Common use of HIGHLY INTEGRATED DUAL ELIGIBLE SPECIAL NEEDS PLAN Clause in Contracts

HIGHLY INTEGRATED DUAL ELIGIBLE SPECIAL NEEDS PLAN. (“HIDE SNP”) STATUS This paragraph is applicable only to an MAO contracted under this Agreement that shall offer a Medicare Advantage D-SNP Plan Benefit Package (PBP) of integrated Medicare and Medicaid health coverage, consistent with State policy, to eligible Full Benefit Dual Eligible Members in conjunction with the requirements of its AHCCCS Complete Care (ACC), ALTCS DD, or ACC-RBHA health plan in accordance with the eligibility terms, restrictions and requirements for each such health plan as described in of Section 4 of this Agreement. MAO serving Full Benefit Dual Eligible Members through an integrated companion ACC, ALTCS DD, or ACC-RBHA health plan contract with AHCCCS shall be designated annually by CMS as a “HIDE SNP” according to the following CMS requirements:

HIGHLY INTEGRATED DUAL ELIGIBLE SPECIAL NEEDS PLAN. (“HIDE SNP”) STATUS This paragraph is applicable only to an MAO contracted under this Agreement that shall offer a Medicare Advantage D-SNP Plan Benefit Package (PBP) of integrated Medicare and Medicaid health coverage, consistent with State policy, to eligible Full Benefit Dual Eligible Members in conjunction with the requirements of its AHCCCS Complete Care (ACC), ALTCS DD, or ACC-RBHA health plan in accordance with the eligibility terms, restrictions and requirements for each such health plan as described in of Section 4 of this Agreement. MAO serving Full Benefit Dual Eligible Members through an integrated companion ACC, ALTCS DD, or ACC-RBHA health plan contract with AHCCCS shall be designated annually by CMS as a “HIDE SNP” according to the following CMS requirements: