New Enrollee definition
Examples of New Enrollee in a sentence
New Enrollee Information The Contractor shall provide New Enrollees with Enrollee Information that meets the requirements of Section 2.8.C including a Provider directory that meets the requirements of Section 2.5.C and an Enrollee handbook based on a model provided by EOHHS, as further directed by EOHHS, that contains the Enrollee Information specified below.
New Enrollee materials are not required for a former Enrollee who was disenrolled because of the loss of Medicaid eligibility and who regains his/her eligibility within sixty (60) days and is automatically reinstated as a Health Plan Enrollee.
New Enrollee Information The Contractor shall provide New Enrollees with Enrollee Information that meets the requirements of Section 2.9.C including a Provider directory that meets the requirements of Section 2.6.D and an Enrollee handbook based on a model provided by EOHHS, as further directed by ▇▇▇▇▇, that contains the Enrollee Information specified below.
New Enrollee – any Enrollee enrolled by EOHHS pursuant to Section 2.5 who has not been previously enrolled in the Contractor within the preceding 12 months, or within another timeframe as determined by EOHHS.
New Enrollee – any Enrollee enrolled by EOHHS pursuant to Section 2.4 who has not been previously enrolled in the Contractor’s Plan within the preceding 12 months, or within another timeframe as determined by EOHHS.
New Enrollee materials are not required for a former Enrollee who was disenrolled because of the loss of Medicaid eligibility and who regains his/her eligibility within 180 days and is automatically reinstated as a Health Plan Enrollee.
If the New Enrollee does not select a MCO, the Puerto Rico Medicaid Program will select a MCO on behalf of the New Enrollee.
The Average Life Cost shall mean the average unreimbursed cost per fiscal year to CPMC for providing services to each New Enrollee over the previous two (2) fiscal years.
For the purposes of this subsection, New Enrollee shall be defined as an Enrollee that applies for enrollment after the Effective Date of this Sanction (the date determined in accordance with 42 CFR 438.730(f)).
The New Enrollee Shortfall shall be the difference between the number of New Enrollees that CPMC was required to accept under the New Medi-Cal Beneficiaries Commitment for that fiscal year and the number of New Enrollees that CPMC did accept in that fiscal year.