Mandatory Populations Clause Samples
The 'Mandatory Populations' clause defines specific groups or categories of individuals to whom certain terms, requirements, or services in the agreement must apply without exception. In practice, this clause might list populations such as minors, employees, or residents of a particular jurisdiction, ensuring that contractual obligations or protections are automatically extended to them. Its core function is to guarantee that these designated groups are consistently included, thereby preventing ambiguity or selective application and ensuring compliance with legal or policy mandates.
Mandatory Populations a. The categories of eligible recipients authorized to be enrolled in the Health Plan are:
(1) Low Income Families and Children;
(2) Sixth Omnibus Budget Reconciliation Act (SOBRA) Children;
(3) Supplemental Security Income (SSI) Medicaid Only,
(4) Refugees;
(5) Title XXI MediKids, in accordance with s. 409.8132, F.S., and
(6) Medicaid Eligible Designated by SOBRA/Aged and Disabled population (Meds AD) unless they otherwise meet a requirement of a voluntary or excluded population.
b. Except as otherwise specified in this Contract, Title XXI MediKids-eligible participants are entitled to the same conditions and services as currently eligible Title XIX Medicaid recipients.
Mandatory Populations. The categories of eligible recipients authorized to be enrolled in the Health Plan are: Low Income Families and Children; Sixth Omnibus Budget Reconciliation Act (SOBRA) Children; Supplemental Security Income (SSI) Medicaid Only, Refugees, and the Meds AD population. Title XXI MediKids are eligible for enrollment in the plan in accordance with section 409.8132, F.S. Except as otherwise specified in this contract, Title XXI MediKids eligible participants are entitled to the same conditions and services as currently eligible Title XIX Medicaid beneficiaries. Women enrolled in the plan who change eligibility categories to the SOBRA eligibility category due to the pregnancy will remain eligible for enrollment in the plan.
Mandatory Populations. There are no mandatory populations for the HIV/AIDS Specialty Plans. For non-Reform HMOs that specialize in HIV/AIDS, mandatory assignments are limited to Medicaid recipients who have HIV/AIDS and who are subject to mandatory assignment.
Mandatory Populations a. Recipients in any of the following programs or eligibility categories are required to enroll in a Managed Care Plan:
Mandatory Populations. Individuals eligible for Medicaid or CHIP who are mandated to participate in a Coordinated Care Network (CCN) include: • Children under 19 years of age including those who are eligible under Section 1931 poverty-level related groups and optional groups of older children in the following categories: o LIFC Program (Low Income Families with Children) - Individuals and families who meet the eligibility requirements of the AFDC State Plan in effect on July 16, 1996; o FITAP Program (Families in Temporary Need of Assistance) - Individuals and families receiving cash assistance through the state’s Temporary Assistance to Needy Families (TANF) Program administered by the DSS; o CHAMP-Child Program - Children up to age 19, who meet financial and non-financial eligibility criteria. Deprivation or uninsured status is not an eligibility requirement; o Deemed Eligible Child Program - Infants born to Medicaid eligible pregnant women, regardless of whether or not the infant remains with the birth mother, throughout the infant’s first year of life; o Youth Aging Out of ▇▇▇▇▇▇ Care - Children under age 21 who were in ▇▇▇▇▇▇ care (and already covered by Medicaid) on their 18th birthday, but have aged out of ▇▇▇▇▇▇ care; o Continued Medicaid Program - Short-term coverage for families who lose LIFC or TANF eligibility because of child support collections, an increase in earnings, or an increase in the hours of employment; and
Mandatory Populations. 42 CFR §438.1(a)(5)(i)
Mandatory Populations. Mandatory Populations are those Medicaid beneficiaries who are required to enroll in a PHP when first offered as a benefit option.