Indian Managed Care Entities definition

Indian Managed Care Entities. (IMCE) means a CCO, MCO, PIHP, PAHP, PCCM, or PCCM entity that is controlled (section 1903(m)(1)(C) of the Act) by the Indian Health Service, a Tribe, Tribal Organization, or Urban Indian Organization, or a consortium, which may be composed of one or more Tribes, Tribal Organizations, or Urban Indian Organizations, and which also may include the Service.
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Examples of Indian Managed Care Entities in a sentence

  • The MCO must follow the requirements related to Indians, Indian Health Care Providers, and Indian Managed Care Entities in accordance with the terms of 42 CFR 438.14.

  • In the latter,the stakeholders may be readily identifiable, while in the former identification of the relevant or legitimate beneficiaries may be more complicated.

  • ICRs Regarding Requirements That Apply to MCO, PIHP, PAHP, and PCCM Contracts Involving Indians, Indian Health Care Providers, and Indian Managed Care Entities (§ 457.1208)Section 457.1208 would apply the requirements of § 438.14 to CHIP.

  • New Statutory Requirements Regarding Indians, Indian Health Care Providers, Indian Managed Care Entities in Medicaid, and CHIP Managed Care Programs Section 5006(d) of the Recovery Act adds a new section 1932(h) to the Medicaid statute and section 2107(e)(1)(J) to the CHIP statute, which will apply consistent rules governing the treatment of Indians, Indian health care providers–I/T/Us, and Indian Managed Care Entities (IMCEs) in a State Medicaid or CHIP managed care program.

  • OHA and Tribes have engaged in discussions about one or more Tribes becoming Indian Managed Care Entities under federal law.

  • Also on the reasons causing judiciary overload, see J.W. COOLEY, Puncturing Three Myths about Litigation, In ABA Journal, The Lawyer’s Magazine, 1984, p.

  • AAG Ted Falk assisted OHA in its work to create Indian Managed Care Entities with four tribes and NARA NW.

  • The special provisions applicable to MCO, PIHP, PAHP, PCCM, AND PCCM entity contracts involving AI/ANs, IHCPs and Indian Managed Care Entities (IMCEs) are found in § 438.14.

  • CareOregon reports high rates of member satisfaction with the program, which has been renewed for a second year.OHA has been working with tribal health representatives from Oregon’s nine Federally-recognized Tribes to support efforts to establish one or more Indian Managed Care Entities.

  • Rules Applicable Under Medicaid and CHIP to Managed Care Entities with Respect to Indian Enrollees and Indian Health Care Providers and Indian Managed Care Entities; • S.Amdt.

Related to Indian Managed Care Entities

  • Managed health care system means: (a) Any health care

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • CMS means the Centers for Medicare and Medicaid Services.

  • Managed care organization means an entity that (1) is under contract with the department to provide services to Medicaid recipients and (2) meets the definition of “health maintenance organization” as defined in Iowa Code section 514B.1.

  • Managed Care Organization (MCO) means a contracted health delivery system providing capitated or prepaid health services, also known as a Prepaid Health Plan (PHP). An MCO is responsible for providing, arranging, and making reimbursement arrangements for covered services as governed by state and federal law. An MCO may be a Chemical Dependency Organization (CDO), Dental Care Organization (DCO), Mental Health Organization (MHO), or Physician Care Organization (PCO).

  • Health Care Operations shall have the meaning given to such term under the HIPAA 2 Privacy Rule in 45 CFR § 164.501.

  • Indian Health Care Provider means a health care program operated by the Indian Health Service (IHS) or by an Indian Tribe, Tribal Organization, or Urban Indian Organization (otherwise known as an I/T/U) as those terms are defined in § 4 of the Indian Health Care Improvement Act (25 USC § 1603). Indian Health Care Provider includes a 638 Facility and provision of Indian Health Service Contract Health Services (IHS CHS).

  • Home health care services means medical and nonmedical services, provided to ill, disabled or infirm persons in their residences. Such services may include homemaker services, assistance with activities of daily living and respite care services.

  • Home Health Care Agency means an agency or organization which provides a program of home health care and which:

  • Foster care services means the provision of a full range of casework, treatment and community

  • Primary care services means the services in respect of which NHS England has a duty or power to make arrangements pursuant to the Primary Care Functions;

  • Child care provider means a provider who receives compensation for providing child care services on a regular basis, including an ‘eligible child care provider’ (as defined in section 658P of the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858n)).

  • Health care services means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease.

  • Health care facilities means buildings, structures, or equipment suitable and intended for, or incidental or ancillary to, use in providing health services, including, but not limited to, hospitals; hospital long-term care units; infirmaries; sanatoria; nursing homes; medical care facilities; outpatient clinics; ambulatory care facilities; surgical and diagnostic facilities; hospices; clinical laboratories; shared service facilities; laundries; meeting rooms; classrooms and other educational facilities; students', nurses', interns', or physicians' residences; administration buildings; facilities for use as or by health maintenance organizations; facilities for ambulance operations, advanced mobile emergency care services, and limited advanced mobile emergency care services; research facilities; facilities for the care of dependent children; maintenance, storage, and utility facilities; parking lots and structures; garages; office facilities not less than 80% of the net leasable space of which is intended for lease to or other use by direct providers of health care; facilities for the temporary lodging of outpatients or families of patients; residential facilities for use by the aged or disabled; and all necessary, useful, or related equipment, furnishings, and appurtenances and all lands necessary or convenient as sites for the health care facilities described in this subdivision.