Vermont Medicaid definition

Vermont Medicaid means the medical assistance provided under the State Plan approved under Title XIX of the Social Security Act, and the terms and conditions of the Global Commitment to Health Waiver, as approved by CMS.
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Vermont Medicaid means the program of medical assistance benefits under Title XIX of the Act, as modified by Vermont’s demonstration waiver under Section 1115 of the Act, operated by Vermont’s Agency for Human Services to provide health coverage to eligible Vermont residents. This term excludes assistance for Vermont residents who receive pharmacy benefits but no other medical benefits under Vermont’s demonstration waiver or Title XIX of the Act.
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Examples of Vermont Medicaid in a sentence

  • This Program Addendum will automatically terminate if the Agreement terminates or if the Participant or Preferred Provider becomes ineligible to participate in Vermont Medicaid, for any reason.

  • Participant warrants that it has the authority to and does bind itself and its employees, including each Provider with an NPI number billing under its TIN who is included on the Vermont Medicaid Next Generation Participant List to the Agreement and this Program Addendum.

  • ACO has entered into an agreement with DVHA through which the ACO will participate in the Vermont Medicaid Next Generation Model (the “Program”), an alternative payment and population health management program with Medicaid, as described in Vermont Medicaid Next Generation Participation Agreement that will be available on the ACO Provider Portal and is incorporated by reference into this ACO Program Addendum.

  • Participant and Preferred Provider agree to participate in the Program, to engage in ACO Activities, to comply with the applicable terms of the Program as set forth in the Vermont Medicaid Next Generation Participation Agreement between ACO and DVHA and to comply with all applicable laws and regulations.

  • Participants whose TIN includes NPIs of a “Primary Care Practitioner” who bills “Qualified Evaluation and Management Services” (as both terms are defined by the Vermont Medicaid Next Generation Participation Agreement) may not participate in more than one Medicaid Next Generation Model Program, or any other Medicaid ACO- based payment reform program or with any other accountable care organization in which they attribute or align lives.

  • THIRD-PARTY PAYMENT Although we are not required to, the FSCH accepts payment from Vermont Medicaid under the Assistive Community Care Services (ACCS) and the Choices for Care Enhanced Residential Care (ERC) Programs, provided however, that the resident understands they are still responsible for their monthly R & B.

  • Additionally, as described in section 15.a, Vermont shall provide CMS Vermont Medicaid claims data, and Vermont Commercial Plans claims data, and Vermont Self-insured Plan claims data to support CMS’s monitoring and evaluation of the Model.

  • In Performance Year 3, the State must work toward maximizing the percent of children and adolescents enrolled in Vermont Medicaid who have a well-care visit and establish a 2020 baseline.

  • In Performance Years 1 and 2, the State must achieve the 50th percentile, as compared to Medicaid plans nationally, for percentage of Vermont adolescents enrolled in Vermont Medicaid who have a well-care visit.

  • In addition to receiving and maintaining the historical files noted above, and in recognition of the importance of historical data to the effective performance of an ACO year over year, Contractor may maintain data provided to it by DVHA pursuant to the VMNG and Vermont Medicaid Shared Saving Program agreements in prior years.

Related to Vermont Medicaid

  • 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.

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

  • 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.

  • 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.

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

  • CMS means the Centers for Medicare & Medicaid Services.

  • 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).

  • Home Health Care means the continual care and treatment of an individual if:

  • Child care means continuous care and supervision of five or more qualifying children that is:

  • Adult foster care means room and board, supervision, and special services to an adult who has a

  • Health care means any of the following intended for use in the diagnosis, treatment, mitigation, or prevention of a human ailment or impairment:

  • School health services means health services provided by a qualified school nurse or other qualified person that are designed to enable a child with a disability to receive FAPE as described in the child’s IEP.

  • Health services means, but shall not be limited to, examination, diagnosis, evaluation, treatment, pharmaceuticals, aftercare, habilitation or rehabilitation and mental health therapy of any kind, as well as payment or reimbursement for any such services.

  • 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.

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

  • Pharmacy care means medications prescribed by a licensed physician and any health-related services considered medically necessary to determine the need or effectiveness of the medications.

  • Health care service means that service offered or provided

  • Foster care services means the provision of a full range of casework, treatment and community

  • Health care practitioner means an individual licensed

  • Family and Medical Leave means a leave of absence for the birth, adoption or foster care of a child, or for the care of your child, spouse or parent or for your own serious health condition as those terms are defined by the Federal Family and Medical Leave Act of 1993 (FMLA) and any amendments, or by applicable state law.

  • 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.

  • Home health services means part-time or intermittent skilled nursing services, other therapeutic services (physical therapy, occupational therapy, speech therapy), and home health aide services made available on a visiting basis in a place of residence used as the client's home.

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

  • Health care provider or "provider" means:

  • Acute care hospital means a Hospital that provides Acute Care Services. Adjudicate means to deny or pay a Clean Claim. Administrative Services see MCO Administrative Services. Administrative Services Contractor see HHSC Administrative Services Contractor.