Expansion population definition
Examples of Expansion population in a sentence
Rhody Health Partner and ACA Adult Expansion population member disenrollment will occur monthly, and the Contractor will normally be notified at the first financial cycle (schedule determined by EOHHS), for disenrollment effective at midnight the last day of the month in which the enrollment report was sent.
ACA extends and simplifies Medicaid eligibility for adults and enables States to expand Medicaid eligibility to certain adults age 19 or older and under 65, referred to as the Expansion population.
As part of the preliminary and final financial reconciliation process described above, the Contractor will be required to prepare supplemental financial schedules to reconcile Medical Expenses reported on the Annual Statement required by the Kentucky Department of Insurance to medical expenses reported to the Department and additional financial schedules describing how reported expenses were directly attributed or allocated to the ACA Expansion population.
On their Medicaid applications, individuals included in the Medicaid Expansion population who are already enrolled in a limited benefit program or who are members of certain selected populations will self-identify (attest) as either “medically complex” or “non-medically complex.” Members of other selected populations may be presumed to be medically complex without having to self-identify.
The Contractor shall report to DMAS monthly regarding its network development for the Medicaid Expansion population.
As part of the preliminary and final financial reconciliation process described above, the Contractor will be required to prepare supplemental financial schedules to reconcile Medical Expenses reported on the Annual Statement required by the Kentucky Department of Insurance to medical expenses reported to the Department for Medicaid Services and additional financial schedules describing how reported expenses were directly attributed or allocated to the ACA Expansion population.
In accordance with 42 CFR § 438.2 a Medicaid eligible RIte Care, Rhody Health Partners, or an ACA Adult Expansion population individual who has not yet been enrolled by the Contractor.
All other individuals included in the Medicaid Expansion population who fall into aid categories 100, 101, 102, or 103, and who do not self-identify as medically complex, who are not included in the initial expansion enrollment effort, who are not part of a population presumed to be medically complex, and who do not meet the definition of medically complex will be covered under this Contract on and after January 1, 2019 through the normal Virginia Medicaid application process.
Open enrollment for members of the Medicaid Expansion population (aid categories 100, 101, 102, and 103) aligns with the Federal Health Insurance Marketplace timeframe (November and December open enrollment period for a January 1 effective date).
In accordance with 42 C.F.R. § 438.2, a Medicaid eligible RIte Care, Rhody Health Partners, or an ACA Adult Expansion population individual who has not yet been enrolled by the Contractor.