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Kick Payments Sample Clauses

Kick Payments. 1. The Agency shall pay the Health Plan one kick payment for the following covered services for enrollees who are not also eligible for Medicare: a. Each obstetrical delivery, and b. Each covered transplant. 2. The Agency shall make kick payments in the amounts indicated in Attachment I. a. For kick payment purposes, an obstetrical delivery includes all births resulting from the delivery; therefore, if an obstetrical delivery results in multiple births, the Agency will make only one kick payment. This includes still births as specified in the Medicaid Physicians Services Handbook. b. For Health Plans under Contract as specialty plans, reimbursement for kick payment services will be counted toward the enrollee’s benefit maximum. 3. To receive a kick payment, the Health Plan must adhere to the specific requirements listed in subsections 4. and 5. below and adhere to the following requirements: a. The Health Plan must have provided the covered kick payment service while the recipient was enrolled in the Health Plan; and b. The Health Plan shall submit any required documentation to the Agency upon its request in order to receive the kick payment applicable to the covered service provided. 4. In addition to subsection 3. above, to receive a kick payment for covered transplants provided to an enrollee without Medicare, the Health Plan shall also comply with the following requirements: a. For each transplant provided, the Health Plan shall submit an accurate and complete CMS-1500 claim form (CMS-1500) and operative report to the fiscal agent within the required Medicaid FFS claims submittal timeframes b. The Health Plan shall list itself as both the pay-to and the treating provider on the CMS- 1500; and c. The Health Plan shall use the following list of transplant procedure codes relative to the type of transplant performed when completing Field 24 D on the CMS-1500: 32851 lung single, without bypass 32852 lung single, with bypass 32853 lung double, without bypass 32854 lung double, with bypass 33945 heart transplant with or without recipient cardiectomy 47135 liver, allotransplantation, orthotopic, partial or whole from cadaver or living donor 47136 liver, heterotopic, partial or whole from cadaver or living donor any age 5. In addition to subsection 3. above, to receive a kick payment for the covered obstetrical delivery provided to an enrollee, the Health Plan shall also comply with the following requirements: a. The Health Plan shall submit an accurate and co...
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Kick PaymentsBeginning September 1, 2006, the Agency shall pay Health Plans one (1) Kick Payment for each covered transplant for the Health Plan’s Enrollees who are not dually eligible for Medicare, and for each obstetrical delivery performed for each obstetrical delivery performed for the Health Plan’s Enrollees. Kick Payments are not made for Enrollees dually eligible for Medicare. 1. The Agency shall pay Kick Payments in the amounts indicated for children and adults in Attachment I, Tables 7 and 8. a. For Health Plans under Contract to provide the Comprehensive Component only, Agency reimbursements to the Health Plan for Kick Payment services will be counted toward the Health Plan’s Catastrophic Component Threshold. Once the Catastrophic Component Threshold has been met, the Agency will continue to reimburse the Health Plan any Kick Payment services delivered by the Health Plan at the Kick Payment amounts. b. For purposes of Kick Payments, an obstetrical delivery includes all births resulting from the delivery; therefore, if an obstetrical delivery results in multiple births, the Agency will reimburse the Health Plan through one Kick Payment only. Obstetrical deliveries also include still births as specified in the Medicaid Physicians Services Handbook. c. For Health Plans under Contract as a Specialty Plan, Agency reimbursements to the Health Plans for Kick Payment services will be counted toward the Enrollee’s Benefit Maximum. 2. To receive a Kick Payment, the Health Plan must adhere to specific requirements listed in subsections 3. and 4. below and adhere to the following requirements: a. The Health Plan must have provided the covered Kick Payment service to the recipient while he or she was enrolled in the Health Plan; and b. The Health Plan must submit any required documentation to the Agency upon its request in order to receive the Kick Payment applicable to the Covered Service provided. 3. In addition to subsection 2. above, to receive a Kick Payment for covered transplants provided to an Enrollee without Medicare, the Health Plan must also comply with the following requirements: a. For each transplant provided, the Health Plan must submit an accurate and complete CMS-1500 Claim Form and (“CMS-1500”) Operative Report to the Fiscal Agent within the required Medicaid Fee-for-Service claims submittal timeframes b. The Health Plan must list itself as both the Pay-to and the Treating Provider on the CMS-1500 Claim Form; and c. The Health Plan must use the followin...
Kick Payments. 1. The Agency shall pay the Health Plan one kick payment for the following covered services for enrollees who are not also eligible for Medicare: a. Each obstetrical delivery, and b. Each covered transplant. 2. The Agency shall make kick payments in the amounts indicated in Attachment I. a. For Health Plans that provide only the comprehensive component, kick payment services will be counted toward the catastrophic component threshold. Once the threshold has been met, the Agency will continue to reimburse the Health Plan any kick payment services delivered by the Health Plan at the kick payment amounts specified in Attachment I of this Contract.

