Managed Care Contract definition

Managed Care Contract shall --------------------- include any Capitation/Case Rate Revenues contract, or any contracts based on a fee-for-service payment methodology or discounted fee-for-service reimbursement methodology and other agreements with third party payors, alternative delivery systems or other purchasers of group health care services.
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Managed Care Contract means the agreement between the agency and an MCO to provide prepaid contracted services to enrollees.
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Managed Care Contract means the agreement between the agency and an MCO to provide prepaid con- tracted services to enrollees.
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Examples of Managed Care Contract in a sentence

  • The elevations of the airport of intended landing and of all specified alternate airports are within the altitude range for which the maximum landing weights have been determined.

  • The Contract between the Parties will consist of the HHSC Managed Care Contract document and all attachments and amendments.

  • If the Contractor is or will be subject to the health insurer’s premium fee for the Capitation Payments being made under this or a previously existing Managed Care Contract with the Commonwealth, the Commonwealth shall compensate the Contractor for that fee and for any federal taxes resulting from such compensation.

  • In addition, legal notices must be sent to the Legal Contact identified in the HHSC Managed Care Contract document.

  • See Attachment A, “HHSC Uniform Managed Care Contract Terms and Conditions,” Article 10, for a description of the methodology for establishing the Delivery Supplemental Payment for the STAR Program.

  • The extension of the regulatory umbrella over the whole financial system still remains a major hurdle.

  • Refer to Attachment A, HHSC Uniform Managed Care Contract Terms and Conditions and Attachment B-5 for performance standards that carry liquidated damage values.

  • Refer to the HHSC Uniform Managed Care Contract Terms and Conditions (Attachment A) and the Liquidated Damages Matrix (Attachment B-5) for additional information.

  • When delivered if delivered personally or sent by express courier service.(b) The notices described in this Section may not be sent by electronic mail.(c) All notices must be sent to the Project Manager identified in the HHSC Managed Care Contract document.

  • STAR HMOs will receive a monthly fee for administering benefits to each SSI Beneficiary who voluntarily enrolls in the HMO (a “Voluntary SSI Member”), in the amount identified in the HHSC Managed Care Contract document.


More Definitions of Managed Care Contract

Managed Care Contract means an agreement with a managed care organization or other Third Party providing for a Discount other than an agreement with respect to a Government Health Care Program.
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Managed Care Contract means any agreement, contract or commitment of or with (directly or indirectly through an independent practice association or other health care provider network) a third party payor, including a federal or state government program (e.g. Medicare or Medicaid), insurance company, self-insured employer, healthcare service plan, non-profit hospital insurance plan or health maintenance organization, for the provision of health care services to any person or persons or for reimbursement of health care services rendered to such person or persons.
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Managed Care Contract means a contract or agreement for Hospital Services between ENH and a Payor, including but not limited to rates, definitions, terms, conditions, policies, and pricing methodology (e.g., per diem, discount rate, and case rate).
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Managed Care Contract means the agreement between the agency and an MCO or PAHP to provide prepaid contracted services to enroll- ees.
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Related to Managed Care Contract

  • Managed care means a system that provides the coordinated delivery of services and supports that are necessary and appropriate, delivered in the least restrictive settings and in the least intrusive manner. Managed care seeks to balance three factors:

  • Managed care organization means an entity that (1) is under contract with the department to provide services to Medicaid recipients and (2) meets the definition of “health maintenance organization” as defined in Iowa Code section 514B.1.

  • Managed Care Organization (MCO means a contracted health delivery system providing capitated or prepaid health services, also known as a Prepaid Health Plan (PHP). An MCO is responsible for providing, arranging, and making reimbursement arrangements for covered services as governed by state and federal law. An MCO may be a Chemical Dependency Organization (CDO), Dental Care Organization (DCO), Mental Health Organization (MHO), or Physician Care Organization (PCO).

  • HMO a health maintenance organization doing business as such (or required to qualify or to be licensed as such) under HMO Regulations.

  • Medicare cost report means CMS-2552-10, the cost report for electronic filing of

  • Medicaid means the medical assistance programs administered by state agencies and approved by CMS pursuant to the terms of Title XIX of the Social Security Act, codified at 42 U.S.C. 1396 et seq.

  • Health care facility or "facility" means hospices licensed

  • Medicare means the “Health Insurance for the Aged Act,” Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended.