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).
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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 enrollees. Medicaid Managed Care will include three types of plans: (1) Standard Plans, (2) BH I/DD Tailored Plans, and (3) Statewide ▇▇▇▇▇▇ Care Plan. The use of Medicaid Managed Care is also inclusive of EBCI Tribal Option, operating as a primary care case management entity (PCCMe).
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Examples of Medicaid Managed Care in a sentence

  • Treatment Grantees shall enroll as a provider with Texas Medicaid and Healthcare Partnership (TMHP) and all Medicaid Managed Care organizations in Grantee’s service region within the first quarter of this procurement term and maintain through the procurement term.

  • In accordance with the Affordable Care Act, manufacturers that participate in the Medicaid drug rebate program are required to pay rebates for drugs dispensed to individuals enrolled with a Medicaid Managed Care Organization.

  • In accordance with the Affordable Care Act, manufacturers that participate in the Medicaid drug rebate program are required to pay rebates for drugs dispensed to individuals enrolled with a Medicaid Managed Care Entity.

  • Contractor shall follow the EOHHS policy and procedures document titled, "EOHHS Medicaid Managed Care Organization (MCO) Requirements for Medicaid Member Demographic Changes." Contractor shall have a process for performing outreach calls and an approach for determining a member’s most recent address and accurate address and telephone number.

  • The Contractor is required to develop and implement subcontracts with providers including Alternative Payment Methodologies as set forth in Transitioning to Alternative Payment Methodologies: Requirements for Medicaid Managed Care Partners.

  • This document sets forth the requirements of the Rhode Island Executive Office of Health and Human Services (EOHHS) for managed care organizations contracted with EOHHS as Medicaid Managed Care Organizations (MCOs).

  • For contracts with entities certified as comprehensive Accountable Entities, subcontracts between the health plan and the certified AE will be in compliance Transitioning to Alternative Payment Methodologies: Requirements for Medicaid Managed Care Partners for the applicable time period.

  • For each contract period, the Contractor will meet or exceed the requirements set forth Transitioning to Alternative Payment Methodologies: Requirements for Medicaid Managed Care Partners for the percent of their total payments made to providers using EOHHS approved alternative payment methods.

  • The Contractor will track and trend parity complaints, grievances and appeals on the EOHHS approved template at a time and frequency as specified in the EOHHS Medicaid Managed Care Organization (MCO) Requirements for Reporting and Non-Compliance.

  • EOHHS has sole authority to disenroll members from any of its contracted Medicaid Managed Care Health Plans, subject to the conditions described below.


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.
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Medicaid Managed Care means a program of health services provided to eligible clients by a managed care organization under a contract with a department.
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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.
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Medicaid Managed Care means Medicaid provided under section three hundred sixty-four-j of this chapter.
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Related to Medicaid Managed Care

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • Managed care means a system that provides the coordinated delivery of services and supports that are necessary and appropriate, delivered in the least restrictive settings and in the least intrusive manner. Managed care seeks to balance three factors:

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Medicaid program means the Kansas program of medical

  • Managed Care Program means the process that determines Medical Necessity and directs care to the most appropriate setting to provide quality care in a cost-effective manner, including Prior Authorization of certain services.

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