Texas uniform managed care contract terms conditions
and State requirements and provisions of the managed-care contract relating “ Payment Adjustment for Health Care-Acquired Conditions” (Texas Uniform 26 Jun 2018 Texas Health and Human Services Commission's management of Medicaid Contracts (UMCC) and the Uniform Managed Care Manual (UMCM). Components of HHSC's contractual requirements on MCOs include:. MCO provider networks, Medicaid contracts with MCOs could: • Require standard terms and conditions as a participating provider; or, alternatively,. • Impose an o A uniform definition of a “Clean. Claim” that is TEXAS. Texas required all MCOs to use the same formulary established for its fee-for-service. Medicaid 5 Apr 2019 HHSC UNIFORM MANAGED CARE MANUAL Item 19, “Claims Payment” is added to meet the requirements of HB3017. MCO or Dental Contractor includes Standard Contract Provisions in its Provider Manual, then the Network Provider contract must Procedures Manual, the Texas Medicaid Provider.
The mission of the Texas Department of Family and Protective Services (DFPS) is to protect the unprotected -- children, elderly, and people with disabilities -- from abuse, neglect, and exploitation. Uniform Terms & Conditions for grant contracts. 5645V: Form used by Residential Child-Care Contracts to determine and manage Contractor
Texas Children’s Health $5,656,397,948 2 Responsibility for managed care contract oversight and audit of MCO contracts at the agency • The Uniform Managed Care Manual provides cost principles for determining allowable and unallowable administrative and other HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel Health and Human Services Commission HHSC Uniform Terms and Conditions - Grant Version 2.13. determine compliance with the terms and conditions of this Contract and all state and federal rules, regulations, and statutes. October 1, 2015 : Initial version of Attachment A, “STAR Kids Managed Care Contract Terms and Conditions” that includes all modifications negotiated by the Parties. Subject: Attachment A – Uniform Managed Care Contract Terms and Conditions Version 2.7 DOCUMENT HISTORY LOG STATUS1 DOCUMENT REVISION2 EFFECTIVE DATE DESCRIPTION 3 Baseline n/a September 1, 2011 Initial version of the Attachment A, “Medicaid and CHIP Uniform Managed Care Contract Terms & Conditions.” Revision 2.1 March 1, 2012 The managed care contracts relevant to this audit include the Uniform Managed Care Contract, the Uniform Managed Care Manual, the STAR+PLUS Expansion Contract, and the CHIP Rural Service Area Contract. For the purpose of this report, the Uniform Managed Care Contract is used for referencing contract requirements. Subject: Attachment A -- General Contract Terms & Conditions Version 1.5 Texas Health & Human Services Commission Definition of “Uniform Managed Care Manual” is modified. determinations made by Texas licensed pharmacists. The Span of Coverage sections of the Uniform Managed Care Contract, STAR+PLUS the Texas Medicaid & Healthcare Partnership (TMHP) is responsible for making the authorization STAR Health Managed Care Contract Terms & Conditions, • Section 5.03, “Span of Coverage” • Attachment B-1, Section 8.1.2, “Covered Services”
6 Mar 2012 Section 13.06 Debt or back taxes owed to State of Texas A – “Uniform Managed Care Contract Terms and Conditions,” and all amendments
CHIP Rural Service Area Contract (PDF) Dental Services Managed Care Managed Care Contracts and Manuals | Texas Health and Human Services To get the latest information on the coronavirus (COVID-19), click here . Subject: Attachment A – Uniform Managed Care Contract Terms and Conditions Version 2.7 DOCUMENT HISTORY LOG STATUS1 DOCUMENT REVISION2 EFFECTIVE DATE DESCRIPTION 3 Baseline n/a September 1, 2011 Initial version of the Attachment A, “Medicaid and CHIP Uniform Managed Care Contract Terms & Conditions.” Revision 2.1 March 1, 2012 Contract amendment did not revise Attachment A HHSC Uniform Managed Care Terms and Conditions Revision 1.5 January 1, 2007 Revised version of the Uniform Managed Care Contract Terms & Conditions that includes provisions applicable to MCOs participating in the STAR, STAR+PLUS, CHIP, and CHIP Perinatal Programs. Texas Medicaid and CHIP - Uniform Managed Care Manual The manual below defines procedures that Managed Care Organizations (MCOs) must follow in order to meet certain requirements in the HHSC managed care contracts, and to provide interpretation on contractual provisions that need clarification. Texas Children’s Health $5,656,397,948 2 Responsibility for managed care contract oversight and audit of MCO contracts at the agency • The Uniform Managed Care Manual provides cost principles for determining allowable and unallowable administrative and other
HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel Health and Human Services Commission HHSC Uniform Terms and Conditions - Grant Version 2.13. determine compliance with the terms and conditions of this Contract and all state and federal rules, regulations, and statutes.
28 Jul 2017 Texas Healthcare Transformation and Quality Improvement requirements, developing managed care contract requirements. information, along with mitigating and exacerbating conditions, and contract terms and managed care organization financial compliance with the Uniform Managed Care. Subject: Attachment A Medicaid and CHIP Managed Care Services RFP, Uniform Managed Care Contract Terms and Conditions Version 2.16 Texas Health
6 Mar 2012 Section 13.06 Debt or back taxes owed to State of Texas A – “Uniform Managed Care Contract Terms and Conditions,” and all amendments
1 Mar 2018 Becoming a Texas Health Steps Provider . The HHSC uniform managed care contract terms and conditions is the final authority on any provision of the Agreement, the provisions of this Appendix shall control Medicaid: Texas' managed care programs for Medicaid recipients, which Person” and “Existing Covered Person” are defined in HHSC Uniform Managed Care. Contractual Document (CD) Subject: Attachment A – Medicaid and CHIP Managed Care Services RFP, Uniform Managed Care Contract Terms and Conditions Version 2.29 Texas Health & Human Services Commission Uniform Managed Care Terms & Conditions
HHSC Uniform Terms and Conditions Version 2.13 Published and Effective: July 15, 2016 Responsible Office: Chief Counsel Health and Human Services Commission HHSC Uniform Terms and Conditions - Grant Version 2.13. determine compliance with the terms and conditions of this Contract and all state and federal rules, regulations, and statutes. October 1, 2015 : Initial version of Attachment A, “STAR Kids Managed Care Contract Terms and Conditions” that includes all modifications negotiated by the Parties. Subject: Attachment A – Uniform Managed Care Contract Terms and Conditions Version 2.7 DOCUMENT HISTORY LOG STATUS1 DOCUMENT REVISION2 EFFECTIVE DATE DESCRIPTION 3 Baseline n/a September 1, 2011 Initial version of the Attachment A, “Medicaid and CHIP Uniform Managed Care Contract Terms & Conditions.” Revision 2.1 March 1, 2012 The managed care contracts relevant to this audit include the Uniform Managed Care Contract, the Uniform Managed Care Manual, the STAR+PLUS Expansion Contract, and the CHIP Rural Service Area Contract. For the purpose of this report, the Uniform Managed Care Contract is used for referencing contract requirements.