Prepaid Ambulatory Health Plan Meaning

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Medicaid Delivery System and Payment Reform: A Guide to …

(2 days ago) WEBPrepaid Ambulatory Health Plan (PAHP): A PAHP is a non-comprehensive prepaid health plan that provides only certain outpatient services, such as dental services or outpatient behavioral health care, and does not cover any inpatient services.5 Prepaid …

https://files.kff.org/attachment/issue-brief-medicaid-delivery-system-and-payment-reform-a-guide-to-key-terms-and-concepts

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Definition: Prepaid ambulatory health plan (PAHP) from 42 CFR § …

(4 days ago) WEBPrepaid ambulatory health plan (PAHP) Prepaid ambulatory health plan (PAHP) means an entity that - (1) Provides services to enrollees under contract with the State, and on …

https://www.law.cornell.edu/definitions/index.php?height=800&def_id=13a0f7ed82f2f1ab1ecb91f68eb66a83

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42 CFR § 438.2 - Definitions. - LII / Legal Information Institute

(5 days ago) WEBPrepaid ambulatory health plan (PAHP) means an entity that— (1) Provides services to enrollees under contract with the State, and on the basis of capitation payments, or …

https://www.law.cornell.edu/cfr/text/42/438.2

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Pass-through payment guidance in final Medicaid managed care

(4 days ago) WEBIn this paper, we use the term “managed care plan” to mean a managed care organization (MCO), prepaid inpatient health plan (PIHP), or prepaid ambulatory …

https://us.milliman.com/en/insight/pass-through-payment-guidance-in-final-medicaid-managed-care-regulations-transitioning-to

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Understanding health plan types: What’s in a name?

(7 days ago) WEBIs the plan an indemnity or prepaid plan? 1 Indemnity plans reimburse the patient or the provider as medical expenses occur or afterward. Prepaid plans pay medical service …

https://www.bls.gov/opub/btn/volume-4/pdf/understanding_health_plan_types.pdf

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42 CFR § 455.101 - Definitions. Electronic Code of Federal

(7 days ago) WEBPrepaid inpatient health plan (PIHP) has the meaning specified in § 438.2. Primary care case manager (PCCM) has the meaning specified in § 438.2 . Significant business …

https://www.law.cornell.edu/cfr/text/42/455.101

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers …

(2 days ago) WEBThe Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Final Rule (CMS-2390-F, 81 FR 27498) published on May 6, 2016 (“final rule”), extends annual …

https://www.medicaid.gov/federal-policy-guidance/downloads/cib061016.pdf

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CMCS Informational Bulletin - HHS.gov

(9 days ago) WEBplans (PIHPs), and prepaid ambulatory health plans (PAHPs). In Medicaid managed care contracts that started on or after July 1, 2017, states were required to include …

https://www.hhs.gov/guidance/sites/default/files/hhs-guidance-documents/cib051519_162.pdf

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Reporting Non‐Emergency Medical Transportation (NEMT) …

(6 days ago) WEBThis best practice document outlines how states should approach reporting transportation Prepaid Ambulatory Health Plans (PAHPs) in the T‐MSIS Managed Care file, Claims …

https://www.medicaid.gov/medicaid/data-and-systems/macbis/tmsis/tmsis-blog/entry/47540

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PIHP • CMHAM - Community Mental Health Association of Michigan

(4 days ago) WEBPIHP is an acronym for Prepaid Inpatient Health Plan, a term contained in federal regulations from the Centers for Medicare & Medicaid Services. It means an entity that …

https://cmham.org/membership/pihp/

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eCFR :: 42 CFR Part 438 -- Managed Care

(Just Now) WEBPrepaid ambulatory health plan (PAHP) Member months mean the number of months an enrollee or a group of enrollees is covered by an MCO, PIHP, or PAHP over a …

https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-438

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State of California—Health and Human Services Agency

(3 days ago) WEBThis APL does not apply to Prepaid Ambulatory Health Plans, AIDS Healthcare Foundation (for SFY 2017-18 and SFY 2018-19 only), SCAN Health Plan, Program of …

https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2021/APL21-018.pdf

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Prepaid Ambulatory Health Plan (PAHP) Definition Law Insider

(3 days ago) WEBBased on 2 documents. Prepaid Ambulatory Health Plan (PAHP) means an entity that provides medical services to enrollees under contract with the state agency, and on the …

https://www.lawinsider.com/dictionary/prepaid-ambulatory-health-plan-pahp

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Definition: PAHP from 42 CFR § 438.2 LII / Legal Information …

(4 days ago) WEBPAHP Prepaid ambulatory health plan (PAHP) means an entity that Source. 42 CFR § 438.2. Scoping language As used in this part

https://www.law.cornell.edu/definitions/index.php?height=800&def_id=a1510460209634314f9c22ffafc5a413

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Centers for Medicare & Medicaid Services, HHS §455 - GovInfo

(8 days ago) WEBPrepaid ambulatory health plan (PAHP) has the meaning specified in §438.2. Prepaid inpatient health plan (PIHP) has the meaning specified in §438.2. Primary care case …

https://www.govinfo.gov/content/pkg/CFR-2016-title42-vol4/pdf/CFR-2016-title42-vol4-sec455-101.pdf

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DEPARTMENT OF HEALTH & HUMAN SERVICES

(Just Now) WEBinpatient health plans (PIHPs), and prepaid ambulatory health plans (PAHPs) related to covering inpatient days and emergency room visits beyond the limitations specified in a …

https://downloads.cms.gov/cmsgov/archived-downloads/SMDL/downloads/smd012403.pdf

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eCFR :: 42 CFR Part 417 -- Health Maintenance Organizations

(Just Now) WEBFurnished, when used in connection with prepaid health care services, “administrator” (of a health benefits plan) has the meaning it is given in the Employment Retirement …

https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-417

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Information for All Providers - Third Party - eMedNY

(9 days ago) WEBThe MEVS response will include information on a maximum of two third party insurance carriers. If a Medicaid enrollee is covered by more than two carriers, you will receive a …

https://www.emedny.org/ProviderManuals/AllProviders/PDFS/Information_for_All_Providers-Third_Party-2008-4.pdf

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Final Medicaid Managed Care Rule Explained

(1 days ago) WEBThe rule requires that each managed care plan submit a “payment analysis” to the state Medicaid agency that compares the total amount paid by the plan for primary …

https://ccf.georgetown.edu/2024/05/03/final-medicaid-managed-care-rule-explained/

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Definition: PAHP from 42 CFR § 457.10 - LII / Legal Information …

(4 days ago) WEBPrepaid ambulatory health plan (PAHP) means an entity that Source. 42 CFR § 457.10. Scoping language For purposes of this part the following definitions apply: Is this …

https://www.law.cornell.edu/definitions/index.php?height=800&def_id=7e90b9c5b9804ec05721bba0d20ceec0

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GHI CBP - EmblemHealth

(9 days ago) WEBWith the GHI CBP plan, you can control your costs by visiting a health care professional in our network. • This plan covers most services in and out of our network. You can find …

https://www.emblemhealth.com/content/dam/emblemhealth/pdfs/2021-GHI-CBP-Benefit-Flyer.pdf

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Horizon Advantage Direct Access - eHealth

(6 days ago) WEBAmbulatory Surgical Center (ASC) 80% after deductible. 60% after deductible. Limited to a $2,000 maximum per We require the employer to contribute a minimum of 10 percent …

https://www.ehealthinsurance.com/ehealthinsurance/benefits/sbg/NJ/NJHorizon_ADV_DA_100_80_60.pdf

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