Contracted Services Reciprocity. When a Beneficiary ----------------------------------- not assigned to Provider under a Capitation Compensation arrangement receives Contracted Services from Provider, then Provider shall accept compensation based upon the rates set forth in Exhibit 1 of this Addendum.
Contracted Services Reciprocity. When a Beneficiary not ---------------------------------- assigned to Provider under a Capitated Compensation method receives services from Provider, then Provider shall accept compensation based upon the rates set forth in Exhibit 1 of this Addendum. Addendum C, Exhibit 1 EXHIBIT 1 TO ADDENDUM C FEE-FOR-SERVICE COMPENSATION SCHEDULE MEDICARE RISK BENEFIT PROGRAMS Compensation to Provider for the delivery of Medically Necessary Covered Contracted Services will be the lesser of 85% of the Medicare allowable fee schedule, 60% of billed charges, or the rate schedule in Attachment A. Addendum D ADDENDUM D TO FACILITY PROVIDER AGREEMENT MEDI-CAL PROGRAM Provider understands and agrees that the obligations of Foundation set forth in this Addendum shall be the obligations of Foundation Health, a California Health Plan, an Affiliate of Foundation Health Corporation ("FHC"), and not the obligations of FHC or any other Affiliate of FHC. Foundation has entered into a prepaid health plan agreement ("PHP Agreement"), with the State Department of Health Services ("DHS") under which Foundation has agreed to provide medical services covered under California's Medi-Cal program, including Provider Risk Services, to Medi-Cal Beneficiaries enrolled in or otherwise assigned to Foundation, on a prepaid basis. Pursuant to the requirements of the Medi-Cal Program, this Agreement and any subcontracts as requested, must be filed with DHS. All references to "Beneficiaries" in this Addendum are deemed to refer to "Medi-Cal Beneficiaries".
Contracted Services Reciprocity. When a Medi-Cal HMO Member not assigned to PPG under a Capitated Compensation method receives services from PPG, then PPG shall accept compensation based upon the rates set forth in Addendum F.?
Contracted Services Reciprocity. When a Member for whom RPO or RPO Provider is not under a Capitated Compensation method receives services from RPO or RPO Provider, then RPO Provider shall accept compensation based upon CMS reimbursement rates for Medicare.
