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 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.

  • The Service Area is the specific geographic area within which the Medicaid Eligible Individual must reside to enroll in the Contractor’s Health Plan.

  • Each Medicaid Eligible Individual can be enrolled or disenrolled from the Contractor’s Health Plan independent of any other Family Member’s enrollment or disenrollment.

  • Each Medicaid Eligible Individual can be enrolled or disenrolled from the Contractor’s Integrated Care Plan independent of any other Family Member’s enrollment or disenrollment.

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

  • Immediately upon written notice to Contractor if there is a threat to the health, safety, or welfare of any OHA client or recipient of services under this Contract, including any Medicaid Eligible Individual, under its care.

  • The Service Area is the specific geographic area within which the Medicaid Eligible Individual must reside to enroll in the Contractor’s Integrated Care 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 Recipients means all Employees, all Non-Employee Directors and all Consultants.

  • 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.

  • Prospective employee means any individual who has committed to become an employee of the Company within sixty (60) days from the date an Award is granted to such individual.

  • Eligible patient means an individual who meets all of the following conditions:

  • Eligible Employees means each employee of the Company or an Affiliate.

  • Covered Employees means all employees and agents of the Company who are responsible for performing, supervising, overseeing, or managing activities related to the maintenance of online political files, as required by the Political Record- Keeping Statute and Rule.

  • Tipped employee means any employee engaged in an occupation in which s/he customarily and regularly receives more than $30 per month in tips. Tips include amounts designated as a tip by credit card customers on their charge slips. Nothing in this rule prevents an employer from requiring employees to share or allocate such tips or gratuities on a pre-established basis among other employees who customarily and regularly receive tips. Employer-required sharing of tips with employees who do not customarily and regularly receive tips, such as management or food preparers, or deduction of credit card processing fees from tipped employees, shall nullify allowable tip credits towards the minimum wage.

  • 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.

  • Medicare eligible expenses means expenses of the kinds covered by Medicare Parts A and B, to the extent recognized as reasonable and medically necessary by Medicare.

  • 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.

  • Newly hired employee or “New Hire” means any employee, whether permanent, full-time, or part-time, hired by the Office and who is still employed as of the date of new employee orientation. It also includes all employees who are or have been previously employed by the Office and whose current position has placed them in the bargaining unit represented by CSEA. For those latter employees, for purposes of this article only, the “date of hire” is the date upon which the employees’ employment status changed as such that the employee was placed in the CSEA unit.

  • 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;

  • Eligible Participant means an employee, officer, consultant or director of the Company or any Affiliate.

  • Qualified Participant means an individual who is a participant of Tier 2 and who meets 1 of the following requirements:

  • Section 162(m) Participant means any key Employee designated by the Administrator as a key Employee whose compensation for the fiscal year in which the key Employee is so designated or a future fiscal year may be subject to the limit on deductible compensation imposed by Section 162(m) of the Code.

  • Covered Participant means a Participant who is a “covered employee” as defined in Section 162(m)(3) of the Code, and the regulations promulgated thereunder, and any individual the Committee determines should be treated as such a covered employee.

  • Designated Employees means a person occupying any of the following position in the Company:

  • Hired Employee has the meaning set forth in Section 6.1.6.

  • Designated Employee means an employee who has been designated by the school to receive complaints of hazing, harassment and bullying pursuant to subdivision 16 V.S.A. 570a(a)(7). The designated employees for each school building are identified in Appendix A of this policy.

  • Eligible Participants means persons who, at a particular time, are employees, officers, consultants, or directors of the Company or its subsidiaries;

  • Active Employee means a contributing member of the TRS who is employed by a public school and is not entitled to coverage under a plan provided under Insurance Code Chapter 1551 (Texas Em- ployees Group Benefits Act) or 1601 (State University Employees Uniform Insurance Benefits Act).

  • Employee Participant means an Employee who holds an outstanding Award under the terms of the Plan.

  • Participating employee means an employee whose election to participate in a Plan has been approved by the employer.