First Tier Entity definition

First Tier Entity means any party that enters into a written arrangement, acceptable to CMS, with an MA Plan to provide administrative services or health care services for a Member. LIBERTY is a First Tier Entity for various MA Plans.

First Tier Entity means any party that enters into a written arrangement, acceptable to ODM, with the MCOP to provide administrative services for Ohio Medicaid-eligible individuals.

First Tier Entity has the meaning set out in 42 C.F.R. § 422.500(b) and § 423.501. First Tier Entities consist of MA Plan’s subcontractors, including Dentist, that provide administrative services or dental care services to MA Member.

Examples of First Tier Entity in a sentence

• CMS requires that specific terms and conditions be incorporated into the Agreement between a Medicare Advantage Organization or First Tier Entity and a First Tier Entity or Downstream Entity to comply with the Medicare laws, regulations, and CMS instructions, including, but not limited to, the Medicare Prescription Drug, Improvement and Modernization Act of 2003, Pub.

• Downstream Entity: any party that enters into a written arrangement, acceptable to CMS, with persons or entities involved with the Medicare Advantage or Medicare Prescription Drug benefit, below the level of the arrangement between Company and a First Tier Entity.

• First Tier Entity: any party that enters into a written arrangement, acceptable to CMS, with the Company to provide administrative services or health care services for a Medicare eligible individual under the Medicare Advantage or Medicare Prescription Drug program.

• Downstream Entity means any party that enters into an acceptable written arrangement below the level of arrangement between an ICDS Plan and a First Tier Entity.

• Any party that enters into a written arrangement, acceptable to CMS, with persons or entities involved with the MA benefit or Part D benefit, below the level of the arrangement between ATRIO and a First Tier Entity.

More Definitions of First Tier Entity

First Tier Entity. Any party that enters into a written arrangement, acceptable to CMS, with an MA Organization or MA Organization applicant to provide administrative services or health care services for a Medicare eligible individual under the MA program.

First Tier Entity means any party that enters into a written arrangement to provide administrative or health care services.

First Tier Entity has the same definition as in 42 C.F.R. §§ 422.2 and 423.4, which, at the time of execution of this MA PPO Addendum, means any person or entity that enters into a written arrangement with The Plan to provide administrative and/or health care services, including Covered Services, to MA PPO Members.

First Tier Entity has the same definition as in 42 C.F.R. §§ 422.2 and 423.4, which, at the time of execution of this MA HMO Addendum, means any person or entity that enters into a written arrangement with BlueLincs HMO to provide administrative and/or health care services, including Covered Services, to MA HMO Members.

First Tier Entity means any party that enters into a written agreement, acceptable to CMS, with Health Plan or applicant to provide administrative services or health care services for a Medicare eligible individual under the Medicare Advantage Program.

First Tier Entity means Alivi.

First Tier Entity means any party that enters into a written arrangement with HPSM to provide administrative services or health care services for a Medicare eligible individual.