Managed Care Plans definition

Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.
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Managed Care Plans. All health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans, and similar arrangements. MANAGEMENT AGREEMENT: Any agreement, whether written or oral, between Lessee or any Sublessee and any other Person pursuant to which Lessee or such Sublessee provides any payment, fee or other consideration to any other Person to operate or manage the Facility. MANAGEMENT SUBORDINATION AGREEMENT: The Management Subordination Agreement which may be executed in the future between Lessee and Lessor. MANAGER: Any Person who has entered into a Management Agreement with Lessee or any Sublessee. MATERIAL STRUCTURAL WORK: Any (i) structural alteration, (ii) structural repair or (iii) structural renovation to the Leased Property, which would customarily require or which require the design and/or involvement of a structural engineer or architect or which would require the issuance of a Permit. .
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Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements. “Margin Stock” is defined in Section 4.14. “Material Adverse Change” means any material adverse change in or effect on: (i) the business, financial condition, properties or assets (including all or any portion of Collateral), liabilities (actual or contingent), operations, or performance of the Credit Parties, taken as a whole, since December 31, 2019; (ii) without limiting the generality of clause (i) above, the rights of the Credit Parties, taken as a whole, in or related to the research, development, manufacture, production, use, commercialization, marketing, importing, storage, transport, offer for sale, distribution or sale of the Product in the Territory; (iii) the ability of the Credit Parties, taken as a whole, to fulfill the payment or performance obligations under this Agreement or any other Loan Document; or (iv) the binding nature or validity of, or the ability of the Agent or any Lender to enforce, the Loan Documents or any of its rights or remedies under the Loan Documents. “Material Contract” means (i) each contract which is identified as a “Material Contract” in the Perfection Certificate, (ii) the Specified Intercompany Agreements, and (iii) any other contract or other arrangement to which any Credit Party or any of its Subsidiaries is a party (other than the Loan Documents) or by which any of its assets or properties are bound, in each case, relating to the research, development, manufacture, production, use, commercialization, marketing, importing, storage, transport, offer for sale, distribution or sale of the Product in the Territory, for which the breach of, default or nonperformance under, cancellation or termination of or the failure to renew could reasonably be expected to result in a Material Adverse Change. For the avoidance of doubt, the GSK Agreement is a Material Contract. “Maximum Guaranteed Amount” is defined in Section 13.2. -96-
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Examples of Managed Care Plans in a sentence

  • Benefit Programs include, but are not limited to:• CalWORKs• CalFresh• Supplemental Security Income/State Supplemental Program (SSI/SSP) and disability benefits advocacy• In-home supportive services• Adult protective services• Child welfare• Child care• Medi-Cal benefits through Managed Care Plans All of the above benefit programs must be included and fully explained in the table.

  • The intent of the law is to establish a basis for Medi-Cal Managed Care Plans to make reasonable payments to Hospitals who are “out-of-network” for these services.

  • Episodes can be used to enhance the effectiveness of different payment models, such as ACOs or within MA Managed Care Plans.

  • A summary of this information for HMOs is included in the Consumer’s Guide to Managed Care Plans in Wisconsin available on OCI’s Web site, or call OCI at 1-800-236-8517 and request a copy.

  • Managed Care Plans lack understanding of HCBS & specialty (medically fragile) populations across Plans.

  • Regarding the Health Insurance Providers Fee (HIPF), CMS issued guidance in October 2014 (Medicaid and CHIP FAQs: Health Insurance Providers Fee for Medicaid Managed Care Plans, http://medicaid.gov/federal-policy-guidance/downloads/faq-10-06-2014.pdf).

  • Spotlight on Oregon and Washington’s Establishment of a Tribal Liaison Position to Improve Relationships Between Medicaid and CHIP Managed Care Plans and IHCPsIn Oregon, each plan in the managed care program has a Tribal Liaison who serves as a single point of contact for Oregon’s nine federally recognized Tribes, their UIO, Native American Rehabilitation Association Northwest, and the state’s Office ofTribal Affairs.

