Medicare-Medicaid Beneficiary. For the purposes of this Demonstration, individuals who are enrolled in Medicare Part A and B and eligible for and receiving MassHealth Standard or CommonHealth and no other comprehensive private or public health coverage. Medicaid — The program of medical assistance benefits under Title XIX of the Social Security Act and various Demonstrations and waivers thereof. Medicare — Title XVIII of the Social Security Act, the federal health insurance program for people age sixty-five (65) or older, people under sixty-five (65) with certain disabilities, and people with End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis. Medicare Part A provides coverage of inpatient hospital services and services of other institutional providers, such as skilled nursing facilities and home health agencies. Medicare Part B provides supplementary medical insurance that covers physician services, outpatient services, some home health care, durable medical equipment, and laboratory services and supplies, generally for the diagnosis and treatment of illness or injury. Medicare Part C provides Medicare beneficiaries with the option of receiving Part A and Part B services through a private health plan. Medicare Part D provides outpatient prescription drug benefits. Medicare Advantage — The Medicare managed care options that are authorized under Title XVIII as specified at Part C and 42 C.F.R. § 422. Minimum Data Set (MDS) — A clinical screening system, mandated by federal law for use in nursing facilities, that assesses the key domains of function, health, and service use. MDS assessment forms include the MDS-HC for home care and the MDS 3.0 for nursing facility residents. Minimum Data Set-Home Care (MDS-HC) — A clinical screening system using proprietary tools developed by interRAI Corporation, which assesses the key domains of function, health, and service use. Network Management — Refers to the activities, strategies, policies and procedures, and other tools used by the Contractor in the development, administration, and maintenance of the collective group of health care providers under contract to deliver Covered Services.
Medicare-Medicaid Beneficiary. For the purposes of this Demonstration, an individual who is entitled to, or enrolled for, benefits under Part A of title XVIII of the Social Security Act, and enrolled for benefits under Part B of title XVIII of such Act, and is eligible for medical assistance under a state plan under title XIX of such Act or under a waiver of such plan.
Medicare-Medicaid Beneficiary. For the purposes of this Demonstration, individuals who are enrolled in Medicare Part A and B and eligible for and receiving MassHealth Standard or CommonHealth and no other comprehensive private or public health coverage.
Medicare-Medicaid Beneficiary. For the purposes of this Demonstration, individuals who are enrolled in Medicare Part A and B and eligible for and receiving MassHealth Standard or CommonHealth and no other comprehensive private or public health coverage. Medicaid — The program of medical assistance benefits under Title XIX of the Social Security Act and various Demonstrations and waivers thereof. Medicare — Title XVIII of the Social Security Act, the federal health insurance program for people age 65 or older, people under 65 with certain disabilities, and people with End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis. Medicare Part A provides coverage of inpatient hospital services and services of other institutional providers, such as skilled nursing facilities and home health agencies. Medicare Part B provides supplementary medical insurance that covers physician services, outpatient services, some home health care, durable medical equipment, and laboratory services and supplies, generally for the diagnosis and treatment of illness or injury. Medicare Part C provides Medicare beneficiaries with the option of receiving Part A and Part B services through a private health plan. Medicare Part D provides outpatient prescription drug benefits. Medicare Advantage — The Medicare managed care options that are authorized under Title XVIII as specified at Part C and 42 C.F.R. § 422. Minimum Data Set (MDS) — A clinical screening system, mandated by federal law for use in nursing facilities, that assesses the key domains of function, health, and service use. MDS assessment forms include the MDS-HC for home care and the MDS 3.0 for nursing facility residents. Minimum Data Set-Home Care (MDS-HC) — A clinical screening system using proprietary tools developed by interRAI Corporation, which assesses the key domains of function, health, and service use. Network Management — Refers to the activities, strategies, policies and procedures, and other tools used by the Contractor in the development, administration, and maintenance of the collective group of health care Providers under contract to deliver Covered Services.
