Medicaid Eligible Individual definition

Medicaid Eligible Individual means any individual who has been deemed eligible for Medicaid benefits by the Utah Department of Human Services or the Utah Department of Workforce Services.
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Medicaid Eligible Individual means any individual who has been certified by the Utah Department of Human Services or the Utah Department of Workforce Services to be eligible for Medicaid benefits. 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 the Contractor. Marketing means any communication from Contractor, its employees, Participating Providers, agents or subcontractors to a potential enrollee that can reasonably be interpreted to influence the potential enrollee to enroll in Contractor’s Medicaid product, or either to not enroll in, or to disenroll from an another Health Plan’s Medicaid product. Marketing Materials means materials that are produced in any medium, by or on behalf of the Contractor, its employees, affiliated Providers, agents or subcontractors to a potential enrollee that can reasonably be intended to market to potential enrollees. Medicaid Fraud Control Unit (MFCU) means the statutorily authorized criminal investigation unit charged with investigating and prosecuting the Medicaid fraud in the Utah Attorney General’s Office. Medically Necessary Service or Medical Necessity means Medically Necessary as defined by Utah Administrative Code R414-1-2(18).
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Medicaid Eligible Individual means any individual who has been certified by the Utah Department of Human Services or the Utah Department of Workforce Services to be eligible for Medicaid benefits. 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 the Contractor. Marketing means any communication from Contractor, its employees, Participating Providers, agents or subcontractors to a potential enrollee that can reasonably be interpreted to influence the potential enrollee to enroll in Contractor’s Medicaid product, or either to not enroll in, or to disenroll from an another Health Plan’s Medicaid product. Marketing Materials means materials that are produced in any medium, by or on behalf of the Contractor, its employees, affiliated Providers, agents or subcontractors to a potential enrollee that can reasonably be intended to market to potential enrollees.
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Examples of Medicaid Eligible Individual in a sentence

  • Amendments, revisions, or additions to the State Plan, the Prepaid Mental Health Plan Waiver or to State or Federal regulations, guidelines, or policies, insofar as they affect the scope or nature of benefits available to a Medicaid Eligible Individual shall be considered incorporated by this Contract and the Contractor shall be required to provide those benefits to Medicaid Eligible Individuals.

  • Amendments, revisions, or additions to the State Plan or to State or Federal regulations, guidelines, or policies, insofar as they affect the scope or nature of benefits available to a Medicaid Eligible Individual shall be considered incorporated by this Contract and the Contractor shall be required to provide those benefits to Medicaid Eligible Individuals.

  • Amendments, revisions, or additions to the State Plan, the Prepaid Mental Health Plan Waiver or to state or federal regulations, guidelines, or policies, insofar as they affect the scope or nature of benefits available to a Medicaid Eligible Individual shall be considered incorporated by this Contract and the Contractor shall be required to provide those benefits to Enrollees.

  • Amendments, revisions, or additions to the State Plan or to state or federal regulations, guidelines, or policies, insofar as they affect the scope or nature of benefits available to a Medicaid Eligible Individual shall be considered incorporated by this Contract and the Contractor shall be required to provide those benefits to Medicaid Eligible Individuals.

  • Enrollment is open to any qualified Medicaid Eligible Individual who meets the eligibility requirements for enrollment.

  • Enrollee means any Medicaid Eligible Individual whose name appears on the Department’s Eligibility Transmission as enrolled in the Contractor's Health Plan.


More Definitions of Medicaid Eligible Individual

Medicaid Eligible Individual means any individual who has been deemed eligible for Medicaid benefits by the Utah Department of Human Services or the Utah Department of Workforce Services. Medicaid Fraud Control Unit (MFCU) means the statutorily authorized criminal investigation unit in the Utah Attorney General’s Office charged with investigating and prosecuting Medicaid and CHIP fraud. Medical Loss Ratio (MLR) means a measure of the percentage of premium dollars that a health plan spends on medical claims and quality improvements, versus administrative costs. Medically Necessary or Medical Necessity means Medically Necessary Service as defined by Utah Administrative Code R414-1-2(18).
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Medicaid Eligible Individual means a participant who meets the eligibility criteria defined in OAR 411-015-0000 through 411-015-0100.
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Related to Medicaid Eligible Individual

  • Eligible Individual means any person who is an Employee, a Consultant or a Non-Employee Director, as determined by the Administrator.

  • Eligible Individuals means directors, officers, employees and consultants of the Company or any of its Subsidiaries or Affiliates, and prospective employees and consultants who have accepted offers of employment or consultancy from the Company or its Subsidiaries or Affiliates.

  • Eligible Person means individuals, corporations, trusts, the estates of deceased individuals, partnerships and unincorporated associations of persons;

  • Eligible Recipient means an employee, director or independent contractor of the Company or any Affiliate of the Company who has been selected as an eligible participant by the Administrator; provided, however, to the extent required to avoid accelerated taxation and/or tax penalties under Section 409A of the Code, an Eligible Recipient of an Option or a Stock Appreciation Right means an employee, non-employee director or independent contractor of the Company or any Affiliate of the Company with respect to whom the Company is an “eligible issuer of service recipient stock” within the meaning of Section 409A of the Code.

  • Covered Employees has the meaning set forth in Section 5.11(a).

  • Eligible Employee means full-time and part-time employees in the bargaining unit who have completed four hundred and fifty (450) hours of service and who are not prohibited from contributing to the Plan by legislation or the Plan rules because of their age or because they are in receipt of a pension from the Plan.

  • Eligible Persons or “Households” means one or more natural persons or a family who pays 30 percent of their household income toward their monthly rent and is determined by Grantee to be eligible for rental assistance under this Agreement.

  • Designated Participant means such employees or officers of the Company or a related entity of the Company as the Board may designate from time to time as eligible to participate in the Plan;