Related to Kick Payments

  • Dividend Equivalent Payments Until your RSUs convert to Shares, if MSCI pays a dividend on Shares, you will be entitled to a dividend equivalent payment in the same amount as the dividend you would have received if you held Shares for your vested and unvested RSUs immediately prior to the record date. No dividend equivalents will be paid to you with respect to any canceled or forfeited RSUs. MSCI will decide on the form of payment and may pay dividend equivalents in Shares, in cash or in a combination thereof, unless otherwise provided in Exhibit C. MSCI will pay the dividend equivalent when it pays the corresponding dividend on its common stock or on the next regularly scheduled payroll date. The gross amount of any dividend equivalents paid to you with respect to RSUs that do not vest and convert to Shares shall be subject to potential recoupment or payback (such recoupment or payback of dividend equivalents, the “Clawback”) following the cancellation or forfeiture of the underlying RSUs. You consent to the Company’s implementation and enforcement of the Clawback and expressly agree that MSCI may take such actions as are necessary to effectuate the Clawback consistent with applicable law. If, within a reasonable period, you do not tender repayment of the dividend equivalents in response to demand for repayment, MSCI may seek a court order against you or take any other actions as are necessary to effectuate the Clawback.

  • Premium Payments The insurance companies shall have no recourse against the County and funding agencies, its officers and employees or any of them for payment of any premiums or assessments under any policy issued by a mutual insurance company.

  • Cash Payments Merchant may not receive any payments from a Cardholder for charges included in any Transaction resulting from the use of any Card nor receive any payment from a Cardholder to prepare and present a Transaction for the purpose of affecting a deposit to the Cardholder's Card account.

  • Quarterly Payments The quarterly payment cannot be increased in cases of target over-achievement. The payments are given on cumulative outputs, in arrears, and therefore the maximum payment available will be given by the end of the Contract if the agreed (target) number of outputs is reached or exceeded.

  • Income Payments Seller shall be entitled to receive an amount equal to all Income paid or distributed on or in respect of the Securities that is not otherwise received by Seller, to the full extent it would be so entitled if the Securities had not been sold to Buyer. Buyer shall, as the parties may agree with respect to any Transaction (or, in the absence of any such agreement, as Buyer shall reasonably determine in its discretion), on the date such Income is paid or distributed either (i) transfer to or credit to the account of Seller such Income with respect to any Purchased Securities subject to such Transaction or (ii) with respect to Income paid in cash, apply the Income payment or payments to reduce the amount, if any, to be transferred to Buyer by Seller upon termination of such Transaction. Buyer shall not be obligated to take any action pursuant to the preceding sentence (A) to the extent that such action would result in the creation of a Margin Deficit, unless prior thereto or simultaneously therewith Seller transfers to Buyer cash or Additional Purchased Securities sufficient to eliminate such Margin Deficit, or (B) if an Event of Default with respect to Seller has occurred and is then continuing at the time such Income is paid or distributed.

  • Grant Payments All grant payments are requested by submitting a Payment Request. Payment Requests and supporting documentation must be submitted on the DOS Grants System at xxxxxxxxx.xxx. The total grant award shall not exceed $[award] which shall be paid by the Division in consideration for the Subgrantee’s minimum performance as set forth by the terms and conditions of this Agreement. The grant payment schedule is outlined below: a. All payments will be made in the amounts identified with the Deliverables in Section 1 of this Agreement. b. All payments will be made in accordance with the completion of those Deliverables.

  • Bonus Payments No employee shall be required or requested to make any written or verbal agreement that will conflict with the terms of this Agreement. All employees must be paid weekly for all hours worked as provided in this Agreement. Any bonuses, commissions or other methods of payments over and above the requirements of this Agreement shall be in addition to the requirements of this Agreement and may not be used to offset such contractual requirements and shall not be subject to negotiations.

  • Interim Payments Interim payments may be made by Department, at its discretion, if the completion of deliverables to date have first been accepted in writing by Department's Grant Manager.

  • Incentive Payments The Settlement Fund Administrator will treat incentive payments under Section IV.F on a State-specific basis. Incentive payments for which a Settling State is eligible under Section IV.F will be allocated fifteen percent (15%) to its State Fund, seventy percent (70%) to its Abatement Accounts Fund, and fifteen percent (15%) to its Subdivision Fund. Amounts may be reallocated and will be distributed as provided in Section V.D.

  • Online Payments Payments made online are made with an free consent after agreeing to the terms and conditions, All payments received online will be by default processed on agreeing with terms and condition, any disputes made afterwards will be null and void. All disputes will be in the jurisdictions of Hyderabad. This agreement is made on this the day, month and year first above mentioned and the parties to this deed have put their signatures at their free will and consent and after going through all the terms and conditions before the following: Amount Paid: 69620 Due Payment: 0.00 Due Date: NA Signature of Client / Applicant Signature of Consultant

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