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Full Delegation Model Sample Clauses

Full Delegation Model. In the Full Delegation Model, the CONTRACTOR is permitted to delegate the full set of Care Coordination functions to a Contract Provider (the delegate) for an attributable membership, and retains oversight and monitoring functions. The CONTRACTOR is only permitted to fully delegate Care Coordination when Care Coordination is included as part of a VBP arrangement(s) that outlines a payment arrangement for the full delegation of Care Coordination and other requirements associated with improving quality and health outcomes. The CONTRACTOR shall clearly define the terms of the VBP payment and Care Coordination delegation in order to fully delegate Care Coordination to the delegate for the attributed membership. The CONTRACTOR shall ensure the additional Care Coordination delegation requirements in VBP arrangements are met as described in the VBP delivery system improvement target in Attachment 2.A. The CONTRACTOR’s Care Coordination program description shall describe the CONTRACTOR’s roles and responsibilities in attributing membership and providing oversight and monitoring for its Full Delegation model. In establishing its Full Delegation model, the CONTRACTOR shall comply with the requirements in the Managed Care Policy Manual. Shared Functions Model In the Shared Functions Model, when offered, the CONTRACTOR retains some Care Coordination functions and allows other Care Coordination activities to be conducted by a delegated individual or entity. It does not require a VBP arrangement (although it may at the discretion of the CONTRACTOR and the delegated individual or entity). Potential shared Care Coordination functions may include the following: Conducting HRAs; Conducting CNAs; Conducting periodic touch points with Members as needed either in-person or telephonically; Coordinating referrals and linking Members to community services; Locating and engaging with Members categorized as CCL0; and Other functions as prior approved by HCA. The CONTRACTOR shall develop written agreements with individuals and entities that specify shared Care Coordination functions, reporting responsibilities, and a mutually-agreed upon reimbursement rate for shared functions of Care Coordination. The CONTRACTOR shall make good faith efforts to contract with tribal organizations (I/T/Us) for shared Care Coordination functions. The CONTRACTOR shall maintain all oversight and monitoring responsibilities for shared Care Coordination functions with the individuals and entities. The CON...
Full Delegation Model. In the Full Delegation Model, the CONTRACTOR delegates the full set of Care Coordination functions to the provider/health system (the delegate) for an attributable membership and only retains oversight and monitoring functions. 4.4.19.1.1 Full delegation of Care Coordination is permitted only when included as part of a Value-Based Purchasing (VBP) arrangement(s) that outlines a payment arrangement for the full delegation of Care Coordination and other requirements associated with improving quality and health outcomes. Through VBPs that clearly define the terms of the VBP payment and delegation, the CONTRACTOR is able to fully delegate Care Coordination for the membership that is attributed to the delegate.
Full Delegation Model. In the Full Delegation Model, the CONTRACTOR delegates the full set of care coordination functions to the provider/health system (the delegate) for an attributable membership and only retains oversight and monitoring functions.
Full Delegation Model. In the Full Delegation Model, the CONTRACTOR is permitted to delegate the full set of Care Coordination functions to a Contract Provider (the delegate) for an attributable membership, and retains oversight and monitoring functions. The CONTRACTOR is only permitted to fully delegate Care Coordination when Care Coordination is included as part of a VBP arrangement(s) that outlines a payment arrangement for the full delegation of Care Coordination and other requirements associated with improving quality and health outcomes. The CONTRACTOR shall clearly define the terms of the VBP payment and Care Coordination delegation in order to fully delegate Care Coordination to the delegate for the attributed membership. The CONTRACTOR shall ensure the additional Care Coordination delegation requirements in VBP arrangements are met as described in the VBP delivery system improvement target in Attachment 2.A. The CONTRACTOR’s Care Coordination program description shall describe the CONTRACTOR’s roles and responsibilities in attributing membership and providing oversight and monitoring for its Full Delegation model. In establishing its Full Delegation model, the CONTRACTOR shall comply with the requirements in the Managed Care Policy Manual.

