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Medical Reimbursement Program definition

Medical Reimbursement Program means Medicare, Medicaid, any other federal health care program (as defined in 42 U.S.C. § 1320a-7b(f)), and any other state sponsored reimbursement program.
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Medical Reimbursement Program shall have the meaning assigned to such term in Section 6.11.
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Medical Reimbursement Program means Medicare, Medicaid, any other federal health care program (as defined in 42 U.S.C. § 1320a-7b(f)), and any state sponsored reimbursement program.
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Examples of Medical Reimbursement Program in a sentence

  • Full-time and regular part-time non-union employees working twenty (20) hours or more per week are eligible to participate in a Medical Reimbursement Program and/or Dependent Care Reimbursement Program under Section 125 of the Internal Revenue Service Code as amended from time to time.

  • In particular, such accounts receivable relating to any Medical Reimbursement Program do not and shall not exceed amounts any obligee is entitled to receive under any capitation arrangement, fee schedule, discount formula, cost-based reimbursement or other adjustment or limitation to its usual charges, in each case to the extent it would not reasonably be expected to have a Material Adverse Effect.

  • None of the Company or any of the Subsidiaries may reasonably be expected to have criminal culpability or to be excluded from participation in the Medicare and Medicaid programs and any other health care program operated by or financed in whole or in part by any Governmental Entity (a "Medical Reimbursement Program") for its corporate actions or failure to act.

  • The Receivables of each Loan Party and each Subsidiary thereof have been adjusted to reflect the requirements of all Laws and reimbursement policies (both those most recently published in writing as well as those not in writing that have been verbally communicated) of any applicable Medical Reimbursement Program, except where such failure would not reasonably be expected to have a Material Adverse Effect.

  • Except as set forth on Schedule 6.23(l), the current Receivables of the Borrower, each of its Subsidiaries and each Supported Practice have been adjusted to reflect the requirements of all applicable Laws and reimbursement policies of any applicable Medical Reimbursement Program, except where such failure could not reasonably be expected to result, individually or in the aggregate, in a Material Adverse Effect.

  • Any Loan Party shall be temporarily or permanently excluded from any Medical Reimbursement Program or similar government or insurance program in any applicable jurisdiction, where such exclusion arises from fraud or other claims or allegations which, individually or in the aggregate, could exceed $250,000 or cause a Material Adverse Effect.

  • To the extent any Owner Physician is actively engaged in the practice of medicine, such Owner Physician, to the knowledge of the Loan Parties: (A) maintains a policy of professional liability insurance in such amounts and with such limits as required by state law to cover any professional medical services rendered by such Owner Physician on behalf of the Supported Practice; and (B) is eligible to participate in any material Medical Reimbursement Program, as applicable.

  • Neither the Loan Parties nor their Subsidiaries have submitted to any Medical Reimbursement Program any false, fraudulent, abusive or improper claim for payment, billed any Medical Reimbursement Program for any service not rendered as claimed, or received and retained any payment or reimbursement from any Medical Reimbursement Program in excess of the proper amount allowed by applicable law and applicable contracts or agreements with the Medical Reimbursement Program.

  • None of the Company, any of the Subsidiaries, or any individual employed by the Company or any of the Subsidiaries, to the knowledge of the Company, may reasonably be expected to have criminal culpability or to be excluded from participation in any Medical Reimbursement Program for its or his corporate or individual actions or failure to act.

  • Promptly upon the institution of any legal actions or investigations by the OIG with respect to any investigation of any Loan Party or any Subsidiary of a Loan Party, or upon the institution of any investigation or proceeding against any Loan Party or any Subsidiary of a Loan Party to suspend, revoke or terminate or which may result in exclusion from any Medical Reimbursement Program.


More Definitions of Medical Reimbursement Program

Medical Reimbursement Program has the meaning set forth in Section 3.15(d).
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Medical Reimbursement Program means the government reimbursement programs, including Medicare, Medicaid, TRICARE, Medicaid waiver programs, and all other programs that qualify as Federal Health Care programs in which the Company or any of its Subsidiaries participate.
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Medical Reimbursement Program means all private and government reimbursement programs to which the Company participates, including, as applicable, health maintenance organizations, preferred provider organizations, other managed care plans, Medicare, Medicaid and all other programs that qualify as a Federal Health Care Program or State Health Care Program.
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Medical Reimbursement Program means all private and government reimbursement programs to which the Sellers participates, including, as applicable, health maintenance organizations, preferred provider organizations, other managed care plans, Medicare, Medicaid and all other programs that qualify as a Federal Health Care Program or State Health Care Program.
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Related to Medical Reimbursement Program

  • Medical Reimbursement Programs means a collective reference to the Medicare, Medicaid and TRICARE programs and any other health care program operated by or financed in whole or in part by any foreign or domestic federal, state or local government and any other non-government funded third party payor programs.

