MCO Sample Clauses
MCO. On an ongoing basis, if a Recipient was previously enrolled with a MCO and loses eligibility for a period of six (6) months or less, the Recipient will be re- enrolled with that MCO;
MCO. If the Recipient’s MCO is not a Centennial Care 2.0 MCO, then he/she will be auto assigned to a Centennial Care 2.0
MCO. Any violation of this Agreement shall constitute a default under the Development Agreement.
MCO. ETO benefits may be used, but will not be considered mandatory, for scheduled work days missed when a nurse is called off, mandated to un- schedule his/her shift or part thereof, or given the option to go off the schedule any time within the nurse’s shift due to low census, nursing unit closures (for example, on a holiday) or low acuity. This includes nurses who may also receive stand-by pay. Trades. When an RN trades shifts with another RN, ETO may be used but will not be considered mandatory.
MCO. A Medicaid managed care organization contracted with HHSC to provide health care services to Medicaid recipients.
MCO. If the Member’s Current MCO is not a Centennial Care 2.0 MCO and the Member fails to select a Centennial Care 2.0 MCO, the Member will be auto-assigned to a Centennial Care 2.0 MCO in the first auto-assignment cycle that begins December 1, 2018.
MCO. Failure to obtain accreditation and failure to maintain accreditation thereafter shall be considered a breach of this Agreement. Achievement of provisional accreditation status shall require a corrective action plan within thirty (30) calendar days of receipt of notification from the accreditation body and may result in termination of this Agreement. The CHC-MCO must submit the final hard copy Accreditation Report for each accreditation cycle within ten (10) days of receipt of the report. Updates of accreditation status, based on annual HEDIS scores must also be submitted within ten (10) days of receipt.
MCO. Covers (for all persons 20 and older) annual tests to determine blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol levels (low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels). (N.J.S.A.§26:2J- 4.6(a)1) (SSA §1905(a)13) For all persons 20 years of age and older, annual cardiovascular screenings are covered. More frequent testing is covered when determined to be medically necessary. Covered for services rendered beyond Medicare Part B limits. Covered. Part B. Covers screenings for cholesterol, lipid, and triglyceride levels once every 5 years. No copay or coinsurance. Part B deductible does not apply. Members generally pay 20% of the Medicare-approved amount for the doctor’s visit itself. (42 CFR §410.17) Any applicable cost sharing is covered by the Medicaid benefit. Members have $0 cost sharing liability. Chiropractic Services Covered. MCO. Categorically Needy. Covers manipulation of the spine which the chiropractor is legally authorized by the State to perform. The chiropractor may prescribe certain services as outlined in N.J.A.C. Covers manipulation of the spine, as well as certain services as outlined in N.J.A.C. 10:68-2, such as clinical laboratory services; certain medical supplies; durable medical equipment; pre- fabricated orthoses; *Covered. Part B. *Limited services provided to correct subluxation when deemed medically necessary. --Does not cover x-rays or any other diagnostic or therapeutic services furnished or ordered by a chiropractor. Member pays 20% of Medicare-approved amount. The Part B deductible applies. (42 CFR §410.21(b)) Any applicable cost sharing is covered by the Medicaid benefit. Members have $0 cost sharing liability. §10:68-2. physical therapy (N.J.A.C. §10:49- services; and
MCO. 1. Management; 2. Finance; 3. Information System; 4. Operations (Access, Network, Waiver Implementation); 5. Quality; and 6. Others to be identified if needed.
MCO. Covers semi- private room accommodations; Covers stays in critical access hospitals; inpatient rehabilitation facilities; inpatient mental health care; semi-private Covered.