Related to Full Delegation Model

  • Delegation; Committees The Trustees shall have the power, consistent with their continuing exclusive authority over the management of the Trust and the Trust Property, to delegate from time to time to such of their number or to officers, employees or agents of the Trust the doing of such things, including any matters set forth in this Declaration, and the execution of such instruments either in the name of the Trust or the names of the Trustees or otherwise as the Trustees may deem expedient. The Trustees may designate one or more committees which shall have all or such lesser portion of the authority of the entire Board of Trustees as the Trustees shall determine from time to time except to the extent action by the entire Board of Trustees or particular Trustees is required by the 1940 Act.

  • Delegation (a) The Administrator, upon prior notice to the Trust and in compliance with applicable law, may delegate any of the Services, or adjust any prior delegation, to any other person or persons that the Administrator controls, is controlled by, or is under common control with, or to specified employees of any such persons, to the extent permitted by applicable law. (b) Subject to prior approval of a majority of the members of a Fund’s Board of Trustees, including a majority of the Trustees who are not “interested persons,” and, to the extent required by applicable law, by the shareholders of a Fund, the Administrator, upon prior consent of the Trust and in compliance with applicable law, may delegate or outsource any of the Services, or adjust any prior delegation or outsourcing, to any other person or persons unaffiliated with the Administrator or to specified employees of any such persons, to the extent permitted by applicable law. (c) Notwithstanding any delegation under clauses (a) or (b) of this Section 4, the Administrator will continue to supervise the Services provided by such persons or employees and any delegation will not relieve the Administrator of any of its obligations under this Agreement.

  • Delegations The Commonwealth Minister may delegate the assessment of performance against milestones and the authorisation of related project payments to senior Commonwealth officials, having regard to the financial and policy risks associated with those payments.

  • Delegation of Board Review of Subcustodians From time to time, the Custodian may agree to perform certain reviews of Subcustodians and of Subcustodian Contracts as delegate of the Fund's Board. In such event, the Custodian's duties and obligations with respect to this delegated review will be performed in accordance with the terms of the attached 17f-5 Delegation Schedule to this Agreement.

  • Assignment; Delegation The Contract shall be binding upon and ensure to the benefit of the City and the Contractor and their respective successors and assigns, provided however, that no right or interest in the Contract shall be assigned and no obligation shall be delegated by the Contractor without the prior written consent of the City. Any attempted assignment or delegation by the Contractor shall be void unless made in conformity with this paragraph. The Contract is not intended to confer rights or benefits on any person, firm or entity not a party hereto; it being the intention of the parties that there are no third party beneficiaries to the Contract.

  • Delegation; Assignment PFPC Trust may assign its rights and delegate its duties hereunder to any affiliate of PFPC Trust or of The PNC Financial Services Group, Inc., provided that PFPC Trust gives the Fund 30 days' prior written notice of such assignment or delegation.

  • Training Plan 19.6.1 An apprentice shall be a party to an individual Training Plan. 19.6.2 The Training Plan sets out the training that the apprentice will do both on – the – job and off – the – job. The Training Plan also sets out how the Registered Training Organisation (RTO) will ensure the apprentice will receive quality training – both on – the – job and off – the – job. 19.6.3 The Training Plan reflects the choices made by the employer and the apprentice in relation to:-

  • HUB Subcontracting Plan The Owner has adopted Exhibit H, Policy on Utilization of Historically Underutilized Business ("Policy"), which is incorporated herein by reference. Contractor, as a provision of the Agreement must comply with the requirements of the Policy and adhere to the HUB Subcontracting Plan submitted with Contractor's Proposal and attached as Exhibit I. No changes to the HUB Subcontracting Plan can be made by the Contractor without the prior written approval of the Owner in accordance with the Policy.

  • Training Program It is agreed that there shall be an Apprenticeship Training Program, the provisions of which are set forth in Exhibit "D", which is attached hereto and forms part of this Agreement.

  • DELEGATION, ASSIGNMENT AND SUBCONTRACTS CONTRACTOR may not delegate the obligations hereunder, either in whole or in part, without 29 prior written consent of COUNTY. CONTRACTOR shall provide written notification of 30 CONTRACTOR’s intent to delegate the obligations hereunder, either in whole or part, to 31 ADMINISTRATOR not less than sixty (60) calendar days prior to the effective date of the delegation. 32 Any attempted assignment or delegation in derogation of this paragraph shall be void.