SOONERCARE PROGRAM OVERVIEW Sample Clauses

SOONERCARE PROGRAM OVERVIEW. The State of Oklahoma operates a Medicaid Program to provide health care for persons eligible under 42 U.S.C. §1396 et seq. Under 42 U.S.C. §1315(a) waiver authority from the Federal government, Oklahoma operates a mandatory managed care program known as SoonerCare for a portion of its Medicaid population. The Oklahoma Health Care Authority (OHCA) operates a Primary Care Case Management (PCCM) system hereinafter referred to as "SoonerCare" for eligible individuals. SoonerCare is comprised of two components; the partially-capitated PCCM program and the voluntary American Indian Case Management PCCM program. The State’s objectives for SoonerCare include the following:
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SOONERCARE PROGRAM OVERVIEW. The State of Oklahoma operates a Medicaid Program to provide health care for persons eligible under 42 U.S.C. §1396 et seq. Under 42 U.S.C. §1315(a) waiver authority from the Federal government, Oklahoma operates a mandatory managed care program known as SoonerCare for a portion of its Medicaid population. The Oklahoma Health Care Authority (OHCA) operates a Primary Care Case Management (PCCM) system hereinafter referred to as "SoonerCare" for eligible individuals. The State’s objectives for SoonerCare include the following:

Related to SOONERCARE PROGRAM OVERVIEW

  • Program Overview A. Goals of the Choice Neighborhoods Program. The Choice Neighborhoods Program employs a comprehensive approach to neighborhood transformation. The program transforms neighborhoods of concentrated poverty into mixed-income neighborhoods of long-term viability by revitalizing severely distressed public and/or assisted housing; improving access to economic opportunities; and investing and leveraging investments in well-functioning services, effective schools and education programs, public assets, public transportation, and improved access to jobs. Choice Neighborhoods ensures that current residents benefit from this transformation by preserving affordable housing in the neighborhood or providing the choice to move to affordable housing in another neighborhood of opportunity. The purpose of this grant is to implement a Transformation Plan that has been developed through a local planning process and furthers the goals of the Choice Neighborhoods Program. The core goals of Choice Neighborhoods are:

  • Professional Development Program (a) The parties agree to continue a Professional Development Program for the maintenance and development of the faculty members' professional competence and effectiveness. It is agreed that maintenance of currency of subject knowledge, the improvement of performance of faculty duties, and the maintenance and improvement of professional competence, including instructional skills, are the primary professional development activities of faculty members.

  • Professional Development Plan Professional Development Plan (PDP) refers to plans developed by faculty members addressing the criteria contained in Article 22 and Appendix G.

  • Peer Assistance and Review Program 1. MCEA and MCPS agree to jointly operate a Peer Assistance and Review (PAR) Program. The PAR Program is a mechanism for maintaining systemwide quality control and ensuring that all MCPS teachers responsible for teaching students are functioning at or above the high MCPS standards of performance. It provides intensive assistance for any teacher who has not yet achieved that standard or who falls below acceptable standards. Assistance and review are provided to both experienced MCPS teachers in need of significant improvement and teachers in their first year of teaching.

  • How to File an Appeal of a Prescription Drug Denial For denials of a prescription drug claim based on our determination that the service was not medically necessary or appropriate, or that the service was experimental or investigational, you may request an appeal without first submitting a request for reconsideration. You or your physician may file a written or verbal prescription drug appeal with our pharmacy benefits manager (PBM). The prescription drug appeal must be submitted to us within one hundred and eighty (180) calendar days of the initial determination letter. You will receive written notification of our determination within thirty (30) calendar days from the receipt of your appeal. How to File an Expedited Appeal Your appeal may require immediate action if a delay in treatment could seriously jeopardize your health or your ability to regain maximum function, or would cause you severe pain. To request an expedited appeal of a denial related to services that have not yet been rendered (a preauthorization review) or for on-going services (a concurrent review), you or your healthcare provider should call: • our Grievance and Appeals Unit; or • our pharmacy benefits manager for a prescription drug appeal. Please see Section 9 for contact information. You will be notified of our decision no later than seventy-two (72) hours after our receipt of the request. You may not request an expedited review of covered healthcare services already received.

  • Program Compliance The School Board shall be responsible for monitoring the program to provide technical assistance and to ensure program compliance.

  • PROFESSIONAL DEVELOPMENT AND EDUCATIONAL IMPROVEMENT A. The Board agrees to implement the following:

  • Campus Program Dr. X. Xxx Xxxxxx, Chairperson of the Department of Management & Business Administration, (000) 000-0000 Division of Continuing Education: Academic advisor at center where student intends to transfer MAXIMUM NUMBER OF COMMUNITY COLLEGE STUDENTS TO BE ADMITTED: open BASIS FOR DETERMINING ADMISSION IF MORE THAN THE MAXIMUM NUMBER OF COMMUNITY COLLEGE STUDENTS APPLY: N/A GENERAL ADMISSION REQUIREMENTS TO THE INDEPENDENT INSTITUTION: Students applying to the university campus program are considered for admission on the basis of their secondary school record and results of the SAT or ACT examinations. For acceptance to the Division of Continuing Education, a prospective student must have a high school diploma or a General Equivalency Diploma. ADMISSION REQUIREMENTS TO THE MAJOR/PROGRAM OF STUDY: None beyond general admission requirements. PROGRAM OF STUDY TO BE TAKEN AT THE COMMUNITY COLLEGE: Complete Associate of Arts degree. Total Academic Hours: 60 PROGRAM OF STUDY AT SAINT XXX UNIVERSITY: (to include 39 hours of upper level credit and 30 hours of residency, 15 of which must be taken in the major)

  • Marketing Plan The MCP shall submit an annual marketing plan to ODM that includes all planned activities for promoting membership in or increasing awareness of the MCP. The marketing plan submission shall include an attestation by the MCP that the plan is accurate is not intended to mislead, confuse or defraud the eligible individuals or ODM.

  • Proposing Integration Activities in the Planning Submission No integration activity described in section 6.3 may be proposed in a CAPS unless the LHIN has consented, in writing, to its inclusion pursuant to the process set out in section 6.3(b).

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