State Plan for Medical Assistance definition

State Plan for Medical Assistance or "the Plan" means the document containing the covered groups, covered services and their limitations, and provider reimbursement methodologies as provided for under Title XIX of the Social Security Act.

State Plan for Medical Assistance or "Plan" means the Commonwealth's legal document approved by CMS identifying the covered groups, covered services and their limitations, and provider reimbursement methodologies as provided for under Title XIX of the Social Security Act.

State Plan for Medical Assistance or “Plan” means the regulations identifying the covered groups,

Examples of State Plan for Medical Assistance in a sentence

• These Additional Services are health care services that are not covered by the South Carolina State Plan for Medical Assistance and/or are in excess of the amount, duration, and scope of those listed in the Managed Care Policy and Procedure Guide and handbooks.

• The State shall provide each individual receiving a Housing Slot under this Agreement with access to services for which that individual is eligible that are covered under the North Carolina State Plan for Medical Assistance, the Centers for Medicare and Medicaid Services (“CMS”) approved Medicaid 1915(b)/(c) waiver, or the State-funded service array.

• DOM is charged with the administration of the Mississippi State Plan for Medical Assistance in accordance with the requirements of Title XIX of the Social Security Act of 1935, as amended, and Miss.

• The MAO and its contracted providers are prohibited from imposing cost-sharing requirements on Dual Eligible Members that would exceed the amounts permitted under the Arizona State Plan for Medical Assistance, per section 1852(a)(7) of the Act and 42 CFR§422.504(g)(1)(iii).

• UNDER MAO MAO and its contracted providers are prohibited from imposing cost-sharing requirements on enrolled Full Benefit Dual Eligible Members that would exceed the amounts permitted under the Arizona State Plan for Medical Assistance, per section 1852(a)(7) of the Act and 42 CFR§422.504(g)(1)(iii).

More Definitions of State Plan for Medical Assistance

State Plan for Medical Assistance or "Plan" means the [ regulations Commonwealth's legal document approved by the Centers for Medicare and Medicaid Services ] identifying the covered groups, covered services and their limitations, and provider reimbursement methodologies as provided for under Title XIX of the Social Security Act.

State Plan for Medical Assistance or “State Plan” - The comprehensive written statement submitted to CMS by the Department describing the nature and scope of the Virginia Medicaid and FAMIS programs and giving assurance that it will be administered in conformity with the requirements, standards, procedures, and conditions for obtaining Federal financial participation. “State Plan Substituted Services” (In Lieu of Services) – Alternative services or services in a setting that are not included in the state plan or not normally covered by this Contract but are medically appropriate, cost effective substitutes for state plan services that are included within this Contract (for example, a service provided in an ambulatory surgical center or sub-acute care facility, rather than an inpatient hospital). However, the Contractor shall not require a Member to use a state plan substituted service/“in lieu of service” as a substitute for a state plan covered service or setting, but may offer and cover such services or settings as a means of ensuring that appropriate care is provided in a cost efficient manner. “Subcontract” A written contract between the Contractor and a third party, under which the third party performs any one or more of the Contractor’s obligations or functional responsibilities under this Contract.

State Plan for Medical Assistance or "State Plan" means the comprehensive written statement submitted to CMS by DMAS describing the nature and scope of the Virginia Medicaid program and giving assurance that the program will be administered in conformity with the requirements, standards, procedures, and conditions for obtaining federal financial participation. DMAS has the authority to administer such State Plan for the Commonwealth pursuant to the authority of the § 32.1-325 of the Code of Virginia.

State Plan for Medical Assistance or "the Plan" means the document containing the covered groups,

State Plan for Medical Assistance or “the Plan” means the Commonwealth’s legal

State Plan for Medical Assistance or "Plan" means the Commonwealth’s legal document

State Plan for Medical Assistance or “State Plan” - The comprehensive written statement submitted to CMS by the Department describing the nature and scope of the Virginia Medicaid program and giving assurance that it will be administered in conformity with the requirements, standards, procedures and conditions for obtaining Federal financial participation. The Department has the authority to administer the State Plan for Virginia under Code of Virginia § 32.1-325, as amended. “State Plan Substituted Services” (In Lieu of Services) – Alternative services that are not (or services provided in a setting that is not) included in the state plan and/or not normally covered by this Contract, but are medically appropriate, cost effective substitutes for state plan services that are included within this Contract (An example of this type of services is a service provided in an ambulatory surgical center or sub-acute care facility, rather than an inpatient hospital). The Contractor shall not, however, require a Member to use a state plan substituted service/“in lieu of service” as a substitute for a state plan covered service or setting, but may offer and cover such services or settings as a means of ensuring that appropriate care is provided in a cost efficient manner. For individuals 21 through 64 years of age, an Institution for Mental Disease (IMD) may be an “in lieu of” service; however, a member’s stay in an IMD shall be limited to no more than fifteen (15) calendar days in any calendar month. Reference 42 CFR §§ 438.3 and 438.6(e).