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

  • CMS means the Centers for Medicare & 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.

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • 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).

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • 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.