covered Medicaid managed care services
(4) Definitions For purposes of this subsection: (A) Indian health care provider The term “Indian health care provider” means an Indian Health Program or an Urban Indian Organization. (B) Indian Medicaid managed care entity The term “Indian Medicaid managed care entity” means a managed care entity that is controlled (within the meaning of the last sentence of section 1396b(m)(1)(C) of this title ) by the Indian Health Service, a Tribe, Tribal Organization, or Urban Indian Organization, or a consortium, which may be composed of 1 or more Tribes, Tribal Organizations, or Urban Indian Organizations, and which also may include the Service. (C) Non-Indian Medicaid managed care entity The term “non-Indian Medicaid managed care entity” means a managed care entity that is not an Indian Medicaid managed care entity. (D) Covered Medicaid managed care services The term “covered Medicaid managed care services” means, with respect to an individual enrolled with a managed care entity, items and services for which benefits are available with respect to the individual under the contract between the entity and the State involved. (E) Medicaid managed care program The term “Medicaid managed care program” means a program under sections 1396b(m) , 1396d(t) , and 1396u–2 of this title and includes a managed care program operating under a waiver under section 1396n(b) or 1315 of this title or otherwise.