Exclusively Aligned definition

Exclusively Aligned means a D-SNP enrolling only full benefit Dual-Eligible Beneficiaries who are also enrolled in an Integrated Medicaid Product offered by SDOH, including but not limited to Medicaid Advantage Plus (“MAP”), that is offered by the Medicare Advantage Organization, its parent organization (directly or indirectly), or another entity owned and controlled by its parent organization.
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Examples of Exclusively Aligned in a sentence

  • The counties within an Exclusively Aligned D-SNP’s Service Area shall be aligned with the service area of its Integrated Medicaid Product.

  • The following are applicable only to Health Plan’s operation of Exclusively Aligned D-SNPs.

  • MCO understands that this designation as a Highly Integrated D-SNP (HIDE SNP) includes that its integrated SNP enrollment will be Exclusively Aligned, and agrees to align administrative systems including beneficiary communication materials, enrollment, communications, grievances and appeals processes, and quality improvement, to improve efficiency and beneficiary experience.

  • One Care Plans and SCO Plans in Massachusetts must meet Massachusetts state and federal requirements to qualify as an Exclusively Aligned Fully Integrated Dual Eligible Special Needs Plan (Exclusively Aligned FIDE SNP), a specialized type of Medicare Advantage Plan that meets criteria for the highest level of integration for serving Dual Eligible individuals.

  • Health Plan’s Exclusively Aligned HIDE D-SNP shall implement a unified grievance and appeal system and process grievances and appeals in compliance with the terms of 42 CFR §§ 422.629 – 634, 438.210, 438.400 & 438.402.

  • A firm of commercial property agents has made an application for 80% mandatory charitable relief from business rates on behalf of two local NHS trusts.

  • Comparison between level of alignment and level of consistency ConsistentInconsistent Whereas the difference between Aligned and Unaligned categories was rather small, the majority of the students choose a job vacancy consistent with the role preference or role competence (87%, N=47).A more detailed analysis of the Aligned students indicated that 8 of the 13 Exclusively Aligned could also be categorized as Exclusively Consistent, 2 as Inclusively Consistent, 3 as Inconsistent.

  • Health Plan’s Exclusively Aligned FIDE or HIDE D-SNP shall implement a unified grievance and appeal system and process grievances and appeals in compliance with the terms of 42 CFR §§ 422.629 – 634, 438.210, 438.400 & 438.402.

  • Thus, IEHP will transition its CMC product and become an Exclusively Aligned Enrollment (EAE) D-SNP effective January 1, 2023, as required by the CalAIM initiative.

  • Office of Plan Licensing SUBJECT: APL 23-019 (OPL) Health Plan Expansion for Medicare Medi-Cal Plans This All Plan Letter (APL) provides background and identifies the subsets of health care service plans (plans) regulated by the Department of Managed Health Care (Department) that are required to submit a filing for Medicare Medi-Cal Plans (MMPs), the California-specific names for Exclusively Aligned Enrollment Dual Eligible Special Needs Plans (EAE D-SNPs).

Related to Exclusively Aligned

  • Stinger-steered automobile or watercraft transporter means an automobile or watercraft transporter

  • Grocery store means any retail establishment, the business of which consists of the sale of food, food products, or beverages for consumption off the premises.

  • Effectively owned or controlled means that a foreign government or any entity controlled by a foreign government has the power, either directly or indirectly, whether exercised or exercisable, to control the election, appointment, or tenure of the Offeror's officers or a majority of the Offeror's board of directors by any means, e.g., ownership, contract, or operation of law (or equivalent power for unincorporated organizations).

  • Nursery stock means all domesticated or wild botanically classified hardy perennial or biennial trees, shrubs, vines, and other plants; cuttings, grafts, scions, buds, bulbs, rhizomes, or roots of any of these; and fruit pits. Nursery stock includes plants and plant parts for, or capable of, propagation, excepting field, vegetable, and flower seeds, corms, and tubers.

  • Female owned business means a business concern which is at least 51% owned by one or more women, or, in the case of a corporation, at least 51% of the stock in which is owned by one or more women; and the management and daily business operations of which are controlled by one or more of the women who own it.

  • CAFRA Centers, Cores or Nodes means those areas with boundaries incorporated by reference or revised by the Department in accordance with N.J.A.C. 7:7-13.16.

  • Constructively Owned shall have the correlative meanings.

  • Common Channel Signaling (CCS) means an out-of-band, packet-switched, signaling network used to transport supervision signals, control signals, and data messages. It is a special network, fully separate from the transmission path of the public switched network. Unless otherwise agreed by the Parties, the CCS protocol used by the Parties shall be SS7.

  • Established business relationship means a relationship between a seller and a consumer based on:

  • Younger-generation substitute gift means the substitute gift created with respect to the younger-generation future interest.

  • Extremely low-income household means a single person,

  • Established geographic service area means a geographic area, as approved by the Commissioner and based on the carrier's certificate of authority to transact insurance in this state, within which the carrier is authorized to provide coverage;

  • Retail marijuana store means an entity licensed to purchase marijuana from marijuana cultivation facilities and marijuana and marijuana products from marijuana product manufacturing facilities and to sell marijuana and marijuana products to consumers.

  • Automobile or watercraft transporters means any tractor truck, lowboy, vehicle, or combination,

  • Wholly-Owned means, with respect to a Subsidiary of a Person, a Subsidiary of such Person all of the outstanding Equity Interests of which (other than (x) director’s qualifying shares and (y) shares issued to foreign nationals to the extent required by applicable Law) are owned by such Person and/or by one or more wholly owned Subsidiaries of such Person.

  • Retail Store – means any business facility that sells goods directly to the consumer whether for or not-for-profit, including, but not limited to, retail stores, restaurants, pharmacies, convenience and grocery stores, liquor stores, as well as seasonal and temporary businesses.

  • Area of shallow flooding means a designated AO or AH Zone on a community's Flood Insurance Rate Map (FIRM) with one percent or greater annual chance of flooding to an average depth of one to three feet where a clearly defined channel does not exist, where the path of flooding is unpredictable and indeterminate; and where velocity flow may be evident. Such flooding is characterized by ponding or sheet flow.

  • Excluded Affiliates means, collectively, any Affiliates of any of the Lead Arrangers that are engaged as principals primarily in private equity, mezzanine financing or venture capital.

  • Combination carrier means a ship designed to carry either oil or solid cargoes in bulk.

  • Common Channel Signaling (CCS means an out-of-band, packet-switched, signaling network used to transport supervision signals, control signals, and data messages. It is a special network, fully separate from the transmission path of the public switched network. Unless otherwise agreed by the Parties, the CCS protocol used by the Parties shall be SS7.

  • Generating Unit means one or more generating equipment combinations typically consisting of prime mover(s), electric generator(s), electric transformer(s), steam generator(s) and air emission control devices.

  • Mobile food unit means a vehicle-mounted food service establishment designed to be readily movable.

  • Mixed beverage or "mixed alcoholic beverage" means a drink composed in whole or in part of

  • Brands means the Sprint PCS Brands and the Sprint Brands.

  • Anatomical gift means a donation of all or part of a human body to take effect after the donor's death for the purpose of transplantation, therapy, research, or education.

  • Stores means the goods specified in the Supply Order or schedule which the supplier / contractor has agreed to supply under contract.