Prepaid Health Plans definition

Prepaid Health Plans means any Health Care Plan to pay or make reimbursement for Health Care Services on a prepaid basis other than insured plans otherwise autho- rized and approved under A.R.S. Title 20.
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Examples of Prepaid Health Plans in a sentence

  • Prepaid Health Plans (PHPs) shall have written policies and procedures that ensure the provision of all medically and dentally appropriate covered services, including urgent care services and emergency services, preventive services and ancillary services, and in those categories of services included in contract or agreements with the Division of Medical Assistance Programs (Division) and Addictions and Mental Health (AMH).

  • Prepaid Health Plans (PHPs) provide Case Management Services under the Oregon Health Plan (OHP).

  • Relevant service and support descriptions are contained in the current MDHHS Medical Services Administration Policy for Prepaid Health Plans and these definitions are incorporated by reference into this agreement, to the extent they are consistent with the Board’s service obligations under MCL 330.1206(1), and the Children’s Waiver.

  • Prepaid Health Plans (PHPs) shall assume the risk for providing capitated services under their contracts and agreements with the Division of Medical Assistance Programs (Division).

  • The Prepaid Health Plans (PHP’s) documentation shall include, at minimum, a log of all oral and written complaints and appeals received by the PHP.

  • Implemented: 414.065 410-141-0050 – MHO Enrollment for Children Receiving Child Welfare Services‌ Pursuant to and in the administration of the Authority in OAR 410-141-0060, Children, Adults and Families (CAF) or the Oregon Youth Authority (OYA) selects Prepaid Health Plans (PHPs) for a child receiving CAF Child Welfare services or OYA services with the exception of children in subsidized adoption and guardianship.

  • Implemented: ORS 414.065 410-141-0220 – Managed Care Prepaid Health Plan Accessibility‌ (1) Prepaid Health Plans (PHPs) shall have written policies and procedures that ensure access to all covered services for all members.

  • Implemented: 414.065 410-141-0050 – MHO Enrollment for Children Receiving Child Welfare Services Pursuant to and in the administration of the Authority in OAR 410-141-0060, Children, Adults and Families (CAF) or the Oregon Youth Authority (OYA) selects Prepaid Health Plans (PHPs) for a child receiving CAF Child Welfare services or OYA services with the exception of children in subsidized adoption and guardianship.

  • Implemented: ORS 414.065 410-141-0220 – Managed Care Prepaid Health Plan Accessibility (1) Prepaid Health Plans (PHPs) shall have written policies and procedures that ensure access to all covered services for all members.

  • Health Plan Operations will continue to develop procedures that will assess the quality of care for Medicaid managed care enrollees consistent with federal regulations and the Protocols for External Quality Review of Medicaid managed care organizations and Prepaid Health Plans, as adopted by Centers for Medicare and Medicaid Services (CMS).

Related to Prepaid Health Plans

  • Health Plans means any and all individual and family health and hospitalization insurance and/or self-insurance plans, medical reimbursement plans, prescription drug plans, dental plans and other health and/or wellness plans.

  • 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.

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

  • 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:

  • State health plan means the employee and retiree insurance program provided for in Article 5, Chapter 11, Title 1.

  • Health and Welfare Plans means any plan, fund or program which was established or is maintained for the purpose of providing for its participants or their beneficiaries, through the purchase of insurance or otherwise, medical (including PPO, EPO and HDHP coverages), dental, prescription, vision, short-term disability, long-term disability, life and AD&D, employee assistance, group legal services, wellness, cafeteria (including premium payment, health flexible spending account and dependent care flexible spending account components), travel reimbursement, transportation, or other benefits in the event of sickness, accident, disability, death or unemployment, or vacation benefits, apprenticeship or other training programs or day care centers, scholarship funds, or prepaid legal services, including any such plan, fund or program as defined in Section 3(1) of ERISA.

  • Health plan or "health benefit plan" means any policy,

  • Qualified health plan means a health benefit plan that has in effect a certification that the plan

  • Credit accident and health insurance means insurance on a debtor to provide

  • Number Portability Administration Center or "NPAC" means one (1) of the seven (7) regional number portability centers involved in the dissemination of data associated with ported numbers. The NPACs were established for each of the seven (7) original Xxxx Operating Company regions so as to cover the fifty (50) states, the District of Columbia and the U.S. territories in the North American Numbering Plan area. "Numbering Plan Area" or "NPA" is also sometimes referred to as an area code. It is a unique three-digit indicator that is defined by the "X," "X" and "C" digits of each 10-digit telephone number within the NANP. Each NPA contains 800 possible NXX Codes. There are two (2) general categories of NPA. "Geographic NPA" is associated with a defined geographic area and all telephone numbers bearing such NPA are associated with services provided within that geographic area. A "Non-Geographic NPA," also known as a "Service Access Code" (SAC Code), is typically associated with a specialized Telecommunications Service which may be provided across multiple geographic NPA areas; 500, Toll Free Service NPAs, 700, and 900 are examples of Non-Geographic NPAs. "NXX," "NXX Code," "Central Office Code," or "CO Code" is the three- (3)-digit Switch entity code which is defined by the "D," "E" and "F" digits of a ten- (10) digit telephone number within the NANP. "Operational Support Systems" or "OSS" shall have the meaning set forth in Section 12. "Optional Testing" is testing conducted by CenturyLink, at the request of CLEC, that is in lieu of testing CLEC should complete to isolate trouble to the CenturyLink network prior to submitting a trouble ticket to CenturyLink.

  • Medicaid program means the medical assistance

  • Child welfare agency means a child-placing agency, child-caring institution or independent foster

  • Welfare Plans shall have the meaning set forth in Section 3.2.4.

  • Medicare Advantage The Medicare managed care options that are authorized under Title XVIII as specified at Part C and 42 C.F.R. § 422.

  • Group health plan means an employee welfare benefit plan as defined in section 3(1) of subtitle A of title I of the employee retirement income security act of 1974, Public Law 93-406, 29 USC 1002, to the extent that the plan provides medical care, including items and services paid for as medical care to employees or their dependents as defined under the terms of the plan directly or through insurance, reimbursement, or otherwise.

  • Transferred Employees has the meaning set forth in Section 6.4(a).

  • Basic health plan means the plan described under chapter

  • Seller Plans has the meaning set forth in Section 3.13(a).

  • Affordable housing program(s means any mechanism in a municipal Fair Share Plan prepared or implemented to address a municipality’s fair share obligation.

  • Aging and People with Disabilities (APD means the program area of Aging and People with Disabilities, within the Department of Human Services.

  • Retiree means any person who has begun accruing a retirement

  • Allied Health Professional means a person registered as an allied health professional with the Health Professions Council;

  • Nursing home-type patients means a patient who has been in hospital more than 35 days, no longer requires acute hospital care, cannot live independently at home or be looked after at home, and either cannot be placed in a nursing home or a nursing home place is not available.

  • 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.

  • Health and Welfare Benefits means any form of insurance or similar benefit programs, which may include but not be limited to, medical, hospitalization, surgical, prescription drug, dental, optical, psychiatric, life, or long-term disability.

  • Home health aide means an individual employed by a home health agency to provide home health services under the direction of a registered nurse or therapist.