Agency for Health Care Administration Sample Clauses

Agency for Health Care Administration the lead agency for Title XXI of the Act for purposes of receipt of federal funds, reporting, and for ensuring compliance with federal and State regulations and rules. Appeal: a review by Insurer of an Adverse Benefit Determination.
Sample 1
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Agency for Health Care Administration. Ancillary Services - Services provided at a hospital include, but are not limited to, radiology, pathology, neurology, and anesthesiology as specified in the Hospital Coverage and Limitations Handbook. Appeal - A formal request from an enrollee to seek a review of an action taken by the Contractor pursuant to 42 CFR 438.400(b).
Sample 1
Agency for Health Care Administration. Ancillary Services - Services provided at a hospital include, but are not limited to, radiology, pathology, neurology, and anesthesiology as specified in the Hospital Coverage and Limitations Handbook. Area Agency on Aging - An agency designated by the Department to develop and administer a plan for a comprehensive and coordinated system of services for older persons. Assessment - An individualized comprehensive appraisal of an individual’s medical, developmental, mental, social, financial, and environmental status conducted by a qualified individual for the purpose of determining the need for long term care services. Capitation Rate - The monthly fee paid by the Agency to the contractor for each enrollee enrolled under the contract for the provision of services during the payment period. Care Plan - A plan which describes the service needs of each recipient, showing the projected duration, desired frequency, type of provider furnishing each service, and scope of the services to be provided. CARES (Comprehensive Assessment and Review for Long Term Care Services) - A nursing facility pre- admission screening program operated by the Agency through an interagency agreement with the Department of Elder Affairs. The program explores all available options to nursing home placement to ensure that long-term care services are provided in the setting most appropriate to the needs of the person and consistent with approved federal waiver programs. Claim - A claim is: (1) a xxxx for services, (2) a line item of service or, (3) all services for one enrollee within a xxxx. Clean Claim - A claim that can be processed without obtaining additional information from the provider (subcontractor) of the service or from a third party. Cold-call Marketing - Any unsolicited personal contact by the contractor or subcontractors with a potential enrollee for the purpose of marketing. Contractor - The organizational entity with whom this agreement is executed. Department: Department of Elder Affairs Disenrollment - The discontinuance of an enrollee's membership in the contractor’s plan. Durable Medical Equipment - Medical equipment that can withstand repeated use; is primarily and customarily used to serve a medical purpose; is generally not useful in the absence of illness or injury; and is appropriate for use in the recipient's home. Emergency Medical Condition - According to 42 CFR 438.114(a), a medical condition manifesting itself by acute symptoms of sufficient severity (includi...
Sample 1
Agency for Health Care Administration. Conducted a Medicaid Information Technology Architecture Assessment and an in-depth analysis of infrastructure and business and technical capabilities, including developing goals and objectives, addressing system impacts, and identifying the desired state of business processes.  Agency for Health Care Administration: Provided project management, research, planning, and procurement support services to assist in procuring a new fiscal agent and enhancements to the development of the Medicaid Management Information System and Decision Support System. Arizona  Management strategy  Project management  Program research, planning, & evaluation  Studies, analyses, scenarios, and reports  Policy and regulation development  Process and productivity improvement
Sample 1
Agency for Health Care Administration. 1. Provide TA to the Department.
Sample 1

Related to Agency for Health Care Administration

  • WAGE ADMINISTRATION The rules governing salary treatment further to a revision or reclassification shall be the following: • if the occupation is downgraded the employee will benefit from wage protection (for clarity, the employee’s rate of pay prior to the downgrade) for the duration of the Collective Agreement and will be entitled annually to a $750.00 lump sum in lieu of a bargained increase as described in Attachment C of the Collective Agreement until the top salary rate for her salary group exceeds her current rate. • if the occupation is upgraded the pay adjustment will be effective from the date of the request.

  • Program Administration An activity relating to the general management, oversight and coordination of community development programs. Costs directly related to carrying out eligible activities are not included.

  • Orally Administered Anticancer Medication In accordance with RIGL § 27-20-67, prescription drug coverage for orally administered anticancer medications is provided at a level no less favorable than coverage for intravenously administered or injected cancer medications covered under your medical benefit.

  • Health Promotion and Health Education Both parties to this Agreement recognize the value and importance of health promotion and health education programs. Such programs can assist employees and their dependents to maintain and enhance their health, and to make appropriate use of the health care system. To work toward these goals:

  • Clinical Management for Behavioral Health Services (CMBHS) System The CMBHS is the official record of documentation by System Agency. Grantee shall:

  • Department of Education The School shall administer all student testing as required by applicable federal and state laws, rules, policies, and procedures.

  • Agreement Administration SBBC has delegated authority to the Superintendent of Schools or his/her designee to take any actions necessary to implement and administer this Agreement.

  • PAY ADMINISTRATION 62.01 Except as provided in this Article, the terms and conditions governing the application of pay to employees are not affected by this Agreement.

  • Department of Health and Human Services An employee notified of a positive controlled substance or alcohol test result may request an independent test of their split sample at the employee’s expense. If the test result is negative, the Employer will reimburse the employee for the cost of the split sample test. An employee who has a positive alcohol test and/or a positive controlled substance test may be subject to disciplinary action, up to and including dismissal, based on the incident that prompted the testing, including a violation of the drug and alcohol free work place rules.

  • Grant Administration The District recognizes that Charter Schools are utilizing revenue sources associated with federal and state agency grants. The District is required to be Fiscal Agent on such grants meaning the District is responsible for oversight, approval, review and distribution of funds. These administrative tasks result in the utilization of District resources. In recognition of this, the District is mandating the following.

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