Care Conference Coverage Sample Clauses

Care Conference Coverage. As described in further detail in Section 5.3.2, the Contractor shall engage the member’s provider in care management through semi-annual care conferences. The Contractor shall reimburse the provider for participation in these care conferences. Services must be billed using Healthcare Common Procedure Coding System (HCPCS) 99211 SC – “office or other outpatient visit for the evaluation and management of an established patient.” Contractors who elect not to utilize a primary medical provider (PMP) model, as described in Section 6.2.3, shall propose to FSSA for review and approval their proposed process for identifying what provider(s) will be engaged in the care conference process and what provider(s) will be eligible for reimbursement for the care conference.
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Related to Care Conference Coverage

  • Health Care Coverage The Company shall continue to provide Executive with medical, dental, vision and mental health care coverage at or equivalent to the level of coverage that the Executive had at the time of the termination of employment (including coverage for the Executive’s dependents to the extent such dependents were covered immediately prior to such termination of employment) for the remainder of the Term of Employment, provided, however that in the event such coverage may no longer be extended to Executive following termination of Executive’s employment either by the terms of the Company’s health care plans or under then applicable law, the Company shall instead reimburse Executive for the amount equivalent to the Company’s cost of substantially equivalent health care coverage to Executive under ERISA Section 601 and thereafter and Section 4980B of the Internal Revenue Code (i.e., COBRA coverage) for a period not to exceed the lesser of (A) 18 months after the termination of Executive’s employment or (B) the remainder of the Term of Employment, and provided further that (1) any such health care coverage or reimbursement for health care coverage shall cease at such time that Executive becomes eligible for health care coverage through another employer and (2) any such reimbursement shall be made no later than the last day of the calendar year following the end of the calendar year with respect to which such coverage or reimbursement is provided. The Company shall have no further obligations to the Executive as a result of termination of employment described in this Section 8(a) except as set forth in Section 12.

  • Insurance Coverage The Company and each Subsidiary maintains in full force and effect insurance coverage that is customary for comparably situated companies for the business being conducted and properties owned or leased by the Company and each Subsidiary, and the Company reasonably believes such insurance coverage to be adequate against all liabilities, claims and risks against which it is customary for comparably situated companies to insure.

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