Managed Care Entity (MCE) definition
Managed Care Entity (MCE) means an entity that enters into a contract to provide services in a managed care delivery system, including but not limited to managed care organizations, prepaid health plans, primary care case managers and Coordinated Care Organizations.¶
Managed Care Entity (MCE) means, as stated in 42 CFR 457.10, an entity that enters into a contract to provide services in a managed care delivery system including, but not limited to, managed care organizations, prepaid health plans, and primary care case managers.
Managed Care Entity (MCE) means, as stated in 42 CFR 457.10, an entity that enters into a contract with the Authority to provide services in a managed care delivery system including but not limited to coordinated care organizations, dental care organizations, mental health organizations, and primary care case managers.
Examples of Managed Care Entity (MCE) in a sentence
If the CONTRACTOR is an Native American Medicaid Managed Care Entity (MCE), the CONTRACTOR may restrict Enrollment of Native Americans in the same manner as Indian Health Programs may restrict the delivery of services to Native Americans.
The Contractor acting as the enrollment broker for the State of Iowa must be independent from any Managed Care Entity (MCE) and health care provider that provides coverage in the same state in which the enrollment broker is conducting enrollment activities.
The State, as the Medicaid Managed Care Entity (MCE), is required by AHS to report HEDIS performance measures of quality, access, and utilization on an annual basis.
More Definitions of Managed Care Entity (MCE)
Managed Care Entity (MCE) is a general term that means an entity that enters into one or more contracts with the Authority to provide services in a managed care delivery system, including but not limited to the following types of entities defined in and subject to 42 CFR Part 438: managed care organizations (MCOs), primary care case managers (PCCMs), prepaid ambulatory health plans (PAHPs), and prepaid inpatient health plans (PIHPs). A CCO is an MCE for its managed care contract(s) with the Authority, without regard to whether the contract(s) involves federal funds or state funds or both.¶
Managed Care Entity (MCE) means a managed care organization, the single pharmacy benefit manager, a MyCare Ohio plan as defined in rule 5160-58-01 of the Administrative Code, and the OhioRISE plan as defined in rule 5160-59-01 of the Administrative Code.
Managed Care Entity (MCE) means an organization having a certificate of authority or certificate of registration from the Washington State Office of Insurance Commissioner that contracts with HCA under a comprehensive risk contract to provide prepaid health care services to eligible HCA Enrollees under HCA managed care programs.
Managed Care Entity (MCE) is a general term that means, an entity that enters into a contractone or more contracts with the Authority to provide services in a managed care delivery system, including but not limited to managed care organizations, prepaid health plans, primary care case managers and Coordinated Care Organizations.¶
Managed Care Entity (MCE) is a general term that means an entity that enters into one or more contracts with the Authority to provide services in a managed care delivery system, including but not limited to the following types of entities defined in and subject to 42 CFR Part 438: managed care organizations (MCOs),