Change in Living Arrangement Prior to Capitation Cut-off Sample Clauses

Change in Living Arrangement Prior to Capitation Cut-off. If the MCO discovers and promptly notifies the STATE that an Enrollee was Institutionalized prior to the first effective date of MSC+ or MSHO enrollment, and was assigned an RCC of “A” or “B” for MSHO or the Nursing Facility benefit for MSC+, based on the information in MMIS at the time of enrollment, the STATE will retroactively close the “P” span so that the plan will not have liability for Medicaid Nursing Facility days for this Enrollee, unless the conditions for a new Nursing Facility benefit period are met.
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Change in Living Arrangement Prior to Capitation Cut-off. If the MCO discovers and promptly notifies the STATE that an Enrollee was Institutionalized prior to the first effective date of MSC+ or MSHO enrollment, and was assigned an RCC of “A” or “B” for MSHO or the Nursing Facility benefit for MSC+, based on the information in MMIS at the time of enrollment, the STATE will retroactively close the “P” span so that the plan will not have liability for Medicaid Nursing Facility days for this Enrollee, unless the conditions for a new Nursing Facility benefit period are met.‌ Premium Tax; HMO Surcharge. Pursuant to applicable Minnesota Statutes,‌ §297I, and § 256.9657, subd. 3, the MCO may be taxed on the premiums paid by the STATE under the Medical Assistance program. If the MCO is exempt or is no longer required to pay these taxes, the MCO’s base rate will be adjusted to reflect that change.
Sample 1
Change in Living Arrangement Prior to Capitation Cut-off. If the MCO discovers and promptly notifies the STATE that an Enrollee was Institutionalized prior‌ to the first effective date of MnDHO enrollment, and was assigned an RCC other than “U”, the STATE will:
Sample 1
Change in Living Arrangement Prior to Capitation Cut-off. If an Enrollee enters the Nursing Facility prior to Capitation Cut-off, the STATE shall retroactively change the eligibility span for the Enrollee so the HEALTH PLAN will not have liability for Nursing Facility days for the Enrollee, unless the conditions for a new Nursing Facility liability period are met.
Sample 1

Related to Change in Living Arrangement Prior to Capitation Cut-off

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