For Directed Payment for Faculty Physicians Affiliated with the Teaching Hospitals for each University of North Carolina Sample Clauses

For Directed Payment for Faculty Physicians Affiliated with the Teaching Hospitals for each University of North Carolina. Medical School, and Hospitals Owned by UNC Health Care or Vidant Medical Center: a) The Department will establish a uniform dollar increase annually at the average commercial rate for certain eligible medical professionals as defined in the Medicaid State Plan, Attachment 4.19-B, Section 5, Page 2, Subsection (c)(2). b) The Department will calculate the directed payment amount to the PHP on a quarterly basis as the difference between the rate paid to the eligible medical professionals PHP and the minimum fee schedule amount determined by the Department multiplied by the actual utilization for the eligible professionals. c) The Department will establish an annual aggregate cap for total eligible medical professional directed payments pursuant to State Law.1 d) The Department will perform an annual verification of the eligible medical professional directed payments based on PHP encounter data submitted to the Department to assure all claims data has been properly captured and calculated for directed payments and to assure compliance with aggregate annual payment cap.
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