  • Medical Review Officer (MRO means a licensed physician, employed with or contracted with the City, responsible for receiving laboratory results generated by the City's drug testing program who has knowledge of substance abuse disorders, laboratory testing procedures, and chain of custody collection procedures; who verifies positive, confirmed test results, and who has the necessary and appropriate medical training to interpret and evaluate an individual's confirmed positive test result together with his or her medical history and any other relevant biomedical information.

  • Independent educational evaluation means an evaluation conducted by a qualified examiner who is not employed by the public agency responsible for the education of the child in question.

  • Cost Reimbursement means a contract which provides for a fee other than a fee based on a percentage of cost and under which a contractor is reimbursed for costs which are allowable and allocable in accordance with the contract terms.

  • Dependent care assistance program or "DCAP" means a benefit plan whereby school employees may pay for certain employment related dependent care with pretax dollars as provided in the salary reduction plan under chapter 41.05 RCW pursuant to 26 U.S.C. Sec. 129 or other sections of the Internal Revenue Code.

  • Expense Reimbursement has the meaning set forth in Section 8.2(c).

  • Medical Review Officer (MRO) means a licensed physician responsible for receiving and reviewing laboratory results generated by the school district’s drug testing program and for evaluating medical explanations for certain drug tests.

  • Utilization review plan or "plan" means a written procedure for performing review.

  • Medical Expense means an expense incurred at the time a past member or his or her health reimbursement account dependent is furnished the medical care or service. To be considered a medical expense under this act, the expense shall meet all of the following conditions:

  • Medical assessment means an assessment of a patient’s medical condition secured by our Assistance Company working in conjunction with the Medical Evacuation Provider’s medical director and in collaboration with the attending physician. The Assistance Company in collaboration with the Medical Evacuation Provider, will utilize the assessment to determine at its sole discretion whether a Plan Holder is fit to fly; the most appropriate means to provide medical evacuation; the medical personnel who will be accompanying the patient on the transport; and to confirm the medical facility closest to one’s home can meet their medical needs. If the patient’s medical facility of choice is unable to provide the high level of medical care required by the patient, arrangements will be made to transport the patient to the appropriate medical facility closest to their home, or closest to patient's preferred medical facility in the US when possible.

  • Clinical review criteria means the written screening procedures, decision abstracts, clinical protocols, and practice guidelines used by a health carrier to determine the necessity and appropriateness of health care services.

  • Medical examination means the preliminary assessment of a person by an authorized health worker or by a person under the direct supervision of the competent authority, to determine the person’s health status and potential public health risk to others, and may include the scrutiny of health documents, and a physical examination when justified by the circumstances of the individual case;

  • Participating Prescription Drug Provider means an independent retail Pharmacy, chain of retail Pharmacies, mail-order Pharmacy or specialty drug Pharmacy which has entered into an agreement to provide pharmaceutical services to participants in the benefit program. A retail Participating Pharmacy may or may not be a select Participating Pharmacy as that term is used in the Vaccinations Obtained Through Participating Pharmacies section.

  • Routine patient care costs means Covered Medical Expenses which are typically provided absent a clinical trial and not otherwise excluded under the Policy. Routine patient care costs do not include:

  • Non-Administrator Dialysis Facility means a Dialysis Facility which does not have an agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan but has been certified in accordance with the guidelines established by Medicare.

  • Medical Expenses means those expenses that an Insured Person has necessarily and actually incurred for medical treatment on account of Illness or Accident on the advice of a Medical Practitioner, as long as these are no more than would have been payable if the Insured Person had not been insured and no more than other hospitals or doctors in the same locality would have charged for the same medical treatment.

  • Basic health plan model plan means a health plan as required in RCW 70.47.060(2)(e).

  • Medical examiner means that term as defined in 49 CFR 390.5.

  • Dental laboratory means a person, firm or corporation

  • New jobs training program or “program” means the project or projects established by a community college for the creation of jobs by providing education and training of workers for new jobs for new or expanding industry in the merged area served by the community college. The proceeds of the certificates, as authorized by the Act, shall be used only to fund program services related to training programs made necessary by the creation of new jobs.

  • Pilot program means the pilot program identified and funded through the Funding Agreement and described in that Funding Agreement and its attachments.

  • Health plan or "health benefit plan" means any policy,

  • Medical history means information regarding any:

  • Medical cannabis pharmacy means the same as that term is defined in Section 26-61a-102.

  • Utilization review means the prospective (prior to), concurrent (during) or retrospective (after) review of any service to determine whether such service was properly authorized, constitutes a medically necessary service for purposes of benefit payment, and is a covered healthcare service under this plan. WE, US, and OUR means Blue Cross & Blue Shield of Rhode Island. WE, US, or OUR will have the same meaning whether italicized or not. YOU and YOUR means the subscriber or member enrolled for coverage under this agreement. YOU and YOUR will have the same meaning whether italicized or not.

  • Prescription monitoring program “PMP,” or “program” means the program established pursuant to 657—Chapter 37 for the collection and maintenance of PMP information and for the provision of PMP information to authorized individuals.

Most Referenced Clauses

Most Referenced Definitions