ACRONYMS, ABBREVIATIONS AND OTHER TERMINOLOGY Clause Samples

ACRONYMS, ABBREVIATIONS AND OTHER TERMINOLOGY. 1.1.1. Acronyms, abbreviations and other terminology are defined at their first occurrence in this Contract. The following list is provided to assist the reader in understanding acronyms, abbreviations and terminology used throughout this document. 1.1.1.1. Accountable Care Collaborative (ACC) - A program designed to affordably optimize client health, functioning and self-sufficiency. The primary goals of the ACC Program are to improve Medicaid client health outcomes and control costs. Regional Care Collaborative Organizations (RCCOs), a Statewide Data and Analytics Contractor (SDAC), and Primary Care Medical Providers (PCMPs) that will serve as Medical Homes work together in collaboration with ACC Program Members and other Medicaid providers to optimize the delivery of outcomes- based, cost-effective health care services. 1.1.1.2. Adults without Dependent Children (AwDC) - As used in 25.5-4-402.3 C.R.S. means a category of Medical Assistance for adults who are at least age 19 but less than 65 years without Medicaid eligible dependent children living in the client’s household. SSI disability determination is not required for this population. AwDC enrollees are covered under a federal 1115 Demonstration Waiver. 1.1.1.3. Advanced Directive - A written instrument recognized under Section 15-14-505(2),

ACRONYMS, ABBREVIATIONS AND OTHER TERMINOLOGY. 2.1.1. Acronyms, abbreviations and other terminology are defined at their first occurrence in this solicitation. The following list is provided to assist the reader in understanding acronyms, abbreviations and terminology used throughout this document. 2.1.1.1. Contract - An agreement that is entered into as a result of this solicitation and being selected from the Price Agreement List to perform Work. This establishes the terms of the relationship between the Contractor and the Department. Task Orders are attached to this Contract. 2.1.1.2. Contractor - The individual(s) or entity/entities selected as a result of this solicitation and a previous solicitation, Solicitation # HCPFIFBDD13CONPRAGRMT, to be on the Price Agreement List with the Department. 2.1.1.3. Department - The Colorado Department of Health Care Policy and Financing, a department of the government of the State of Colorado. 2.1.1.4. Effective Date - The effective date defined in the Contract. 2.1.1.5. HIPAA - The Health Insurance Portability and Accountability Act of 1996. 2.1.1.6. Health Care Consulting Services - Services from the following three (3) categories performed within the context of the health care industry: 1) Facilitation; 2) Analytical, Evaluative and Research Services; 3) Communication (e.g. Outreach, Coaching).

ACRONYMS, ABBREVIATIONS AND OTHER TERMINOLOGY. 1.1.1. Acronyms, abbreviations and other terminology are defined at their first occurrence in this Contract. The following list is provided to assist the reader in understanding acronyms, abbreviations and terminology used throughout this document. 1.1.1.1. Accountable Care Collaborative (ACC) – A program designed to affordably optimize member health, functioning and self-sufficiency. The primary goals of the ACC Program are to improve Medicaid member health outcomes and control costs. Regional Care Collaborative Organizations (RCCOs), a Statewide Data and Analytics Contractor (SDAC), and Primary Care Medical Providers (PCMPs) that will serve as Medical Homes work together in collaboration with ACC Program Members and other Medicaid providers to optimize the delivery of outcomes- based, cost-effective health care services. 1.1.1.2. Action – Denial or limited authorization of a requested service, including the type or level of service; reduction, suspension, or termination of a previously authorized service; denial, in whole or in part, of payment for a service; failure to provide services in a timely manner, as a defined by the State; or the failure of the Contractor to process grievances, appeals or expedited appeals within required timeframes. 1.1.1.3. Advanced Directive – A written instrument recognized under Section 15-14- 505(2), C.R.S. relating to the provision of medical care when the individual is incapacitated. 1.1.1.4. All-Payer Claims Database (APCD) – statewide information repository that collects health insurance claims information from all healthcare payers. 1.1.1.5. Appeal – Request for review of an action.