HFS Medical Program definition

HFS Medical Program means the (i) Illinois Medical Assistance Program administered under Article V of the Illinois Public Aid Code (305 ILCS 5/5-1 et seq.) or its successor program, and Title XIX (42 USC 1396 et seq.) and XXI (42 USC 1397aa et seq.) of the Social Security Act, and Section 12-4.35 of the Illinois Public Aid Code (305 ILCS 5/12-435); and (ii) the State Children’s Health Insurance Program administered under 215 ILCS 106 and Title XXI of the Social Security Act (42 USC 1397aa et seq.)

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HFS Medical Program means: (i) the Illinois Medicaid Program; and, the State Children’s Health Insurance Program, as authorized under the Illinois Insurance Code (215 ILCS 106/1 et seq.) and Title XXI of the Social Security Act, the State Children’s Health Insurance Program (SCHIP). For the purposes of this Contract, HFS Medical Program does not include any program or population excluded from coverage under this Contract as designated in Attachment II.

HFS Medical Program means: (i) the Illinois Medicaid Program; and, the State Children’s Health Insurance Program, as authorized under the Illinois Insurance Code (215 ILCS 106/1 et seq.) and Title XXI of the Social Security Act, the State Children’s Health Insurance Program. For the purposes of this Contract, HFS Medical Program does not include any program or population excluded from coverage under the State Contract as designated in Attachment II.

Examples of HFS Medical Program in a sentence

• The Department and Contractor enter into this Contract in order to deliver integrated and quality managed care to Enrollees, supporting Seniors, Persons with a Disability, Families and Children, Special Needs Children, and adults qualifying for the HFS Medical Program under the Affordable Care Act (ACA Adults).

• The State has the exclusive right to determine an individual’s eligibility for the HFS Medical Program and eligibility to become an Enrollee.

• Contractor shall make best efforts to have any non-Affiliated Provider billing for services rendered in Illinois be enrolled in the HFS Medical Program prior to paying a claim.

• Contractor shall assure that all Affiliated Providers, including out-of-State Affiliated Providers, are enrolled in the HFS Medical Program, if such enrollment is required by the Department’s rules or policy in order to submit claims for reimbursement or otherwise participate in the HFS Medical Program.

• For hospital stays that would otherwise be reimbursed under the HFS Medical Program on a per diem basis, Contractor’s liability shall begin on the effective date of enrollment.

• Notwithstanding the foregoing, for hospital stays that would otherwise be reimbursed under the HFS Medical Program on a DRG basis, Contractor will have no liability for the hospital stay.

• Contractor shall ensure that all Network Providers, including out-of-state Network Providers, are enrolled in the HFS Medical Program, if such enrollment is required by the Department’s rules or policy in order to submit claims for reimbursement or otherwise participate in the HFS Medical Program.

• Contractor shall make best efforts to have any non- Affiliated Provider billing for services be enrolled in the Medicare Program or HFS Medical Program, as appropriate and in the same manner as Affiliated Providers under Section 2.8.1.2, prior to paying a claim.

• Contractor shall make best efforts to have any non-Affiliated Provider billing for services be enrolled in the Medicare Program or HFS Medical Program, as appropriate and in the same manner as Affiliated Providers under Section 2.8.1.2, prior to paying a claim.

• The Department has the exclusive right to determine an individual’s eligibility for the HFS Medical Program and eligibility to become an Enrollee.

More Definitions of HFS Medical Program

HFS Medical Program means the Illinois Medical Assistance Program administered under Article V of the Illinois Public Aid Code (305 ILCS 5/5-1 et. seq.) or its successor program, and Titles XIX (42 USC 1396 et. seq.)

HFS Medical Program means the Illinois Medical Assistance Program administered under Article V of the Illinois Public Aid Code (305 ILCS 5/5-1 et. seq.) or its successor program, and Titles XIX (42 USC 1396 et. seq.) and XXI (42 USC 1397aa et. seq.) of the Social Security Act and Section 12-4.35 of the Illinois Public Aid Code (305 ILCS 5/12-435); the State Children‘s Health Insurance Program administered under 215 ILCS 106 and Title XXI of the Social Security Act (42 USC 1397aa et. seq.). The HFS Medical Program is a Program as defined in the Agreement.

HFS Medical Program means programs administered by The Department of Healthcare and Family Services, Division of Medical Programs, in conjunction with, the federal government, Illinois’ Medical Assistance Program, consisting of Medicaid and numerous other programs associated with it, providing comprehensive healthcare coverage to Illinois residents. Sometimes these programs are called Medicaid, All Kids, Family Care, Moms & Babies, or HFS Medical Program.