Hospital-Determined Presumptive Eligibility Sample Clauses

Hospital-Determined Presumptive Eligibility effective January 1, 2014. Effective January 1, 2014, hospitals that elect to do so may make presumptive eligibility determinations for individuals who appear eligible for HIV-Family Assistance or the Breast and Cervical Cancer Treatment Program under the demonstration, in addition to populations that are eligible in accordance with the Medicaid state plan. The hospital-determined presumptive eligibility benefit for pregnant women and unborn children is a full MassHealth Standard benefit. Presumptive Eligibility through December 31, 2013. Effective through December 31, 2013, presumptive eligibility is offered to certain children who appear eligible for MassHealth Standard or Family Assistance as well as pregnant women who appear eligible for MassHealth Prenatal program. Presumptive eligibility begins 10 calendar days prior to the date the Medical Benefit Request (MBR) is received at the MassHealth Enrollment Center (MEC) or MassHealth outreach site and lasts until MassHealth makes an eligibility determination (but no longer than 60 days). If information necessary to make the eligibility determination is not submitted within 60 days after the begin date, the MBR will be deactivated and presumptive eligibility will end. A child may receive presumptive eligibility only once in a 12-month period. A presumptively-eligible child receiving services under the Family Assistance program is not assessed a monthly health insurance MassHealth premium.
Sample 1
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Related to Hospital-Determined Presumptive Eligibility

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

  • Member Eligibility Verify Member eligibility contemporaneous with the rendering of services. BCBS will provide systems and/or methods for verification of eligibility and benefit coverage for Members. This is furnished as a service and not as a guarantee of payment;

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

  • Employee Eligibility Verification The Contractor warrants that it fully complies with all Federal and State statutes and regulations regarding the employment of aliens and others and that all its employees performing work under this Contract meet the citizenship or alien status requirement set forth in Federal statutes and regulations. The Contractor shall obtain, from all employees performing work hereunder, all verification and other documentation of employment eligibility status required by Federal or State statutes and regulations including, but not limited to, the Immigration Reform and Control Act of 1986, 8 U.S.C. §1324 et seq., as they currently exist and as they may be hereafter amended. The Contractor shall retain all such documentation for all covered employees for the period prescribed by the law. The Contractor shall indemnify, defend with counsel approved in writing by County, and hold harmless, the County, its agents, officers, and employees from employer sanctions and any other liability which may be assessed against the Contractor or the County or both in connection with any alleged violation of any Federal or State statutes or regulations pertaining to the eligibility for employment of any persons performing work under this Contract.

  • Benefit Level Two Health Care Network Determination Issues regarding the health care networks for the 2017 insurance year shall be negotiated in accordance with the following procedures:

  • Determination of Eligibility The Plan Administrator shall determine the eligibility of each Employee for participation in the Plan based upon information provided by the Employer. Such determination shall be conclusive and binding on all individuals except as otherwise provided herein or by operation of law.

  • Employee Eligibility For purposes of this section, “eligible employee” shall be defined by the Public Employees’ Medical and Hospital Care Act.

  • Verification of Employment Eligibility By executing this Agreement, Consultant verifies that it fully complies with all requirements and restrictions of state and federal law respecting the employment of undocumented aliens, including, but not limited to, the Immigration Reform and Control Act of 1986, as may be amended from time to time, and shall require all subconsultants and sub-subconsultants to comply with the same.

  • 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.

  • Determination Final The determination by Xxxxxxx Mac or the Global Agent of the interest rate on the Notes and the determination of any payment on any Note (or any interim calculation in the determination of any such interest rate, index or payment) shall, absent manifest error, be final and binding on all parties. If a principal or interest payment error occurs, Xxxxxxx Mac or the Global Agent may correct it by adjusting payments to be made on later Payment Dates or in any other manner Xxxxxxx Mac or the Global Agent considers appropriate. If the source of One-Month LIBOR changes in format, but Xxxxxxx Mac or the Global Agent determines that the source continues to disclose the information necessary to determine the related Class Coupon substantially as required, Xxxxxxx Mac will amend the procedure for obtaining information from that source to reflect the changed format. All One-Month LIBOR values used to determine interest payments are subject to correction within 30 days from the applicable payment. The source of a corrected value must be the same source from which the original value was obtained. A correction might result in an adjustment on a later date to the amount paid to the Holder.

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