Flexible Services Sample Clauses

Flexible Services. Alternative services that are not included in the state plan or a waiver of the Arkansas Medicaid Program and that are appropriate and cost-effective services that improve the health or social determinants of a member of an enrollable Medicaid beneficiary population that affect the health of a member of an enrollable Medicaid beneficiary population. Fraud Prevention Activities Fraud Prevention Activities are as defined in 42 CFR § 438.8.
Flexible Services. Enrollees that are enrolled in an ACO may be able to access Flexible Services as part of their ACO enrollment. Flexible Services are unique goods and services that are not otherwise covered under the Enrollee’s MassHealth benefit and which are provided to address a health-related social need. Flexible Services are authorized by an ACO through the Enrollee’s care plan. Governing Body – a board or other organized group of individuals, with the exclusive authority to make final decisions on behalf of the Contractor. Governance Structure - the corporate structure or affiliations, as described in Section 2.1, through which the Contractor will perform the requirements of the Contract. Grievance – any expression of dissatisfaction by an Assigned or Engaged Enrollee (or their authorized representative, if applicable), about any action or inaction by the Contractor. Possible subjects for Grievances include, but are not limited to, quality of supports provided, aspects of interpersonal relationships such as rudeness of an employee of the Contractor, or failure to respect the Assigned or Engaged Enrollee’s rights. Home and Community-Based Services (HCBS) Waiver – a federally approved program operated under Section 1915(c) of the Social Security Act that authorizes the U.S. Secretary of Health and Human Services to grant waivers of certain Medicaid statutory requirements so that a state may furnish home and community based services to certain Medicaid beneficiaries who require a level of care that is provided in a hospital, nursing facility, or Intermediate Care Facility for the Intellectually Disabled (ICF/ID). The ten HCBS Waivers are: the Frail Elder Waiver, the two ABI Waivers, the Traumatic Brain Injury Waiver, the four DDS Waivers and the two Money Follows the Person (MFP) Waivers. There are ten MassHealth HCBS Waivers: The Acquired Brain Injury Non-Residential waiver, the Acquired Brain Injury Residential Habilitation waiver, the Children’s Autism Spectrum Disorder waiver, the DDS Intensive Supports waiver, the DDS Community Living waiver, the DDS Adult Supports waiver, the Frail Elder waiver, the Money Follows the Person Community Living waiver, the Money Follows the Person Residential Supports waiver, and the Traumatic Brain Injury waiver. Identified Enrollee (Identification) – an Enrollee identified by EOHHS for Assignment to a Community Partner based on the Enrollee’s claims and service history or in another manner determined by EOHHS. Independent Living - ...

Related to Flexible Services

  • Ambulance Services Ground Ambulance This plan covers local professional or municipal ground ambulance services when it is medically necessary to use these services, rather than any other form of transportation as required under R.I. General Law § 27-20-55. Examples include but are not limited to the following: • from a hospital to a home, a skilled nursing facility, or a rehabilitation facility after being discharged as an inpatient; • to the closest available hospital emergency room in an emergency situation; or • from a physician’s office to an emergency room. Our allowance for ground ambulance includes the services rendered by an emergency medical technician or paramedic, as well as any drugs, supplies and cardiac monitoring provided. Air and Water Ambulance This plan covers air and water ambulance services when: • the time needed to move a patient by land, or the instability of transportation by land, may threaten a patient’s condition or survival; or • if the proper equipment needed to treat the patient is not available from a ground ambulance. The patient must be transported to the nearest facility where the required services can be performed and the type of physician needed to treat the patient’s condition is available. Our allowance for the air or water ambulance includes the services rendered by an emergency medical technician or paramedic, as well as any drugs, supplies and cardiac monitoring provided.

  • Marketing Services The Manager shall provide advice and assistance in the marketing of the Vessels, including the identification of potential customers, identification of Vessels available for charter opportunities and preparation of bids.