  • Historically, some hospitals have litigated payments from Managed Care Plans that were high enough for the federal CMS to determine them to be unreasonable for the services provided.

  • Medi-Cal Managed Care Plans that have signed a comprehensive risk contract with the Department of Healthcare Services pursuant to the Medi- Cal Act1 or the Waxman-Duffy Prepaid Health Plan Act2, and that are not regulated by the California Department of Managed Healthcare or the California Department of Insurance.

  • If there is insufficient SIP-PL participation and/or capacity to begin enrolling the I/DD population mandatorily, the State will develop criteria that will be used to qualify non-provider-led Mainstream Managed Care Plans (MMCPs) choosing to operate a Specialized I/DD Plan – Mainstream (SIP-M) as a separate line of business to provide coverage of I/DD services.


More Definitions of Managed Care Plans

Managed Care Plans. We participate with a full range of insurance plans in order to offer flexibility to our patients. Our medical providers strictly follow the regulations and guidelines of these plans. On the date of service, we are contractually obligated to collect any appropriate co-payments, co-insurance and deductibles from you, the patient, as per our agreement with the carriers.
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Managed Care Plans means any health maintenance organization,
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Managed Care Plans means, with respect to a Project, any health maintenance organization, preferred provider organization, individual practice association, competitive medical plan, referral service or similar arrangement, entity, organization, or Person.
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Managed Care Plans means a health insurer authorized under chapter 624, an exclusive provider organization authorized under chapter
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Related to Managed Care Plans

  • Managed care plan means a health benefit plan that either requires a covered person to use, or creates incentives, including financial incentives, for a covered person to use health care providers managed, owned, under contract with or employed by the health carrier.

  • Managed Care Program means the process that determines Medical Necessity and directs care to the most appropriate setting to provide quality care in a cost-effective manner, including Prior Authorization of certain services.

  • 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 (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).

  • 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 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.

  • HMO means any health maintenance organization, managed care organization, any Person doing business as a health maintenance organization or managed care organization, or any Person required to qualify or be licensed as a health maintenance organization or managed care organization under applicable federal or state law (including, without limitation, HMO Regulations).

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Medicare Advantage plan means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

  • Medicaid program means the medical assistance

  • Health plan or "health benefit plan" means any policy,

  • 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.

  • Database Management System (DBMS) A system of manual procedures and computer programs used to create, store and update the data required to provide Selective Routing and/or Automatic Location Identification for 911 systems. Day: A calendar day unless otherwise specified. Dedicated Transport: UNE transmission path between one of CenturyLink’s Wire Centers or switches and another of CenturyLink’s Wire Centers or switches within the same LATA and State that are dedicated to a particular customer or carrier. Default: A Party’s violation of any material term or condition of the Agreement, or refusal or failure in any material respect to properly perform its obligations under this Agreement, including the failure to make any undisputed payment when due. A Party shall also be deemed in Default upon such Party’s insolvency or the initiation of bankruptcy or receivership proceedings by or against the Party or the failure to obtain or maintain any certification(s) or authorization(s) from the Commission which are necessary or appropriate for a Party to exchange traffic or order any service, facility or arrangement under this Agreement, or notice from the Party that it has ceased doing business in this State or receipt of publicly available information that signifies the Party is no longer doing business in this State.

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Dependent care assistance program means a benefit plan

  • Child Care Program means a person or business that offers child care.

  • Child welfare services means social services including

  • MCO means an organization having a certificate of authority or certificate of registration from the 11 Washington State Office of Insurance Commissioner that contracts with HCA under a comprehensive 12 risk contract to provide prepaid health care services to eligible HCA Enrollees under HCA managed 13 care programs.

  • Health Care Operations shall have the meaning given to such term under the HIPAA 2 Privacy Rule in 45 CFR § 164.501.