Retroactive Eligibility Sample Clauses
The Retroactive Eligibility clause establishes that certain rights, benefits, or obligations under an agreement can be applied to events or actions that occurred before the formal execution or effective date of the contract. In practice, this means that parties may be entitled to claim benefits or fulfill requirements for a period prior to when the agreement was officially signed, such as recognizing prior service, expenses, or performance. This clause is particularly useful for ensuring that no party is disadvantaged by administrative delays or timing issues, thereby providing fairness and continuity in contractual relationships.
Retroactive Eligibility. The State will limit retroactive eligibility for all individuals eligible under the State Plan or demonstration to a 5-day period prior to the date of application with the exception of individuals requesting long-term care services in which case up to three months of retroactive eligibility will be allowed.
Retroactive Eligibility. Retroactive eligibility is provided in accordance to STC 50 Table F.
Retroactive Eligibility. The state’s systems performance will ensure seamless coverage between Medicaid and the Exchange after changes outlined in the Affordable Care Act are effectuated, evaluating a need for retroactive eligibility.
Retroactive Eligibility. Any funds collected based upon retroactive eligibility that impacts the Tribe’s administration or training claim will be reimbursed to the Tribe.
Retroactive Eligibility. Retroactive eligibility is provided in accordance to Table D. 21. Calculation of Financial Eligibility. Financial eligibility for demonstration programs is determined by comparing the family’s Modified Adjusted Gross Income (MAGI) with the applicable income standard for the specific coverage type, with the exception of adults aged 19 and above who are determined eligible on the basis of disability and whose financial eligibility is determined as described below. MAGI income counting methodologies will also be applied to disabled adults in determining eligibility for MassHealth Standard and CommonHealth; however, household composition for disabled adults will always be determined using non-tax filer rules, regardless of whether the individual files income taxes or is claimed as a dependent on another person’s income taxes. In determining eligibility for MassHealth Standard and CommonHealth for disabled adults, the Commonwealth will apply the five percent income disregard that is also applied to non-disabled adults.
Retroactive Eligibility. With the exception of newborns, the Health Plan shall not be responsible for any payments owed to Vendor or its providers for services rendered prior to a Medicaid Member's enrollment with the Health Plan, even if the date of service fell within an established period of retroactive eligibility.
Retroactive Eligibility. To be eligible for retroactive pay pursuant to the ratification of an updated Agreement, the employee must be permanently working 14 or more hours per week in the maintenance unit at the time of ratification of the Agreement.
A.1. BASIC WAGE MATRIX AND OVERRIDES
Retroactive Eligibility. Retroactive eligibility as provided for under the approved Medicaid state plan does not apply to demonstration eligibles.
Retroactive Eligibility. Retroactive eligibility is provided in accordance to Table D. 19. Calculation of Financial Eligibility. Through December 31, 2013, financial eligibility for demonstration programs is determined by comparing the family group’s gross income with the applicable income standard for the specific coverage type. The monthly income standards are determined according to annual Federal Poverty Level (FPL) standard published in the Federal Register. Effective January 1, 2014, financial eligibility for demonstration programs is determined by comparing the family’s Modified Adjusted Gross Income (MAGI) with the applicable income standard for the specific coverage type, with the exception of adults aged 19 and above who are determined eligible on the basis of disability and whose financial eligibility is determined as described below. MAGI income counting methodologies will also be applied to disabled adults in determining eligibility for MassHealth Standard and CommonHealth; however, household composition for disabled adults will always be determined using non-tax filer rules, regardless of whether the individual files income taxes or is claimed as a dependent on another person’s income taxes. Specifically, MassHealth will apply the five percent income disregard to disabled adults for the purposes of MassHealth Standard eligibility at the 133 percent FPL threshold.
Retroactive Eligibility. Eligibility will be effective 10 calendar days prior to the Commonwealth’s receipt of an application if certain conditions are met for the following demonstration programs: Standard, CommonHealth, Prenatal, Limited and direct coverage Family Assistance.