Medicaid Managed Care definition

Medicaid Managed Care. Orthopedic Footwear means shoes, shoe modifications, or shoe additions which are used to correct, accommodate or prevent a physical deformity or range of motion malfunction in a diseased or injured part of the ankle or foot; to support a weak or deformed structure of the ankle or foot, or to form an integral part of a brace.

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Medicaid Managed Care refers to one or all of the following health care plans authorized and contracted by New York to manage a specified benefit package of Medicaid benefits for a defined group of eligible enrollees: Mainstream Managed Care Plan (MMCP), Health and Recovery Plan (HARP), Medicaid Advantage Plus (MAP), or Managed Long Term Care Partial Capitation (MLTCP).

Medicaid Managed Care means North Carolina’s program under which contracted Managed Care Organizations arrange for medical and other services to be delivered to Medicaid and NC Health Choice enrollees. Medicaid Managed Care will include four types of plans: (1) Standard Plans,

Examples of Medicaid Managed Care in a sentence

• The Children and Families Specialty Plan (CFSP) is an integrated Medicaid Managed Care plan that covers services specified to address a spectrum of Member needs, including those related to physical health, behavioral Health, I/DD, LTSS, and pharmacy services and unmet health-related resource needs.

• The Department will ensure that Medicaid Beneficiaries and their families and caregivers are supported in the transition to Medicaid Managed Care and the CFSP throughout the Enrollment process, including enrolling in the CFSP and selecting a Primary Care Provider (PCP).

• The Department shall not mandate Medicaid Managed Care providers enrolled with the State participate in the State Medicaid Fee-for-Service program.

• The CFSP must notify the Department with an attestation of any Member still enrolled in Medicaid Managed Care prior to the first day of the next month following the 90th day of stay, if there is a delay in the Department’s disenrollment notification.

• The North Carolina Medicaid Managed Care and CFSP Enrollment Policy outlines the expectations of the Department, the Enrollment Broker, and the CFSP in the Enrollment of Beneficiaries into the CFSP.

• To the extent Participating Provider is an Indian Health Care Provider, Participating Provider shall execute and comply with the Medicaid Managed Care Addendum for Indian Health Care Providers.

• Medicaid Managed Care Addendum for Indian Health Care Providers includes the information required by this provision or to Contracts when the CFSP and provider have mutually agreed to an alternative reimbursement arrangement.

• The contract must define those technical managed care terms used in the provider contract, and whether those definitions reference other documents distributed to providers and are consistent with definitions included in Medicaid Member materials issued in conjunction with the Medicaid Managed Care Program.

• Providers will use a single, electronic application to submit information to be verified and screened to become a Medicaid enrolled provider, with the application serving for enrollment as a Medicaid Fee-for-Service provider as well as a Medicaid Managed Care Provider.

• The Department reserves the right to amend this Policy based on an increase or decrease in covered populations in Medicaid Managed Care, changes in North Carolina or federal law or 9 North Carolina Department of Health and Human Services, Facilities, ▇▇▇▇▇://▇▇▇.▇▇▇▇▇▇.▇▇▇/divisions/dsohf/facilities.

More Definitions of Medicaid Managed Care

Medicaid Managed Care. The name of the North Carolina managed care program for North Carolina Medicaid and NC Health Choice benefits; does not include LME/MCOs.

Medicaid Managed Care means a program of health services provided to eligible clients by a managed care organization under a contract with a department.

Medicaid Managed Care. A NC Medicaid Managed Care plan that will serve members as described in Section 9E.22 of Session Law 2023-134. d. Section III.

Medicaid Managed Care means Medicaid provided under section three hundred sixty-four-j of this chapter.

Medicaid Managed Care. North Carolina’s program under which contracted Managed Care Organizations arrange for integrated medical, physical, pharmacy, behavioral, and other services to be delivered to Medicaid and NC Health Choice Beneficiaries. Medicaid Managed Care will include four types of plans: (1) Standard Plans, (2) BH I/DD Tailored Plans, and (3) Children and Families Specialty Plan. The use of Medicaid Managed Care is also inclusive of) EBCI Tribal Option, operating as a primary care case management entity (PCCMe).