Dual Eligible Covered Persons Sample Clauses

Dual Eligible Covered Persons. Provider agrees that in no event, including but not limited to, non-payment by the State Medicaid agency or other applicable regulatory authority, other State source, or breach by Subcontractor of the Agreement, shall Provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against any Dual Eligible Covered Person, person acting on behalf of the Dual Eligible Covered Person, or Subcontractor or Health Plan (unless notified otherwise) for Medicare Part A and B Cost Sharing. Instead, Provider will either: (a) accept payment made by or on behalf of Subcontractor as payment in full; or
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Dual Eligible Covered Persons. Provider shall not charge Covered Persons who are dually eligible for Medicare and Medicaid for Covered Services. Provider shall identify third-party liability coverage, including Medicare and long-term care insurance, as applicable, and seek third-party liability payments before submitting claims to Health Plan. Attachment A: Medicaid COMPENSATION SCHEDULE FACILITY SERVICES BEHAVIORAL HEALTH Mental Health Crisis Center Of Lancaster County This compensation schedule (“Compensation Schedule”) sets forth the maximum reimbursement amounts for Covered Services provided by Contracted Providers to Covered Persons enrolled in a Medicaid Product. Where the Contracted Provider’s tax identification number (“TIN”) has been designated by the Payor as subject to this Compensation Schedule, Payor shall pay or arrange for payment of a Clean Claim for Covered Services rendered by the Contracted Provider according to the terms of, and subject to the requirements set forth in, the Agreement and this Compensation Schedule. Payment under this Compensation Schedule shall consist of the Allowed Amount as set forth herein less all applicable Cost-Sharing Amounts. All capitalized terms used in this Compensation Schedule shall have the meanings set forth in the Agreement, the applicable Product Attachment, or the Definitions section set forth at the end of this Compensation Schedule.
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Dual Eligible Covered Persons. Provider agrees that in no event, including but not limited to, non-payment by the State Medicaid agency or other applicable regulatory authority, other State source, or breach by Subcontractor of the Agreement, shall Provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against any Dual Eligible Covered Person, person acting on behalf of the Dual Eligible Covered Person, or Subcontractor or Health Plan (unless notified otherwise) for Medicare Part A and B Cost Sharing. Instead, Provider will UHC/PRO.ST.PROG..XXXXXX.00.00.XX UnitedHealthcare Confidential and Proprietary either: (a) accept payment made by or on behalf of Subcontractor as payment in full; or
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Dual Eligible Covered Persons. Covered Persons eligible for both Medicare and Medicaid will not be held liable for Medicare Part A and B cost sharing when the State is responsible for paying such amounts. Provider may not impose cost-sharing that exceeds the amount of cost-sharing that would be permitted with respect to the individual under Title XIX if the individual were not enrolled in such a plan. Providers will: (1) accept the Plan payment under the terms of the Agreement as payment in full, or (2) xxxx the appropriate State source. [42 C.F.R. §§ 422.504(i)(3)(i) and 422.504(g)(1)(i)]
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Related to Dual Eligible Covered Persons

  • Special Maternity Allowance for Totally Disabled Employees (a) An employee who:

  • Dependent Eligibility To be eligible to enroll as a Covered Dependent, a person must be:

  • Special Eligibility The following employees also receive an Employer Contribution:

  • General Eligibility 1. Except as provided in #2 below, a teacher who received an evaluation rating of ineffective or improvement necessary in the prior school year is not eligible for any salary increase and remains at their prior year salary.

  • Special Parental Allowance for Totally Disabled Employees (a) An employee who:

  • Service Eligibility Criteria 4.3.4.1 High capacity EELs must comply with the following service eligibility requirements:

  • Non-Qualifying Operations 1. A good shall not be considered to be an originating good merely by reason of:

  • Termination; General The Underwriter may terminate this Agreement by notice to the Fund, at any time at or prior to Closing Time (i) if there has been, since the time of execution of this Agreement or since the respective dates as of which information is given in the Prospectus, any material adverse change in the condition, financial or otherwise, or in the earnings, business affairs or business prospects of the Fund or the Adviser, whether or not arising in the ordinary course of business, or (ii) if there has occurred any material adverse change in the financial markets in the United States or the international financial markets, any outbreak of hostilities or escalation thereof or other calamity or crisis or any change or development involving a prospective change in national or international political, financial or economic conditions, in each case the effect of which is such as to make it, in the judgment of the Underwriter, impracticable to market the Shares or to enforce contracts for the sale of the Shares, or (iii) if trading in any securities of the Fund has been suspended or materially limited by the Commission or the New York Stock Exchange, or if trading generally on the American Stock Exchange or the New York Stock Exchange or in the Nasdaq National Market has been suspended or materially limited, or minimum or maximum prices for trading have been fixed, or maximum ranges for prices for securities have been required, by any of said exchanges or by such system or by order of the Commission, the National Association of Securities Dealers, Inc. or any other governmental authority, or (iv) if a banking moratorium has been declared by either Federal or New York authorities.

  • Continuing Eligibility To continue health benefits, a permanent intermittent employee must be credited with a minimum of 480 paid hours in a control period or 960 paid hours in two consecutive control periods.

  • Benefit Eligibility For purposes of the Benefit Plan entitlement, common-law and same sex relationships will apply as defined.

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