OHP Plus definition

OHP Plus means only the Medicaid benefit packages provided under OAR 410-120-1210(4)(a) and (b). This excludes individuals receiving Title XXI benefits.

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OHP Plus means only the Medicaid benefit packages provided under OAR 410-120-1210(4)(a) and (b).

OHP Plus each means the benefit package described in OAR 410-120- 1210.

Examples of OHP Plus in a sentence

• Contractor shall not prohibit or otherwise restrict a Health Care Professional from advising a Member who is a patient of that professional about the health status of the Member or treatment for the Member’s condition or disease, regardless of whether benefits for such care or treatment are provided under the OHP Plus or OHP Standard Benefit Package of Covered Services or if a Co-Payment may be required, if the professional is acting within the lawful scope of practice.

• The Weekly and Monthly Enrollment file (as described in Exhibit B, Part 3, Section 7 of this Contract) will identify Member’s current eligibility status for either the OHP Plus or the OHP Standard Benefit Package.

• The portion of the OHP Plus- equivalent benefits for which HOP benefit package paid under this Medicaid Contract is paid with Emergency Health Benefit Funding and is referred to as ³EHB.´EHB is comprised of benefits that OHA may utilizepay for utilizing federal funds received under Titles XIX and XXI of the Social Security Act.

• TCMC shall provide to RAE the Weekly and Monthly Enrollment file (as described in the Core Contract, Exhibit B, Part 3, Section 6.c.) to identify the current eligibility status of RAE’s enrolled membership for either the OHP Plus or the OHP Standard Benefit Package.

• Notify Members eligible for the OHP Plus Benefit Package of their responsibility for paying a Co-Payment for some services, as specified in OAR 410-120-1230.

• For HOP Members not eligible for CWM/CWX benefits, all OHP Plus- equivalent benefits are covered by the Non-Medicaid Contract.

• The complete HOP benefit package provided to eligible individuals is equivalent to the OHP Plus benefit package.

• Contractor shall Provide OHP Plus Benefit Package and OHP Standard Benefit Package of Covered Services to OHP Members consistent with OAR 410-141-0120, Oregon Health Plan Prepaid Health Plan Provision of Health Care Services; OAR 410-141-0520, Prioritized List of Health Services; and OAR 410-141-0480, Oregon Health Plan Benefit Package of Covered Services.

• RAE shall provide to its enrolled Members any and all ID cards developed by TCMC related to eligibility for Covered Services under the OHP Plus or OHP Standard Benefit Package.

• Subject to the provisions of this Contract, Contractor shall provide for Covered Services to Members eligible for the OHP Plus Benefit Package and the OHP Standard Benefit Package.