MA Member definition

MA Member means a natural person who is a member of a PACFA Member Association, and for whom the required Per Capita Fee is payable, provided that the Member Association has paid its Per Capita Fees.

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MA Member means a MA beneficiary covered under a MA PPO Subscriber Agreement that provides for Covered Services.

MA Member means, for purposes of this Attachment, a Member who is covered under a Medicare agreement between CMS and Plan under Part C of Title XVIII of the Social Security Act ("Medicare Advantage Program") and for Plan's DSNP Medicare Program, the beneficiary is also entitled to Medicaid under Title XIX of the Social Security Act, see 42 USC §1396 et seq..

Examples of MA Member in a sentence

This provision shall survive termination of the Agreement, regardless of the reason for termination, including the insolvency of MA Plan and shall supersede any oral or written agreement between Dentist and a MA Member.
Dentist shall comply with final determinations of MA Plan or its designee with respect to Dentist and MA Member grievances and appeals.
In the event of such termination or non-renewal, Dentist will no longer be paid for dental services rendered to MA Members of MA Plan with the exception of services required by law to be provided post-termination including services provided in the event of MA Plan’s insolvency or MA Member being hospitalized on the date of termination.
Such data may include medical records and other data necessary to characterize each encounter between a MA Member and Dentist.
The parties acknowledge that Dentist’s right to appeal an administrative denial is in addition to any MA Member appeal rights established by applicable law or regulation.
Dentist acknowledges that MA Plan is required under applicable federal law and regulations to submit to CMS certain information regarding the benefits provided by MA Plan and quality and performance indicators, including but not limited to, (i) disenrollment rates of MA Members enrolled in MA Plan for the previous two years; (ii) information regarding MA Member satisfaction with MA Plan and (iii) information on dental outcomes.
The Agreement does not prohibit Dentist from collecting Member Cost Sharing Provisions, as specifically provided in the Plan Description, or fees for non-covered services as long as MA Member has been informed in advance of what services are not covered and has agreed to be financially responsible.
Dentist agrees that in no event, including but not limited to non-payment by the State, shall Dentist bill, charge, collect a deposit from, impose surcharges or have any recourse against a Dual Eligible MA Member for Medicare Part A and Part B Cost Sharing that is the responsibility of the State Medicaid program.
This provision shall survive termination of the Agreement for Covered Services rendered prior to termination regardless of the cause giving rise to such termination and shall be construed to be for the benefit of the MA Member.
Provider will in no event, including but not limited to nonpayment, insolvency or breach of the Agreement, ▇▇▇▇, charge, collect a deposit from, seek payment from, maintain any action at law or in equity or have any other recourse against a MA Member or person (other than Health Plan) acting on behalf of Member for Covered Services provided pursuant to the Agreement.