Common use of ACA PCP Payments to Capitated Plans Clause in Contracts

ACA PCP Payments to Capitated Plans. Upon the Agency’s receipt and approval of the capitated Health Plan’s ad hoc and quarterly reports of utilization and encounter data for physicians eligible for the ACA primary care physician payment increase, the Agency shall pay the Health Plan a supplemental payment for eligible services provided between January 1, 2013 and December 31, 2014. This payment will be based on the Agency’s approved health plan payment methodology from the Centers for Medicare & Medicaid Services. 1. The Agency shall notify the Health Plan of the supplemental payment being made. 2. Such payment shall be made through the Medicaid fiscal agent. The Health Plan shall address errors found regarding such reports in accordance with Attachment II, Exhibit 13, Method of Payment, Item E., Errors, of this Contract.

ACA PCP Payments to Capitated Plans. Upon the Agency’s receipt and approval of the capitated Health Plan’s ad hoc and quarterly reports of utilization and encounter data for physicians eligible for the ACA primary care physician payment increase, the Agency shall pay the Health Plan a supplemental payment for eligible services provided between January 1, 2013 and December 31, 2014. This payment will be based on the Agency’s approved health plan payment methodology from the Centers for Medicare & Medicaid Services. 1. The Agency shall notify the Health Plan of the supplemental payment being made. 2. Such payment shall be made through the Medicaid fiscal agent. The Health Plan shall address errors found regarding such reports in accordance with Attachment II, Exhibit 13, Method of Payment, Item E.F., Errors, of this Contract. NOTE: This exhibit provides Health Plan requirements in addition to Attachment II of this Contract, unless otherwise specified.

ACA PCP Payments to Capitated Plans. Upon the Agency’s receipt and approval of the capitated Health Plan’s ad hoc and quarterly reports of utilization and encounter data for physicians eligible for the ACA primary care physician payment increase, the Agency shall pay the Health Plan a supplemental payment for eligible services provided between January 1, 2013 and December 31, 2014. This payment will be based on the Agency’s approved health plan payment methodology from the Centers for Medicare & Medicaid Services. 1. The Agency shall notify the Health Plan of the supplemental payment being made. 2. Such payment shall be made through the Medicaid fiscal agent. The Health Plan shall address errors found regarding such reports in accordance with Attachment II, Exhibit 13, Method of Payment, Item E., Errors, of this Contract. NOTE: This exhibit provides Health Plan requirements in addition to Attachment II of this Contract, unless otherwise specified.