Common use of CRITERIA FOR REIMBURSEMENT Clause in Contracts

CRITERIA FOR REIMBURSEMENT. In the event County refers and pays for the provision of Medical Respite Care for qualifying CalOptima Medi-Cal members, County may seek reimbursement from CalOptima for such Medical Respite Care services subject to the terms and conditions below and this Amendment. 1. County shall have agreements in place with Recuperative Care Services providers to provide the Medical Respite Care services hereunder. 2. County shall pay the Recuperative Care Services providers for Medical Respite Care services rendered. CalOptima shall not have liability to Recuperative Care Services providers for any services. 3. The Medical Respite Care Fund is that Fund that was established by the CalOptima Board of Directors through reallocating $250,000.00 from the Intergovernmental Transfer (IGT) funds allocated to the County’s Whole Person Care Recuperative Care program. Funding for Medical Respite Care Services is limited to those funds remaining in the Medical Respite Care Fund. No payments may be made under this Agreement for Medical Respite Care services other than from the Medical Respite Care Fund.

CRITERIA FOR REIMBURSEMENT. In the event County refers and pays for the provision of Medical Respite Care for qualifying CalOptima Medi-Cal members, County may seek reimbursement from CalOptima for such Medical Respite Care services subject to the terms and conditions below and this Amendment. 1. County shall have agreements in place with Recuperative Care Services providers to provide the Medical Respite Care services hereunder. 2. County shall pay the Recuperative Care Services providers for Medical Respite Care services rendered. CalOptima CalOpti ma shall not have liability to Recuperative Care Services providers for any services. 3. The Medical Respite Care Fund is that Fund that was established by the CalOptima Board of Directors through reallocating $250,000.00 from the Intergovernmental Transfer (IGT) funds allocated to the County’s Whole Person Care Recuperative Care program. Funding for Medical Respite Care Services is limited to those funds remaining in the Medical Respite Care Fund. No payments may be made under this Agreement for Medical Respite Care services other than from the Medical Respite Care Fund.