Managed Care Organizations definition

Managed Care Organizations or “MCOs” means pharmacies, managed health care organizations, group purchasing organizations, large employers, long-term care organizations, formularies, insurers, government agencies and programs (e.g., Medicare and the VHA and other federal, state and local agencies), or similar organizations.

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Managed Care Organizations. "MCOs" means Medicaid managed care organizations a certified health maintenance organization (HMO) that provides health care services to Medicaid members pursuant to an agreement or contract with the Bureau for Medical Services.

Managed Care Organizations or “MCOs” means the entities under Contract with the Agency to manage Medicaid services for identified individuals, which are, as of December 2016, Amerigroup Iowa, Inc., AmeriHealth Caritas Iowa, Inc. and UnitedHealthcare Plan of the River Valley, Inc.

Examples of Managed Care Organizations in a sentence

This document sets forth the requirements of the Rhode Island Executive Office of Health and Human Services (EOHHS) for managed care organizations contracted with EOHHS as Medicaid Managed Care Organizations (MCOs).
The PH-MCO must receive advance written approval of the list and scope of services to be referred or prior authorized by the Department as outlined in Exhibit H, Prior Authorization Guidelines for Participating Managed Care Organizations in the HealthChoices Program, and Exhibit M(1), Quality Management and Utilization Management Program Requirements.
Any change mandated by the Affordable Care Act which pertains to Managed Care Organizations (MCO) and/or Medicaid Services shall be implemented by the Contractor without amendment to this Contract.
The Contractor has one of the top four highest percentages of Enrollees fully vaccinated among all MassHealth Accountable Care Partnership Plans (“ACPP”), Managed Care Organizations (“MCO”), and Primary Care Accountable Care Organizations (“PCACO”).
If the child is enrolled in one of SCDHHS’ Managed Care Organizations (MCO), the Service Coordinator must send a hardcopy of the IFSP and the MCO Universal BabyNet Prior Authorization (PA) form to the MCO for the PA process to proceed .

More Definitions of Managed Care Organizations

Managed Care Organizations means the health plans under contract with DHS to provide covered services to Medicaid beneficiaries through the Medicaid/NJ FamilyCare program and that will be directed to distribute Medicaid managed care rate increase payments to hospitals under the County Option Program.

Managed Care Organizations means pharmacies, managed health care organizations, group purchasing organizations, large employers, long-term care organizations, formularies, government agencies and programs (e.g., Medicare and the VA), or similar organizations.

Managed Care Organizations. "MCOs" means Medicaid managed care organizations

Managed Care Organizations. Where the Resident enrolls in or switches the Resident’s enrollment to any managed care organization (hereafter “MCO”), including MCOs that provide Medicare or Medicaid benefits, the Resident agrees as follows:

Managed Care Organizations has the meaning ascribed to it in Section 2.1(b)(ii) of this Agreement.

Managed Care Organizations means health maintenance -------------------------- organizations, networks of healthcare providers or other similar entities that provide, or otherwise make available, a program of health care services to a member/subscriber for a fixed fee.

Managed Care Organizations. Each managed care organization participating in Connecticut’s HUSKY, Part A managed care program is responsible for ensuring that children enrolled in the plan receive periodic screening examinations and all necessary diagnostic and treatment services in a timely fashion. Responsibilities include, but are not limited to requirements that managed care organizations: • Inform families about EPSDT and its services and the importance of EPSDT services for their children’s health and well-being; • Conduct outreach to ensure children receive EPSDT services; • Link children to primary care providers and dental providers; • Schedule appointments for children for comprehensive EPSDT screening examinations in accordance with the EPSDT periodicity schedule, for necessary interperiodic exams, and for vision and hearing services when medically necessary; • Remind families when EPSDT exams are due and follow-up on missed appointments. • Ensure that primary care providers participating in the HUSKY, Part A managed care program are knowledgeable about the requirements of the EPSDT program and that the providers provide comprehensive screening exams, diagnosis, and treatment in accordance with EPSDT requirements.