COVERED POPULATION. The eligible population consists of those BadgerCare Plus eligible children and adolescents who meet the following criteria:
COVERED POPULATION. Deleted: Medicaid/BadgerCare The eligible population will be those BadgerCare Plus eligible children who meet the following criteria:
COVERED POPULATION. Provider shall provide services to the enrollment populations identified in and in accordance with the State Contract, as amended from time to time.
COVERED POPULATION. 6 A. RESIDENCY 6 B. AGE 6
COVERED POPULATION. The CY 2008 CFC capitation rates have been developed using historical experience for the population eligible for managed care enrollment based on age, gender, and program assignment. The program assignments shown in Table 1 were included in the development of the CY 2008 CFC capitation rates. Milliman makes no representations or warranties regarding the contents of this letter to third parties . Likewise, third parties are instructed that they are to place no reliance upon this letter prepared for ODJFS by Milliman that would result in the creation of any duty or liability under any theory of law by Milliman or its employees to third parties. Other parties receiving this letter must rely upon their own experts in drawing conclusions about the information presented. FINAL and CONFIDENTIAL Table 1 STATE OF OHIO DEPARTMENT OF JOB AND FAMILY SERVICES Summary of Managed Care Eligible Population Program Assignment Description PREG Healthy Start Pregnant Women PREGE Healthy Start Pregnant Women Expansion PREGEX Healthy Start Expedited Pregnant Women RPREGEX Healthy Start Expedited Pregnant Women RMF HSC Healthy Start Children HSCE Healthy Start Expansion <= 150% RHSC Healthy Start Children RMF CHIP1 Healthy Start CHIP 1 <=150% CHIP2 Healthy Start CHIP 2 000-000% RCHIP1 Healthy Start CHIP 1 <=150% RMF RCHIP2 Healthy Start CHIP 2 000-000% RMF RCHSUP Healthy Family Child Support Extended RMF CHSUP Healthy Family Child Support Extended OWFFAM Ohio Works First Families — Cash ROWFFAM Ohio Works First Families — Cash RMF LIFAM Low Income Families RLIFAM Low Income Families RMF HYFAM Healthy Families (Expansion 7/00 Reduced 1/06) TRANS Transitional LIIND Low Income Individuals RLIIND Low Income Individuals RMF Milliman extracted the eligible population information from historical data. The eligible population includes the Healthy Start and Healthy Families populations. If a member was ineligible during a month, all claims and eligibility for the month were excluded from the actuarial models.
COVERED POPULATION active, retired and former employees, as well as survivors of former employees or retirees, of Covered Entities.
COVERED POPULATION. 1. RESIDENCY The child/adolescent is a legal resident of Milwaukee County.
COVERED POPULATION. The CY 2008 ABD capitation rates have been developed using historical experience from the FFS population. The historical experience was developed for the population eligible for managed care enrollment based on age and program assignment. The program assignments shown in Table 1 were included in the development of the capitation rates. Xx. Xxx Xxxxxx, Ph.D. December 12, 2007 Table I STATE OF OHIO DEPARTMENT OF JOB AND FAMILY SERVICES Summary of Managed Care Eligible Population Program Assignment Description AGED Aged RAGED Aged as defined on RMF BLIND Blind RBLIND Blind as defined on RMF DISABLED Disabled RDISABLED Disabled as defined on RMF RESMED Residential State Supplement & Medicaid Milliman extracted the eligible population information from historical data. The eligible population includes the adult ABD population excluding: retro-active periods, back-dated periods, institutionalized, waiver, spend-down, Medicare dual-eligibles, and long-term nursing facility recipients. Adults are defined based on age greater than or equal to 21 during the base experience period. Long-term nursing facility was defined as stays lasting past the last day of the month following the admission to the nursing facility. If a member was ineligible during a month, all claims and eligibility for the month were excluded from the actuarial models.
COVERED POPULATION. The CY 2008 ABD capitation rates have been developed using historical experience from the FFS population. The historical experience was developed for the population eligible for managed care enrollment based on age and program assignment. The program assignments shown in Table 1 were included in the development of the capitation rates. Milliman makes no representations or warranties regarding the contents of this letter to third parties. Likewise, third parties are instructed that they are to place no reliance upon this letter prepared for ODJFS by Milliman that would result in the creation of any duty or liability under any theory of law by Milliman or its employees to third parties. Other parties receiving this letter must rely upon their own experts in drawing conclusions about the information presented Mx. Xxx Xxxxxx, Ph.D. December 12, 2007 Page 3 FINAL and CONFIDENTIAL Table 1 STATE OF OHIO DEPARTMENT OF JOB AND FAMILY SERVICES Summary of Managed Care Eligible Population Program Assignment Description AGED Aged RAGED Aged as defined on RMF BLIND Blind RBLIND Blind as defined on RMF DISABLED Disabled RDISABLED Disabled as defined on RMF RESMED Residential State Supplement & Medicaid Milliman extracted the eligible population information from historical data. The eligible population includes the adult ABD population excluding: retro-active periods, back-dated periods, institutionalized, waiver, spend-down, Medicare dual-eligibles, and long-term nursing facility recipients. Adults are defined based on age greater than or equal to 21 during the base experience period. Long-term nursing facility was defined as stays lasting past the last day of the month following the admission to the nursing facility. If a member was ineligible during a month, all claims and eligibility for the month were excluded from the actuarial models.
