Non-Participating Providers. A) Payment by the Contractor for general hospital emergency department services provided to an Enrollee by a Non-Participating Provider shall be at the Medicaid fee-for-service rate, inclusive of the capital component, in effect on the date that the service was rendered without regard to whether such services meet the definition of Emergency Medical Condition.
Appears in 4 contracts
Samples: Special Needs Plan, Special Needs Plan, Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)
Non-Participating Providers. A) Payment by the Contractor for general hospital emergency department services provided to an Enrollee by a Non-Participating Provider shall be at the Medicaid fee-for-service rate, inclusive of the capital component, in effect on the date that the service was rendered without regard to whether such services meet the definition of Emergency Medical Conditionrendered.
Appears in 2 contracts
Samples: Medicaid Advantage Model Contract (Wellcare Health Plans, Inc.), Non Covered Services (Wellcare Health Plans, Inc.)
Non-Participating Providers. A) Payment by the Contractor for general hospital emergency department services provided to an Enrollee by a Non-Non- Participating Provider shall be at the Medicaid fee-for-service rate, inclusive of the capital component, in effect on the date that the service was rendered without regard to whether such services meet the definition of Emergency Medical Condition.
Appears in 2 contracts
Samples: Hiv Special Needs Plan Model Contract, Hiv Special Needs Plan Model Contract
