inter-periodic screening and diagnostic services to determine Physical and Behavioral Health needs as well as the provision of all Medically Necessary Services listed in Section 1902(a) of the Social Security Act even if the service is not available under the State’s Medicaid State Plan. Electronic Clinical Data Systems (ECDS) are a NCQA network of HEDIS data containing a Member’s personal health information and records of their experiences within the health care system. Electronic Health Record (EHR) means a record in digital format that is a systematic collection of electronic health information. EHRs may contain a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, xxxxx xxxxx, personal statistics such as age and weight, and billing information. Emergency Medical Condition means a Physical Health or Behavioral Health condition manifesting itself through acute symptoms of sufficient severity (including nerve pain) such that a prudent layperson with average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result i...
Directed Payment means a payment to be made to the Offering Parties by the Stockholders in connection with a Substitute Acquisition, which payment shall be made (a) if possible, by the Stockholders directing the counterparty to, or paying agent for or with respect to, a Substitute Acquisition to make payments in the amounts required by this Agreement and consistent with the Payment Methodology to the Offering Parties upon the consummation of such Substitute Acquisition, or (b) if payment as contemplated by subsection (a) immediately above is not possible, by wire transfer made by the Stockholders to the Offering Parties in the amounts specified by this Agreement and consistent with the Payment Methodology, with such payments to be made concurrently with the Stockholders’ receipt of Gross Proceeds with respect to a Substitute Acquisition.
Examples of Directed Payment in a sentence
HCA shall communicate the requirements of the Directed Payment to the CONTRACTOR through a Letter of Direction.
All assurances specified in 42 C.F.R. § 438.6(c)(2)(ii)-(iii) applicable to the type of Directed Payment, as defined in 42 C.F.R. § 438.6(c)(1)(i)-(iii), and made by HCA part of the approval process for Directed Payments are restated and reaffirmed.
More Definitions of Directed Payment
Directed Payment means three hundred thousand dollars ($300,000).
Directed Payment means Provider payments as directed by HSD and approved by CMS in accordance with 42 C.F.R. § 438.6(c). Dual Eligible(s) means individuals who – by reason of age, income, and/or disability – qualify for Medicare and full Medicaid benefits under Section 1902(a)(10)(A) or 1902(a)(10)(C) of the Social Security Act, under Section 1902(f) of the Social Security Act or under any other category of eligibility (XXX) for medical assistance for full benefits. Dual Eligible Special Needs Plans (D-SNP) means plans that enroll members who are entitled to both Medicare (Title XVIII) and Medical Assistance from a State Plan under Title XIX (Medicaid), and offer the opportunity of enhanced benefits by combining those available through Medicare and Medicaid. Durable Medical Equipment (DME) means equipment and supplies that are primarily used to serve a medical purpose, that are medically necessary to individuals with an illness, physical disability, or injury and that are commonly used at home. Early and Periodic Screening, Diagnostic and Treatment (EPSDT) means the federally required Early and Periodic Screening, Diagnostic and Treatment program, as defined in Section 1905(r) of the Social Security Act and 42 C.F.R. § 441, Subpart B for Members under the age of twenty-one (21). It includes comprehensive periodic and inter-periodic screening and diagnostic services to determine Physical and Behavioral Health needs as well as the provision of all Medically Necessary Services listed in Section 1902(a) of the Social Security Act even if the service is not available under the State’s Medicaid State Plan.
Directed Payment means a payment arrangement authorized by CMS that permits the department to direct specific payments made by a managed care plan to providers.