Maryland Medicaid Managed Care Program definition

Maryland Medicaid Managed Care Program means the Medicaid reform program established under COMAR 10.09.62—10.09.73, as authorized by Health-General Article, Title 15, Subtitle 1, Annotated Code of Maryland.
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Maryland Medicaid Managed Care Program means the Health Choice Program authorized by:
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Maryland Medicaid Managed Care Program means the Maryland Voluntary Medicaid Managed Care Program and/or the Maryland Mandatory Medicaid Managed Care Program.
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Examples of Maryland Medicaid Managed Care Program in a sentence

  • However, most innovation studies concerning environmental scanning are in the area of market orientation.

  • Detail the types of models/scorecards used (e.g., generic/custom, vendor, etc.), by application, and determine whether the development process is consistent with the bank’s risk appetite and desired levels of subprime loans.

  • A system of primary care and other medical services that are provided and coordinated by HealthChoice providers in accordance with the provisions of COMAR 10.09.62 -10.09.73 Maryland Medicaid Managed Care Program.

  • A practitioner (listed in COMAR 10.09.66.05.) who is the primary coordinator of care for the Enrollee and whose responsibility is to provide accessible, continuous, comprehensive, and coordinated health care services covering the full range of benefits required by the Maryland Medicaid Managed Care Program.

  • Respond to 100% of all referrals within 30 business days or the timeframe specified; provide written feedback to the referral source that includes 1) An explanation of attempts and success in contacting the beneficiary; 2) Details relating to the case, including any pertinent materials; 3) Any determination that the MCO failed to meet the requirements of the Maryland Medicaid Managed Care Program; and 4) Any other information required by the Department.

  • On local governments:NONE scheduled.10.09.65 Maryland Medicaid Managed Care Program: Managed Care OrganizationsAuthority: Insurance Article, §15-112, 15-605, and 15-1008; Health-General Article, §§2-104, 15-102.3, and 15-103; Annotated Code of Maryland.19 MCO Reimbursement.

  • Note to Training ParticipantsYou are about to join the facilitator training on the participatory planning process for comprehensive SRH services and programming.

  • The report to the Department must include the following: (1) An explanation of how the case was resolved; (2) Details relating to the case, including any pertinent materials; (3) Any determination that the MCO has failed to meet the requirements of the Maryland Medicaid Managed Care Program; and (4) Any other information required by the Department.For reporting purposes, the quarterly report on staffing/salaries and quarterly cumulative budget expense report must be submitted for each grant.

  • Having nine separate components, the program took on nationwide implementation of major governance reforms at all levels of the system with insufficient attention to piloting and phasing and with conservative estimates of the required time and resources.

  • Amend Regulation .05-1 under COMAR 10.67.05 Maryland Medicaid Managed Care Program: Access.Statement of PurposeThe purpose of this action is to recodify the MCO Rural Access Incentive regulation, sunset the MCO Value-Based Purchasing Program effective December 31, 2021 and implement the HealthChoice Population Health Incentive Program (PHIP) effective January 1, 2022.

Related to Maryland Medicaid Managed Care Program

  • 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.

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

  • Centers for Medicare and Medicaid Services or “CMS” means the federal office under the Secretary of the United States Department of Health and Human Services, responsible for the Medicare and Medicaid programs.

  • Federal Health Care Program has the meaning set forth in 42 U.S.C. 1320a-7b(f).

  • 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.

  • Medicaid program means the medical assistance

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

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

  • Indian Health Care Provider means a health care program operated by the Indian Health Service (IHS) or by an Indian Tribe, Tribal Organization, or Urban Indian Organization (otherwise known as an I/T/U) as those terms are defined in § 4 of the Indian Health Care Improvement Act (25 USC § 1603). Indian Health Care Provider includes a 638 Facility and provision of Indian Health Service Contract Health Services (IHS CHS).

  • Health care provider or "provider" means:

  • Licensed health care practitioner means a physician, as defined in Section 1861(r)(1) of the Social Security Act, a registered professional nurse, licensed social worker or other individual who meets requirements prescribed by the Secretary of the Treasury.

  • Managed health care system means: (a) Any health care

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • Health care practitioner means an individual licensed

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

  • Health care system means any public or private entity whose function or purpose is the management of, processing of, enrollment of individuals for or payment for, in full or in part, health care services or health care data or health care information for its participants;

  • Emergency medical care provider means an individual who has been trained to provide emergency and nonemergency medical care at the first responder, EMT-basic, EMT-intermediate, EMT-paramedic, paramedic specialist or other certification levels recognized by the department before 1984 and who has been issued a certificate by the department.

  • Licensed health care professional means a person who possesses a professional medical license that is valid in Oregon. Examples include, but are not limited to, a registered nurse (RN), nurse practitioner (NP), licensed practical nurse (LPN), medical doctor (MD), osteopathic physician (DO), respiratory therapist (RT), physical therapist (PT), physician assistant (PA), or occupational therapist (OT).

  • Home health care services means medical and nonmedical services, provided to ill, disabled or infirm persons in their residences. Such services may include homemaker services, assistance with activities of daily living and respite care services.

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • 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.

  • Health care services means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease.

  • Home Health Care Agency means an agency or organization which provides a program of home health care and which:

  • 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.

  • Basic health care services means in and out-of-area emergency services, inpatient hospital and

  • Child care provider means a provider who receives compensation for providing child care services on a regular basis, including an ‘eligible child care provider’ (as defined in section 658P of the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858n)).