Delivery System installations used for the purposes of producing, processing, compressing, testing, measuring and selling the Gas at the Delivery Point;
Delivery System. The School District shall retain the right to explore, jointly with the Federation, a contract for workers’ compensation benefits through insurance and/or other delivery systems, including but not limited to a capitated medical delivery program that complies with the terms of this Section.
Delivery System. 50. Defendants, Commissioner and Department of Mental Health and Mental Retardation shall establish, either within the Department or through contracts with private agencies, community support services which, within reason, are accessible geographically to all class members. The plan described in Section V(B) above shall also set forth a schedule, on an annualized basis, for meeting the needs of class members for community support workers and for ISP's which conform to the requirements of this Agreement. The needs shall be met as quickly as possible. In any event, defendants shall assure that all class members who want an ISP or community support worker shall have them by September 1, 1995.
Delivery System. An individual choosing to enroll in the REM program is prohibited from enrolling in an MCO. Services are delivered on a FFS basis.
Delivery System. Provider Participation in the pilot must be limited to primary care clinician sites that participate or enroll in the Primary Care Clinician Plan (PCCP). The practices must be responsible for supervision and coordination of the medical team, including Community Health Workers; delivery of asthma-related services paid for by the PMPM payment; as well as the PMPM cost of each beneficiary enrolled. Provider participation in the pilot must be determined through a Request for Proposal (RFP) process. The state must prioritize participation by qualified practices that serve a high number of patients with high-risk asthma enrolled in PCCP and have the capacity to manage asthma in a coordinated manner. In addition, the state must seek to include qualified practices that are geographically dispersed across the state and represent a range of provider types, such as physician group practices, community health centers, and hospital outpatient departments, in order to explore a variety of infrastructure challenges.
Delivery System. Services provided through this Demonstration are paid via a managed care delivery system via CMOs. Standard Medicaid managed care rules will apply including freedom of choice of provider for family planning services as specified in 42 CFR 431.51(a)(5).
Delivery System. The state will operate the ICS program in a manner consistent with its approved Community Options 1915(c) waiver program and must meet all quality, administrative, operational, and reporting requirements contained therein.
Delivery System. The parties acknowledge and agree that Ethicon shall have the right to purchase Delivery Systems directly from a third party manufacturer and/or to provide such Delivery Systems itself, but only to the extent that the manufacture, use or sale of such Delivery System is not covered by a Valid Claim of a Patent. In the event Ethicon so elects to obtain or provide a Delivery System, the parties shall negotiate in good faith an equitable adjustment to the Purchase Price to take into account any modification in the costs incurred by Focal as a result thereof.
Delivery System. The MassHealth section 1115 demonstration provides benefits through multiple delivery systems and programs. A fundamental philosophy of MassHealth is that the Commonwealth will enable beneficiaries to take advantage of available and qualified employer-sponsored (ESI) or student health (SHIP) insurance if cost effective. These circumstances include the availability of ESI, the employer’s contribution level meeting a state-specified minimum, and its cost-effectiveness. MassHealth pays for medical benefits directly (direct coverage) only if no other source of payment is available and cost-effective. Beneficiaries are required, as a condition of eligibility under some coverage types, to obtain or maintain private health insurance if MassHealth determines it is cost effective to do so, with the premium assistance necessary to make it affordable for the beneficiary. All demonstration programs, except MassHealth Limited have a premium assistance component.
Delivery System. Physical health and vision benefits are rendered through one of eight Medicaid MCOs; rehabilitation services (occupational therapy, physical therapy, and speech) are rendered on a fee for service basis for children (20 years old and under); dental services are rendered through a dental Administrative Services Organization (ASO); and behavioral health benefits (mental health and substance use disorder benefits) are rendered through an ASO. The managed care authority applies to all populations except for those listed in STC 23.
