COVERED POPULATIONS Sample Clauses

COVERED POPULATIONS. Medallion 4.0 covers all Medicaid and FAMIS mandatory eligibility groups as well as various optional categorically needy and medically needy groups as defined in this contract. The Contractor agrees to provide services to the general populations as defined and outlined in Federal and State regulations as well as this Contract. In addition, the Contractor agrees to provide services to any additional populations or services that the Department, Governor or General Assembly may deem appropriate. The Department reserves the right to transition populations and services into either CCC Plus or Medallion programs in the future. The Contractor shall work with the Department to ensure services are provided to the populations outlined below as well as ensuring that Departmental goals and focuses are met. Pursuant to 12 VAC30-30-10, the current Medallion 4.0 population includes:

COVERED POPULATIONS. The MyCare Ohio eligible population includes all “full benefit” Medicare and Medicaid enrollees age 18 and over within the selected MyCare demonstration counties. The following describes the populations not eligible to participate in the MyCare program:  Partial Medicare Eligibility  Delayed and Other Spend-down  PACE  Intellectual Disabilities and Other Developmental Disabilities (IDD)  Receives Third-Party Liability (TPL) Benefits  CMS Independence at Home (IAH) Demonstration  Employee Union Coverage and/or Retiree Drug Subsidy  Incarcerated Recipients  Other Exclusion Populations

COVERED POPULATIONS. The following populations will be served by the MCO:  Children and youth who are in xxxxxx care  Individuals receiving adoption assistance  Children ages three (3) up to twenty-one (21) eligible for the CSED waiver and enrolled in the MCO as slots are available  Youth formerly in xxxxxx care up to age twenty-six (26) who aged out of xxxxxx care while enrolled in Medicaid in the state of West Virginia.

COVERED POPULATIONS. The following populations will be served by the MCO: • Children and youth who are in xxxxxx care (effective March 1, 2020); • Individuals receiving adoption assistance (effective March 1, 2020); • Children from three (3) up to age twenty-one (21) eligible for the SED waiver and enrolled in the MCO as slots are available (effective March 1, 2020);

COVERED POPULATIONS. Contractor shall provide managed care services on a statewide basis. There will be no regional coverage variations. The populations covered under this Contract are set forth in the Special Contract Exhibit D, Table D.01.