Cost Sharing Enhancement Project Sample Clauses

Cost Sharing Enhancement Project. Per 42 CFR §447.56(f), the aggregate cost sharing of premiums and copays for a Medicaid Member cannot exceed 5% of the Member’s family income. The State intends to enhance cost sharing logic in MMIS and the Pharmacy Benefit Management (PBM) systems, to proactively discontinue Member copay charges on claims based on the Member’s income threshold. Analysis and design activities began in 2021. Contractor shall deliver and maintain a Work Plan that identifies staff allocation and estimated hours to be worked, and shall deliver monthly status reporting for those activities performed by Contractor. Upon receipt of Contractor’s Work Plan, State shall review and, if approved, provide written authorization of the Work Plan. Based upon State written authorization of the Work Plan, Contractor shall invoice the State monthly for actual hours worked. For the Cost Sharing Enhancement Project, Contractor shall perform the following activities and make related MMIS Core Changes as detailed below: MAGI Household MMIS Enhancements: receive and store enhanced VHC income file information to include household formation and expanded Member income data. Copay calculation: MMIS calculates and stores updated copay information for Members weekly (after weekly PBM claims are received) based on a <5% household income threshold and sends Member copay info to PBM. Medical claims processing: update MMIS claims processing to use new copay calculation information, to not deduct copay for claims where Member has exceeded threshold. MMIS eligibility features: enhanced to include new copay determination, so that Providers can look up whether copay should be charged. Update existing retro copay reporting and processes to find and reimburse any situations where copay was charged above the 5% federal cap (due to non-real time limitations). MMIS to generate cost sharing cap notices to Members. Provide Project Management support and deliverables Other TBD system changes / contingency. Produce Provider outreach, communications, documentation updates (included with existing Contractor Provider Services).
Sample 1
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Related to Cost Sharing Enhancement Project

  • Cost Sharing a) With respect to the funding in C6.1a), should there be an amount of employee co-pay, the Trust shall advise boards what that amount shall be. Unless advised otherwise, there will be no deductions upon the Participation Date.

  • Enhancement Budget Enhancements refer to additional functionality and deliverables unknown to the Authorized User at the time of Mini-Bid release. An Authorized User is permitted to include an enhancement budget, as included in the Mini-Bid (up to 10%). The total cost of the project including the enhancement budget shall not exceed the Lot threshold from which the award was made. An Authorized User shall use Appendix F, Attachment 3, Enhancement Request Template to reflect such modifications. Mini-Bid/Statement of Work documents will define specific criteria and method of reimbursement for the enhancement budget. Written approval of the Enhancement Budget Request is required from both the Authorized User and the Contractor.

  • Student Tuition Recovery Fund “The State of California established the Student Tuition Recovery Fund (STRF) to relieve or mitigate economic loss suffered by a student in an educational program at a qualifying institution, who is or was a California resident while enrolled, or was enrolled in a residency program, if the student enrolled in the institution, prepaid tuition, and suffered an economic loss. Unless relieved of the obligation to do so, you must pay the state-imposed assessment for the STRF, or it must be paid on your behalf, if you are a student in an educational program, who is a California resident, or are enrolled in a residency program, and prepay all or part of your tuition. You are not eligible for protection from the STRF, and you are not required to pay the STRF assessment, if you are not a California resident, or are not enrolled in a residency program.”

  • Administrative Cost Recovery 3.1 In order to assist in the defrayment of the costs of administration and other expenses incurred by the Bank under this Agreement, the Bank may, following deposit of Contribution funds, deduct from such funds and retain for the Bank’s own account an amount equal to five percent (5.0%) of the Contributions.

  • Additional Benefits/Card Enhancements The Credit Union may from time to time offer additional services to your account, such as travel accident insurance, at no additional cost to you. You understand that the Credit Union is not obligated to offer such services and may withdraw or change them at any time.

  • Cost Allocation Cost allocation of Generator Interconnection Related Upgrades shall be in accordance with Schedule 11 of Section II of the Tariff.

  • Performance Improvement Plan timely and accurate completion of key actions due within the reporting period 100 percent The Supplier will design and develop an improvement plan and agree milestones and deliverables with the Authority

  • Tuition Reimbursement Program 21.2.1 The District will fund $28,000 each fiscal year for incentive pay for employees pursuing their National Board Certification, a master’s degree, or an endorsement.

  • Performance Improvement Process 9.5.1 The purpose of the Performance Improvement Process is to remedy or mitigate the impact of a Performance Factor. The Performance Improvement Process may include: a requirement that the Hospital develop an Improvement Plan; or an amendment of the Hospital’s obligations as mutually agreed by the parties.

  • Cost Savings Developer shall work cooperatively with Architect, Construction Manager, subcontractors and District, in good faith, to identify appropriate opportunities to reduce the Project costs and promote cost savings. Any identified cost savings from the Guaranteed Maximum Price shall be identified by Developer, and approved in writing by the District. In the event Developer realizes a savings on any aspect of the Project, such savings shall be added to the Contingency and expended consistent with the Contingency. In addition, any portion of Allowance remaining after completion of the Project shall be added to the Contingency. If any cost savings require revisions to the Construction Documents, Developer shall work with the District and Architect with respect to revising the Construction Documents and, if necessary, obtaining the approval of DSA with respect to those revisions. Developer shall be entitled to an adjustment of Contract Time for delay in completion caused by any cost savings adopted by District pursuant to Exhibit D, if requested in writing before the approval of the cost savings.

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