Dually Eligible definition
Examples of Dually Eligible in a sentence
The MCO/SNP agrees to apply any Medicare savings not utilized to buy down the Medicare Part D premium to meet the LIS standard in accordance with CMS guidance or required to be returned to CMS, for the benefit of Dually Eligible Enrollees of the SNP and agrees to consult with STATE about any such benefits offered prior to the initial MCO agrees to notify the STATE of changes in such benefits following the approval of the bid.
DSRIP payments made to the Contractor, as appropriate, to support the transition of Participating Safety Net Hospitals, as described in Section 5.2.B. Dually Eligible – individuals determined eligible for both Medicaid and Medicare.
Health Plan’s D-SNP aligned with the Integrated Benefits for Dually Eligible Enrollees Program (IB-Dual) for MMC/HARP is permitted to also enroll Medicaid FFS beneficiaries and may enroll the categories of Dual Eligible Beneficiaries listed above in D.1.
The Contractor shall electronically submit all materials related to marketing Medicaid Advantage to Dually Eligible persons to the CMS Regional Office for prior written approval.
The MCO/SNP agrees to apply any Medicare savings not utilized to buy down the Medicare Part D premium to meet the LIS standard in accordance with CMS guidance or required to be returned to CMS, for the benefit of Dually Eligible Enrollees of the SNP and agrees to consult with STATE about any such benefits offered prior to the initial submission of the bids to CMS.
Health Plan’s D-SNP aligned with the Integrated Benefits for Dually Eligible Enrollees Program (IB-Dual) for MMC/HARP is permitted to also enroll Medicaid FFS beneficiaries and may enroll the categories of Dual Eligible Beneficiaries listed above in E.1.
Retrospective DUR shall utilize telephonic or written interventions with prescribers to determine medical necessity for prescribed medications Dual-Eligible Special Needs Plan (D-SNP)--means the program that the State developed to enroll persons who are Dually Eligible for both Medicaid and Medicare into a Coordinated Care Plan as defined by the Medicare Modernization Act of 2003 and amended by the Medicare Improvements for Patients and Providers Act of 2008.
Consultant will provide Company ECB and/or Board of Managers during the Term (and any extension thereof) bi-weekly written reports setting forth the general nature of the Services and status of all negotiations provided, rendered or held during such period involving Consultant, including the names of companies/agencies communicated with and the identities of the individuals contacted thereat.
Factors As of 2018, the nationwide CMS Data records include approximately 12 million beneficiaries who are identified as Dually Eligible Individuals.
D-SNP Contractor may also enroll Full-benefit Dual-Eligible Beneficiaries, which includes QMB+, SLMB+, and Other Full Benefit Dually Eligible Beneficiaries who are also enrolled in the MCP affiliated with D-SNP Contractor.