Medi-Cal Sample Clauses

Medi-Cal. California's Medicaid public health insurance program which provides medical services, mental health and substance use disorder services, including behavioral health treatment, for children and adults with limited income.

Medi-Cal is the federal and state funded health care program established by Title XIX of the Social Security Act, as administered in California by DHCS.

Medi-Cal. The cost of the medication should be billed by the Participating 15 Pharmacy to Medi-Cal as appropriate and the County shall be billed for the BHS Clients’ Share of Cost 16 requirement as appropriate.

Medi-Cal. Pass-Throughs. ---------------------- (a) The parties acknowledge it is possible that as part of any new rate the State of California may require that a specific amount of money be spent for a specific purpose, which purpose was not specifically previously required, and that the Tenant will have no discretion on how that part of the rate is used. That type of requirement has occurred from time to time in the past and is referred to as a pass-through requirement. For example, the State may require that facilities provide more nursing hours per patient day than are currently required or that a specific increase in wages be paid to employees; and the State may provide an additional amount in the rate for those specific purposes and mandate that the licensee spend the money that is added to the rate for the specific purposes so indicated. In the event the State of California adds any amount to the rate of payment for services that consists of a pass- through amount, the parties agree that two thirds (2/3) of the pass-through increase shall not be included in the Percentage Increase in Medi-Cal for purposes of the rent adjustment pursuant to paragraph 6.2; provided, however, to the extent that Tenant shall demonstrate to Lessor that Tenant is not receiving any benefits from pass-through increase, then, the entire pass-through increase shall not be included for purposes of computing the Percentage Increase in Medi- Cal for purposes of the rent adjustment in the applicable year. (b) In the event of any dispute regarding the proper interpretation of this provision regarding pass-through amounts, it shall be resolved by reference to a certified public accountant to be designated by mutual agreement of Lessor and Tenant ("Accountant"

Medi-Cal. This Notice of Action does NOT change or stop Medi- Cal benefits. Keep your plastic Benefits Identification Card(s). Rules: These rules apply; you may review them at your welfare office: MPP 42-711.54. TEMP 2175 (7/99) SIP REVIEW REQUEST APPROVAL (REQUIRED FORM - NO SUBSTITUTES PERMITTED) STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY • You have the right to ask for a hearing if you disagree with any County decision regarding your status (standing) in Cal-Learn/Welfare to Work, your activity, or your supportive services. • Asking for a hearing will not affect your CalWORKs cash aid. • You have only 90 days to ask for a hearing. • The 90 days started the day after we gave or mailed you a notice.

Medi-Cal. Reimbursement for authorized Health Services shall be at one hundred percent (100%) of the attached ANTHEM Medi-CAL Proprietary Fee Schedule (Fee Schedule) per county. Provider shall accept the above reimbursement for services or the Provider’s billed amount, whichever is less as payment in full for those Covered Services provided to Members. Anthem may update or adjust the Fee Schedule from time to time upon ninety (90) days prior written notice to Provider. PROVIDER shall indicate which CS will be rendered and which ECM population of focus will be served. Provider shall render services and be compensated in the counties (service area) listed in Exhibit C. Anthem may add counties in Exhibit C, to Provider’s service area upon thirty (30) days written notice to Provider. ☐ Housing Transition Navigation Services ☐ Housing Deposits ☐ Housing Tenancy and Sustaining Services ☐ Short-Term Post-Hospitalization Housing ☐ Recuperative Care (Medical Respite) ☐ Respite Services ☐ Day Habilitation Programs ☐ Nursing Facility Transition/Diversion to Assisted Living Facilities, such as Residential Care Facilities for Elderly (RCFE) and Adult Residential Facilities (ARF) ☐ Community Transition Services/Nursing Facility Transition to a Home ☐ Personal Care and Homemaker Services ☐ Environmental Accessibility Adaptations (Home Modifications) ☐ Medically Supportive Food/Meals/Medically Tailored Meals ☐ Sobering Centers ☐ Asthma Remediation ☐ High utilizers(Adults) ☐ Individuals experiencing homelessness, including chronic homelessness ☐ Adults & Children/Youth transitioning from incarceration ☐ Adults with Serious Mental Illness or Substance Use Disorder ☐ Adults at risk for institutionalization, eligible for long-term care ☐ Nursing facility residents who desire to return to living in the community ☐ Children or youth MCMCP ECM CS Agreement packet 2021 v1.2 Provider can service Members within the following counties as check marked below: Bay Area Gold Country Central Valley Northern Eastern Sierra Los Angeles ☐ Alameda ☐ Contra Costa ☐ Sacramento ☐ San ▇▇▇▇▇▇ ☐ San Francisco ☐ Santa ▇▇▇▇▇ ☐ ▇▇▇▇▇▇ ☐ Butte ☐ Calaveras ☐ El Dorado ☐ Mariposa ☐ Nevada ☐ Placer ☐ Plumas ☐ Sierra ☐ Tuolumne ☐ Yuba ☐ Fresno ☐ Kings ☐ Madera ☐ Tulare ☐ Colusa☐ ▇▇▇▇▇ ☐ Alpine ☐ Inyo ☐ Mono ☐ Los Angeles ☐ ▇▇▇▇▇▇ ☐ Tehama

Medi-Cal pregnant Members who received adequate prenatal care based on: a. The month of pregnancy in which the beneficiary became a Member of the health plan. b. The month of pregnancy in which the initial comprehensive medical/OB visit occurred for each pregnant Member. c. The number of pregnancy related medical/OB visits during pregnancy, exclusive of delivery for each pregnant woman. d. The delivery date for each pregnant Member.

Medi-Cal. If you are a Medi-Cal patient, please note that we are not a Medi-Cal provider and therefore all service need to be paid for in full at the time of service.

Medi-Cal. Clients’ Permanent Residence: County agrees that Client’s Medi- Cal codes remain within his/her county of origin throughout his/her stay at Contractor’s facility. County agrees not to intentionally recode Client’s Medi- Cal county codes to Contractor’s County. County agrees to promptly take steps to correct any coding error should a Medi-Cal number be recoded through County’s conduct in any manner to Contractor’s County.