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.

Managed care contract means the agreement between the agency and an MCO to provide prepaid con- tracted services to enrollees.

Examples of Managed care contract in a sentence

• Please see the Uniform Managed Care Contract Terms & Conditions and Attachment B-5, Deliverables/Liquidated Damages Matrix.

• The Medi-Cal Managed Care Contract is available on the DHCS webpage at ▇▇▇.▇▇▇▇.▇▇.▇▇▇.

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

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

• Capitalized terms have the meaning ascribed by MCP’s Medi-Cal Managed Care Contract with the California Department of Health Care Services (“DHCS”), unless otherwise defined herein.

• Refer to Attachment A, "Uniform Managed Care Contract Terms and Conditions," Section 4.08(c) for information regarding Readiness Reviews of the MCO’s Material Subcontractors.

• 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.

• MCP may delegate its obligations under this MOU to a Fully Delegated Subcontractor or Partially Delegated Subcontractor as permitted under the Medi-Cal Managed Care Contract, provided that such Fully Delegated Subcontractor or Partially Delegated Subcontractor is made a Party to this MOU.

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

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

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.

Managed care contract means a contract entered into by the commission and a managed care organization under which the organization agrees to provide comprehensive health care services to clients under a managed care program.

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).

Managed care contract means a contract entered

Managed care contract means the agreement between the agency and an MCO or PAHP to provide prepaid contracted services to enroll- ees.

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.