Functionally Necessary Covered Services definition

Functionally Necessary Covered Services means Community-based Long Term Care services provided to assist STAR+PLUS Members with activities of daily living based on a functional assessment of the Member’s activities of daily living and a determination of the amount of supplemental supports necessary for the STAR+PLUS Member to remain independent or in the most integrated setting possible.
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Examples of Functionally Necessary Covered Services in a sentence

  • HMOs must provide Functionally Necessary Covered Services to Community Long-term Care Service Members.

  • MCOs must provide both Medically Necessary and Functionally Necessary Covered Services to Community Long-term Services and Supports Members.

  • A STAR+PLUS HMO must also make payment for all Functionally Necessary Covered Services provided to all Members for whom the HMO is paid a capitation.

  • All Members living within a STAR+PLUS MCO's Service Area must have access to Medically Necessary and Functionally Necessary Covered Services.

  • The MCO must ensure that current providers are paid for Medically Necessary and Functionally Necessary Covered Services that are delivered in accordance with the Member’s existing treatment/Long-Term Services and Supports plan after the Member has become enrolled in the MCO and until the transition plan is developed.

  • A STAR+PLUS MCO must also pay for all Functionally Necessary Covered Services provided to Members.

  • Valladares, eds., Cultural Issues in Criminal Defence (New York: Juris, 2000) (Looseleaf), c.

  • All Members living within a STAR+PLUS MCO’s Service Area must have access to Medically Necessary and Functionally Necessary Covered Services.

  • The MCO must ensure that current providers are paid for Medically Necessary and Functionally Necessary Covered Services that are delivered in accordance with the Member’s existing care plan after the Member is enrolled in the MCO and until the transition plan is developed.

  • The MCO must ensure that current Providers are paid for Medically Necessary and Functionally Necessary Covered Services that are delivered in accordance with the Member’s existing care plan after the Member is enrolled in the MCO and until the transition plan is developed.

Related to Functionally Necessary Covered Services

  • Medically Necessary Services means those covered services that are, under the terms and conditions of the contract, determined through contractor utilization management to be:

  • Covered Services means all or a part of those medical and health services set forth in rule 441—86.14(514I).

  • Dependent care assistance program means a benefit plan

  • Medically Necessary means a service which is appropriate and consistent with the treatment of the condition in accordance with accepted standards of community practice.

  • Primary Care Provider (PCP) means a health care professional who is contracted with BCBSAZ as a PCP and generally specializes in or focuses on the following practice areas: internal medicine, family practice, general practice, pediatrics or any other classification of provider approved as a PCP by BCBSAZ. Your benefit plan does not require you to have a PCP or to have a PCP authorize specialist referrals.

  • Medical personnel means those persons assigned, by a Party to the conflict, exclusively to the medical purposes enumerated under subparagraph (e) or to the administration of medical units or to the operation or administration of medical transports. Such assignments may be either permanent or temporary. The term includes:

  • Platform Services means the products and services that Platform Users receive from a Stripe Connect Platform, regardless of whether fees are charged (e.g., web development, customer support or hosting services).

  • Outpatient services means those services rendered in a practitioner’s office or in the department of an approved facility where services are rendered to persons who have not had an overnight stay and are not charged for room and board.

  • Shared Services means shared order filling or shared order processing, or both.

  • Contractor Personnel means and refers to Contractor’s employees and employees of Contractor’s permitted subcontractors or permitted agents assigned by Contractor to perform Services under this Contract.

  • Provider Personnel means all persons employed or engaged by the Provider together with the Provider’s servants, agents, consultants and Sub-Contractors (and all persons employed by any Sub-Contractor together with the Sub-Contractor’s servants, consultants, agents, Provider’s and Sub-Contractors) used in the performance of its obligations under this Agreement;

  • Managed Services means the services provided by a Client to End Users using the SaaS and Client’s intellectual capital and/or additional services supplied by Client.

  • Medical Reimbursement Programs means a collective reference to the Medicare, Medicaid and TRICARE programs and any other health care program operated by or financed in whole or in part by any foreign or domestic federal, state or local government.