Limited Cost Sharing Sample Clauses

Limited Cost Sharing. Demonstration Plans will not charge Medicare Parts C or D premiums, nor assess any cost sharing for Medicare Parts A and B services. For drugs and pharmacy products, including those covered by both Medicare Part D and the State Medicaid agency, Demonstration Plans will be permitted to charge co-pays to individuals currently eligible to make such payments. Co-pays charged by Demonstration Plans for Part D drugs must not exceed the applicable amounts for brand and generic drugs established yearly by CMS under the Part D Low Income Subsidy, although plans may elect to reduce this cost sharing for all Enrollees as a way of testing whether reducing Enrollee cost sharing for pharmacy products improves health outcomes and reduces overall health care expenditures through improved medication adherence under the Demonstration. For Medicaid services beyond the pharmacy cost sharing described here, Demonstration Plans will not charge cost sharing to Enrollees above levels established under the Medicaid State Plan. Demonstration Plans are free to waive Medicaid cost sharing requirements.

Limited Cost Sharing. Participating Plans will not charge Medicare Parts C or D premiums, or assess any cost sharing for Medicare Parts A and B services. For drugs and pharmacy products (including both those covered by both Medicare Part D and Medi-Cal), Plans will be permitted to charge copays to individuals currently eligible to make such payments. Copays charged by Participating Plans must not exceed the applicable amounts for brand and generic drugs established yearly by CMS under the Part D Low Income Subsidy or Medi-Cal cost-sharing rules, as applicable, although Participating Plans may elect to reduce this cost sharing for all enrollees as a way of testing whether reducing enrollee cost sharing for pharmacy products improves health outcomes and reduces overall health care expenditures through improved medication adherence under the Demonstration. Copays charged to HIV-positive individuals for all drugs on the AIDS Drug Assistance Program (ADAP) formulary may be paid by the California Department of Public Health, Office of AIDS to ensure continuity of HIV drug treatment and utilization. Participating Plans will not assess any cost sharing for Medi-Cal services.

Limited Cost Sharing. ICDS Plans will not charge Medicare Parts C or D premiums, nor assess any cost sharing for Medicare Parts A and B services. For drugs and pharmacy products (including both those covered by both Medicare Part D and Ohio Medicaid), Plans will be permitted to charge co-pays to individuals currently eligible to make such payments. Co-pays charged by ICDS Plans for Part D drugs must not exceed the applicable amounts for brand and generic drugs established yearly by CMS under the Part D Low Income Subsidy, although plans may elect to reduce this cost sharing for all Enrollees as a way of testing whether reducing Enrollee cost sharing for pharmacy products improves health outcomes and reduces overall health care expenditures through improved medication adherence under the Demonstration. ICDS Plans will not assess any cost sharing for Ohio Medicaid services, beyond the pharmacy cost sharing described herein.

Limited Cost Sharing. MMIPs will not charge Medicare Parts C or D premiums, nor assess any cost sharing for Medicare Parts A and B services. For drugs and pharmacy products, including those covered by both Medicare Part D and the State Medicaid agency, MMIPs will be permitted to charge co-pays to individuals currently eligible to make such payments, consistent with co-pays applicable for Medicare and Medicaid drugs, respectively. Co-pays charged by MMIPs for Part D drugs must not exceed the applicable amounts for brand and generic drugs established yearly by CMS under the Part D Low Income Subsidy or State Medicaid program cost-sharing rules, as applicable, although MMIPs may elect to reduce this cost sharing for all Enrollees as a way of testing whether reducing Enrollee cost sharing for pharmacy products improves health outcomes and reduces overall health care expenditures through improved medication adherence under the Demonstration. For Medicaid services beyond the pharmacy cost sharing described here, MMIPs will not charge cost sharing to Enrollees for Medicaid services, beyond the HCBS waiver cost sharing amounts allowed under the Medicaid State Plan. MMIPs are free to waive Medicaid cost sharing requirements in order to reduce Enrollees’ out-of-pocket expenses.

Limited Cost Sharing. The parties do not contemplate a sharing of costs for the activities under each party’s respective IL-21 Plan and each party shall individually bear the costs for its respective activities. From time to time, in the interest of expediting time and cost efficiency, the JSC may approve cost sharing between the parties for Shared Activities in accordance with SECTION 3.1(c). An accounting and balancing between the parties of costs for Shared Activities will occur quarterly at the end of March, June, September and December.