Health Plan Program Standards Sample Clauses
Health Plan Program Standards. 1. Section 2.15.01.01 - Fee Schedule Increase, Adoption of Minimum/Maximum Fee Schedule and State Directed Payment Requirements is amended by REPLACING the State directed payments table with the table shown below:
Health Plan Program Standards. Section 2.01.01.01 Alternative Payment Methodologies is amended by INSERTING a new paragraph to the end of the section to read as follows, “MCOs are required to participate in primary care capitation policy, planning, and design processes led by OHIC and EOHHS and leveraging the technical expertise of contractors, including but not limited to Bailit Health and CTC-RI. Participation shall include attendance at relevant meetings, providing requested data, financial analysis, design preferences, and any other such effort to support the development of both financial and clinical models to enable implementation of primary care capitation. The MCO shall also simulate practice revenues under the designed model to test the efficacy of the model per guidance from EOHHS.” This section is also amended by DELETING ‘Rhode Island Executive Office of Health and Human Services “Transitioning to Alternative Payment Methodologies: Requirements for Medicaid Managed Care Partners” and REPLACING with “Transitioning to Alternative Payment Methodologies: Requirements for Medicaid Managed Care Partners.”
Health Plan Program Standards. 9. Section 2.01.01 Alternative Payment Methodologies (APMs), Health System Transformation Project (HSTP), and Accountable Entities (AEs), is hereby amended by changing the number in sentence three from 3,000 to 2,000 attributed lives.
Health Plan Program Standards