Incentive Plan Requirements Clause Samples

Incentive Plan Requirements. Contractor may implement and maintain a Physician Incentive Plan only if: A. No specific payment is made directly or indirectly under the incentive plan to a physician or physician group as an inducement to reduce or limit Medically Necessary Covered Services provided to an individual Enrollee; and B. The stop-loss protection (reinsurance), Enrollee survey, and disclosure requirements of 42 CFR 417.479, 42 CFR 422.208 and 42 CFR 422.210 are met by Contractor.