CalOptima Program definition

CalOptima Program means the Medi-Cal Programs administered by CalOptima under contract with DHCS.
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CalOptima Program means the Medi-Cal, OneCare (Medicare Advantage), Program of All-Inclusive Care for the Elderly (PACE), and OneCare Connect (Cal MediConnect) programs administered by CalOptima. Provider participates in the specific CalOptima Program(s) identified on Attachment AMedicare Program administered by CalOptima under contract with CMS.
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Examples of CalOptima Program in a sentence

  • Notice shall be given by first-class mail, postage prepaid to the attention of the State or Federal contracting officer for the pertinent CalOptima Program.

  • Member grievances, complaints, and/or appeals shall be resolved in accordance with Federal and/or State laws, regulations and Government Guidance and as set forth in CalOptima Policies relating to the applicable CalOptima Program.

  • County shall verify a Member’s eligibility for the applicable CalOptima Program benefits upon receiving a request for Covered Services.

  • Additional procedures related to claims processing and payment are set forth in the attached CalOptima Program Addenda.

  • County shall cooperate with CalOptima and Government Agencies in any complaint, appeal or other review of LHA Services (e.g., medical necessity) and shall accept as final all decisions regarding disputes over LHA Services by CalOptima or such Government Agencies, as applicable, and as required under the applicable CalOptima Program.

  • County shall coordinate benefits with other programs or entitlements recognizing where other OHC is primary coverage in accordance with CalOptima Program requirements.

Related to CalOptima Program

  • Development Program means the implementation of the development plan.

  • Educational program means a program for educating and preparing physician assistants which is approved by the board.

  • Marijuana products means concentrated marijuana products and marijuana products that are comprised of marijuana and other ingredients and are intended for use or consumption, such as, but not limited to, edible products, ointments, and tinctures.

  • Development Plan has the meaning set forth in Section 3.2.

  • Marketing Plan means a plan or system concerning a material aspect of conducting business. Indicia of a marketing plan include any of the following: