Medicaid beneficiary definition

Medicaid beneficiary means any person participating, through either a state plan amendment or waiver authority, in any Medicaid program administered by the West Virginia Department of Health and Human Resources or its Bureau for Medical Services.
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Medicaid beneficiary or “Medicaid enrollee” means any
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Medicaid beneficiary means an individual determined by the Department to be eligible for
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Examples of Medicaid beneficiary in a sentence

  • The savings must be expended for the benefit of the Medicaid beneficiary enrolled in the waiver.

  • Expenditure authority for inpatient hospital stays related to COVID-19 to extend the 30-day spell of illness limitation described in the state plan for an additional 30 days to allow a Medicaid beneficiary to stay up to 60 days in a hospital.

  • On information and14 belief, WHCA covered the three-drug treatment for any Medicaid beneficiary who was15 HCV irrespective of the person’s Metavir Fibrosis score.16 14.

  • Provider(s) shall verify each Medicaid beneficiary’s eligibility each time a service is rendered.c. The Medicaid beneficiary may have service restrictions due to their eligibility category that would make them ineligible for this service.

  • Contractor is required to implement mechanisms to comprehensively assess each Medicaid beneficiary identified as needing LTSS to identify any ongoing special conditions of the beneficiary that require a course oftreatment or regular care monitoring.

  • When a Medicaid beneficiary is enrolled in a managed care organization and services are provided by the managed care organization that are included under the State Plan, the Commonwealth shall seek adjustment or recovery from the individual's estate for the capitation payments in the Commonwealth's claim against the estate.

  • EXAMPLE: A Medicaid beneficiary receives services from a provider employed by, for example, a VA or IHS facility.

  • How will the State (or if this is a renewal or amendment of an existing selective contracting waiver, provide evidence that the State) regularly monitor(s) the selective contracting program to determine appropriate Medicaid beneficiary utilization, as defined by the utilization standard described above?The LIDDA’s performance contract requires that the LIDDA assign a habilitation coordinator within 30 days two business days of the PASRR Evaluation being completed.

  • For example, if a school-based provider is qualified under State or local law to provide counseling to any child (or any child in the school system), the State cannot impose additional provider qualification requirements under State law as a condition for receiving Medicaid payment for counseling provided to a Medicaid beneficiary.

  • For all physician incentive plans, Contractor must provide to CMS, and to any Medicaid beneficiary, the information specified in 42 CFR 422.210.


More Definitions of Medicaid beneficiary

Medicaid beneficiary means any person
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Medicaid beneficiary means any person participating,
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Medicaid beneficiary means a child who has been determined by
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Related to Medicaid beneficiary

  • Qualified beneficiary means a beneficiary who, on the date the beneficiary's qualification is determined:

  • Income beneficiary means a person to whom net income of a trust is or may be payable.

  • Designated Beneficiary means the beneficiary or beneficiaries the Participant designates, in a manner the Administrator determines, to receive amounts due or exercise the Participant’s rights if the Participant dies or becomes incapacitated. Without a Participant’s effective designation, “Designated Beneficiary” will mean the Participant’s estate.

  • primary beneficiary means the individual for whose primary benefit the trust is then held. For purposes of Section 8.3, a Qualified Entity is a member of each Family Group to which such one or more Qualified Trusts that are its equity holders belong.

  • Disability benefit recipient means a member who is receiving a disability benefit.

  • Covered benefits or “benefits” means those health care services to which a covered person is entitled under the terms of a health benefit plan.

  • Remainder beneficiary means a person entitled to receive principal when an income interest ends.

  • Pharmacy benefit manager means a person, business or other

  • Alternate Payee means any spouse, former spouse, child, or other dependent of a Participant who is recognized by a qualified domestic relations order as having a right to receive all, or a portion of, the benefits payable under a Plan with respect to such Participant.

  • Beneficiary means each designated person, or the estate of the deceased Executive, entitled to benefits, if any, upon the death of the Executive, determined according to Article 4.

  • 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.

  • Successor of a beneficiary means a person who succeeds to substantially all of the rights of a beneficiary by operation of law, including a corporation with or into which the beneficiary has been merged or consolidated, an administrator, executor, personal representative, trustee in bankruptcy, debtor in possession, liquidator, and receiver.

  • 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:

  • Spouse means, an individual who,

  • Retiree Health Plan means an "employee welfare benefit plan" within the meaning of Section 3(1) of ERISA that provides benefits to individuals after termination of their employment, other than as required by Section 601 of ERISA.

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

  • Surviving Spouse means the widow or widower, as the case may be, of a Deceased Participant or a Deceased Beneficiary (as applicable).

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.