Managed care entity definition
Managed care entity means either a managed care organization licensed by the department of insurance (e.g., HMO or PHP) or a primary care case management program (i.e., MediPASS).
Managed care entity means an insurer that:
Managed care entity means any entity including
More Definitions of Managed care entity
Managed care entity means an entity that enters into a contract to provide services in the statewide managed care system pursuant to articles 4, 5, and 6 of title 25.5.
Managed care entity means any entity which delivers, administers, or indemnifies health care services with systems or techniques to control or influence the quality, accessibility, utilization, or costs and prices of such services to a defined enrollee population, but does not include an employer purchasing coverage or action on behalf of its employees or the employees of one or more subsidiaries or affiliated corporations of the employer or a pharmacy licensed by this state;
Managed care entity. (MCE) means:
Managed care entity or "MCE" means any entity permitted under 42 C.F.R. Part 438 to contract with a state for services provided under a risk contract or a nonrisk contract within the state's Medicaid managed care program, including but not limited to managed care organization (MCO), primary care case management (PCCM), primary care case management entity (PCCM entity), prepaid ambulatory health plan (PAHP), and prepaid inpatient health plan (PIHP).
Managed care entity means an entity licensed as a health maintenance organization under Title 56, Chapter 32, and certified by the state as a risk-bearing entity, that meets the federal requirements of 42 U.S.C. § 1396 u-2(a) and regulations promulgated thereto.
Managed care entity means an organization which makes available to an enrolled participant health care services provided by providers selected by the organization and which has a contractual arrangement with the department of health services for the provision of services to medicaid enrollees.
Managed care entity means an entity that enters