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 coordinatedmanaged care organizations, dental care organizations, mentalprepaid health organizationsplans, and primary care case managers and Coordinated Care Organizations.

Examples of Managed Care Entity (MCE in a sentence

• Managed Care Entity (MCE) means managed care organizations (MCOs), PIHPs, PAHPs, PCCMs, and HIOs1, as defined by 42 CFR §455.101.Managing employee means a general manager, business manager, administrator, director, or other individual who exercises operational or managerial control over, or who directly or indirectly conducts the day-to-day operation of an institution, organization, or agency.

• Also, to the extent necessary to enable the state to limit beneficiary choice of providers for beneficiaries enrolled in a Managed Care Entity (MCE) and a Prepaid Inpatient Health Plan (PIHP) under the demonstration to those providers that are within the MCE and PIHP networks.

• For purposes of this section, except where the context clearly indicates otherwise, the fol- lowing terms have the meanings indi- cated:Aggregate lifetime dollar limit means a dollar limitation on the total amount of specified benefits that may be paid under a State plan or a Managed Care Entity (MCE) (as defined at § 457.10) that contracts with the State plan.

• The capitation rates offered may not be appropriate for any specific Managed Care Entity (MCE).

• 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.

More Definitions of Managed Care Entity (MCE

Managed Care Entity (MCE means managed care organizations (MCOs), PIHPs, PAHPs, PCCMs, and HIOs.

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 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 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 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 MCOs, PHPs, and PCCMs. OAR 410-141-3000.

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),