MCO definition
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.
MCO means a health maintenance organization ("HMO") or prepaid health service plan ("PHSP") certified under Article 44 of the New York State PHL.
MCO means managed care organization.
Examples of MCO in a sentence
MCO, MCO must comply with all Fraud, Waste, and Abuse requirements found in HHS Circular C-027.
Any disclosure or transfer of Confidential Information by MCO, including information required by HHSC, will be in accordance with applicable law.
The MCO must comply with Circular C-027 requirements in addition to other Fraud, Waste, and Abuse provisions in the contract and in state and federal law.
Except as otherwise disclosed and approved by HHSC prior to the Effective Date of the Contract, MCO warrants that, as of the Effective Date and to the best of its knowledge and belief, there are no relevant facts or circumstances that could give rise to an organizational conflict of interest affecting this Contract.
MCO certifies that it will comply with the Anti- Kickback Act of 1986 (41 U.S.C. § 51 58), 42 U.S.C. § 1320a-7b(b), and Federal Acquisition Regulation Subpart 52.203-7, to the extent applicable.
More Definitions of MCO
MCO means the person, natural or corporate, or any groups of such persons, certified under Public Health Law Article 44, who enter into an arrangement, agreement or plan or any combination of arrangements or plans which provide or offer a comprehensive health services plan, or a health and long term care services plan. “Independent Practice Association” or “IPA” shall mean an entity formed for the limited purpose of contracting for the delivery or provision of health services by individuals, entities and facilities licensed and/or certified to practice medicine and other health professions, and, as appropriate, ancillary medical services and equipment. Under these arrangements, such health care Providers and suppliers will provide their service in accordance with and for such compensation as may be established by a contract between such entity and one or more MCOs. “IPA” may also include, for purposes of this Agreement, a pharmacy or laboratory with the legal authority to contract with other pharmacies or laboratories to arrange for or provide services to enrollees of a New York State MCO.
MCO means Managed Care Organization.
MCO means a member’s HSD contracted managed care organization.
MCO means a managed care organization Medicaid Only means an individual who is eligible for Medicaid either categorically or through optional coverage groups such as medically needy or special income levels for institutionalized or home and community-based waivers, but who does not meet the federal income or resource criteria for QMB or SLMB. For purposes of this Agreement, Medicaid Only does not include individuals required to recertify eligibility monthly. Medicare Advantage Dual Eligible Special Needs Plan or MA Dual SNP means a Medicare Advantage coordinated care plan that is filed and approved as a dual eligible special needs plan by CMS. The plan must be designed for and offered to individuals who are eligible for Medicare under Title XVIII of the Member Advisory Committee has the same meaning as enrollee advisory committee, as provided in 42 CFR Section 422.107(f).
MCO means managed care organization. MCO or Contractor means the MCO that is a party to this Contract and is an insurer licensed or approved by TDI as an HMO, ANHC formed in compliance with Chapter 844 of the Texas Insurance Code, or an EPO with an Exclusive Provider Benefit Plan approved by TDI in accordance with 28 T.A.C. §3.9201-3.9212.
MCO means managed care organization. MCO or Contractor means the MCO that is a party to this Contract and is an insurer licensed or approved by TDI as an HMO, ANHC formed in compliance with Chapter 844 of the Texas Insurance Code, or an EPO with an Exclusive Provider Benefit Plan approved by TDI in accordance with 28 T.A.C. §3.9201-3.9212. MCO Administrative Services means the performance of services or functions, other than the direct delivery of Covered Services, necessary for the management of the delivery of and payment for Covered Services, including Network, utilization, clinical or quality management, service authorization, claims processing, management information systems operation, and reporting. This term also includes the infrastructure development for, preparation of, and delivery of, all required Deliverables under the Contract, outside of the Covered Services.
MCO means managed care organization, which is an entity that participates in Centennial Care under contract with HSD to assist the State in meeting the requirements established under NMSA 1978, § 27-2-12.