Managed Care Plan —. An eligible plan under Contract with the Agency to provide services in the LTC or MMA Statewide Medicaid Managed Care Program.
Managed Care Plan —. Tenant has entered into a contract with Health Choice Managed Care Plan and is fully entitled to participate as a provider of services under the Health Choice Managed Care Plan. During the Term of this Lease, Tenant shall maintain its contractual relationship with Health Choice Managed Care Plan and shall not terminate or allow the termination of Tenant's relationship as a provider of services under such Plan without the written consent of the Landlord. Provided, however, in the event that Tenant's relationship as a provider of services to Health Choice Managed Care Plan is terminated for any reason, such termination shall not be an event of default hereunder if Tenant within sixty (60) days following such termination establishes a similar contractual relationship as a provider of services with a similar managed care plan (or other similar type plan) reasonably acceptable to Landlord.
Managed Care Plan —. It is my responsibility to know and understand my managed care plan. Generally, insurance plans require payment of deductibles and/or co- payments. I understand that if Synapse Association contracts with my insurer, this office will only file patient insurance claims if I provide them with the proper information, along with a copy of my current insurance card and/or other sufficient proof of insurance. In the event that an insurer overpays, this office will refund the overpayments to me within a reasonable time after written request. Otherwise, overpayments will be credited to my account for future services. Initial:
Managed Care Plan —. The Resident may not enroll in a health maintenance organization (“HMO”) or other managed care plan for which the Community is not a network or participating provider, and the Resident may not enroll in or subscribe to any HMO or managed care plan providing equivalent Medicare benefits without the written consent of the Community. Prior to enrolling in any HMO or managed care plan, the Resident shall sign an addendum identifying the plan and reflecting the Community’s approval or disapproval. In the event that the Resident subscribes to an HMO or other managed care plan, including a managed care plan that provides Medicare benefits, and the Community is not a participating provider in the Resident’s managed care plan, the Community may elect, at its option, to attempt to negotiate an agreement with and to obtain payment from the Resident’s managed care plan for covered services to be provided by the Community. If the Resident’s managed care plan and the Community do not reach an agreement on the terms under which services would be provided, or the Resident’s managed care plan does not agree to provide payment for covered services provided by the Community, the Resident shall either transfer to and receive services from a participating provider in the Resident’s managed care plan or shall pay the Community, in addition to the Monthly Service Fee, the cost of routine nursing care or personal care which otherwise would have been covered by Medicare indemnity coverage, but only for the limited period of time during which Medicare or other required insurance coverage would have been available. The Resident shall pay for all other ancillary charges and services related to such care. In the event that the Resident is transferred to a provider participating in the Resident’s managed care plan, the Resident shall continue to pay the Monthly Service Fee and additionally all costs and charges related to the transfer to and occupancy of the participating provider. There will be no reduction in the Monthly Service Fee, as a result of the Resident’s participation in any health insurance program or managed care plan, which provides for payment for services rendered in Nursing Care or for other services provided by the Community. If the Community is or becomes a network provider in the Resident’s managed care plan, the Community reserves the right to withdraw from participating as a network provider.
Managed Care Plan —. An agency or organization that is duly organized and recognized by the State of California as a “Medi-Cal Managed Care” contract recipient. These contracts provide for health care services through established networks of organized systems of care, which emphasize primary and preventive care, for Medi-Cal recipients. Participating Agency See “Covered Homeless Organization” Permanent Housing (PH) — includes Permanent Supportive Housing and Rapid Re-Housing Community-based housing without a designated length of stay, and includes both permanent supportive housing and rapid rehousing. To be permanent housing, the program participant must be the tenant on a lease for a term of at least one year, which is renewable for terms that are a minimum of one month long, and is terminable only for cause. 24 CFR 578.3 Permanent Supportive Housing (PSH)
