Medicaid definition
Examples of Medicaid in a sentence
Any dual eligible CONSUMER with a deductible/coinsurance will be paid by the PAYOR in total up to the agreed upon payment amount for the billed service(s) identified in this agreement after all other payments, contractual adjustments, and any applicable co-payment, CONSUMER pay, or Medicaid Spend Down amounts have been deducted.
Any marketing or informative materials intended for distribution through written or other media to eligible non-Medicaid CONSUMERs, Medicaid eligible, or the broader community that describe the availability of covered services and supports and how to access those services and supports pursuant to this Agreement, must be submitted by the PROVIDER or the PROVIDER’s subcontractors for the PAYOR ’s approval or disapproval prior to any distribution.
The Provider is required to identify and seek recovery from all liable third parties, consistent with the requirements of the Mental Health Code, the MDHHS/CMHSP Master Contract for General Funds and with the MDHHS/PIHP Master Contract for Medicaid Funds.
Provider shall not offer hours of operation that are less than the hours of operation offered to commercial members or not comparable to Medicaid fee-for-service (FFS), if the provider serves only Medicaid members.
The PAYOR shall make contractual payments to the PROVIDER in accordance with the requirements of the Mental Health Code, the MDHHS Rules, the MDHHS/CMHSP Master Contract, and applicable state and federal laws, including Medicaid regulations.