Medical Provider Network. SB 899 also amended LC section 4616; hence, on or after January 1, 2005, an insurer or employer may establish or modify a medical provider network (MPN) for the provision of medical treatment to injured employees. If an employer establishes an MPN, the employee is limited to treating within the network for the life of the claim, except for employees who have predesignated a personal physician. SCIF has established two medical provider networks, Xxxxxx Permanente Alliance and the Preferred Provider Network (PPN). An MPN physician may be found by calling 0-000-000-0000 or through SCIF’s MED finder program at xxx.xxxx.xxx/, click on MEDfinder in the top right corner of the page. If you have any questions about this notice, please contact Xxxxx Xxxxxxxx-Xxxx, Policy Analyst, Policy Development Unit, at (000) 000-0000. Sincerely,
Medical Provider Network. If the CITY chooses to use the CONSULTANT’s Medical Provider Network services, the cost shall not exceed Twelve Dollars and Fifty Cents ($12.50) per claim for the period July 1, 2019 through June 30, 2020, for a maximum amount not to exceed Twenty Thousand Dollars ($20,000). For the period of July 1, 2020 through June 30, 2021, the cost shall not exceed Thirteen Dollars ($13) per claim, for a total maximum amount not to exceed Twenty Thousand Dollars ($20,000). For the period of July 1, 2021 through June 30, 2022, the cost shall not exceed Thirteen Dollars and Fifty Cents ($13.50) per claim, for a total maximum amount not to exceed Twenty Thousand Dollars ($20,000). For the period of July 1, 2022 through June 30, 2023, the cost shall not exceed Thirteen Dollars and Seventy-Five Cents ($13.75) per claim, for a total maximum amount not to exceed Twenty Thousand Dollars ($20,000).For the period of July 1, 2023 through June 30, 2024, the cost shall not exceed Fourteen Dollars ($14) per claim, for a total maximum amount not to exceed Twenty Thousand Dollars ($20,000). For the period of July 1, 2024 through June 30, 2025, the cost shall not exceed Fourteen Dollars and Fifty Cents ($14.50) per claim, for a total maximum amount not to exceed Twenty Thousand Dollars ($20,000).
Medical Provider Network. The JC shall use a Medical Provider Network (“MPN”) which will include an extensive list of providers in all specialties, throughout California.
Medical Provider Network. LWP offers our client’s access to a proprietary Medical Provider network that we believe offers a very distinct advantage, both in quality of care and in cost. The network is offered in two forms- one including Xxxxxx and one excluding Xxxxxx, with all other features of the networks being identical. Some advantages to our network include: ▪ Network developed by industry leading network developers ▪ Providers were carefully chosen based on extensive data that measures outcomes (return-to-work and treatment durations) ▪ Need for utilization review is significantly reduced by quality of physicians (saving time and expense) ▪ Significantly deeper discounts than most MPNs ▪ No access fee (client pays only the per-bill bill review fee, which includes MPN access) ▪ Simplified enrollment Should the City of Gardena choose to utilize LWP’s network, there is no filing to do. LWP will provide the documents for posting, and the MPN can be utilized on Day 1. Should the City of Gardena prefer not to use a network, or prefer to choose another network, LWP’s bill review partner can access any network that the City of Gardena makes available. LWP has implemented an aggressive, multi-pronged approach to controlling Pharmacy Costs. Our program includes the following: ▪ No prescriptions can be filled in physicians’ offices ▪ First Fill cards provided to employer ▪ Home Delivery service available ▪ Brand to generic channeling ▪ Both network discounts and out-of-network retrospective reviews ▪ Robust database checks for drug interactions, non-formulary prescriptions, over-utilization and prescriptions filed by multiple physicians ▪ Proper utilization of drug at therapeutic level ▪ Absence of prescribed drug (triggering a non-renewal of the drug) ▪ Presence of illicit drugs
Medical Provider Network. On May 1, 2018 City of Los Angeles implemented three (3) custom MPNs for City’s Workers’ Compensation Program. One custom MPN has been developed for members of the Police Protective League, in conjunction with an Alternative Dispute Resolution and Prevention Program. Another custom MPN has been developed for those civilian unions that have negotiated a separate Alternative Dispute Resolution Program. A third MPN has been established for all other City employees. City may implement additional custom MPNs.
a. Contractor shall provide custom MPNs and propose MPN providers approved by City to improve medical outcomes, and produce cost savings.
b. Contractor shall, at City's request, assist City in completing the required State documents to certify the MPN is in compliance with State requirements and guidelines. City may request Contractor to provide ancillary services at Contract pricing, associated with certifying and maintaining the MPN, including, but not limited to State mandated employee notification.
c. Contractor will be responsible for issuing initial employee notifications and material change notifications as required by Title 8 California Code of Regulations.
d. Contractor’s MPN, as approved by City for hospital, physician and other medical services, will provide quality medical services at discount rates to City and will include a large number of participating providers in the greater Los Angeles area as well as throughout California and the United States. Contract with MPN shall be entered into and maintained by Contractor.
e. Contractor will be responsible for and follow City’s PAP program as described in Attachment C, Section I, 6. Prior Authorization Program.
f. Contractor shall be responsible for making and maintaining contracts with MPN network, which must be approved by City. The MPN network shall be responsible for making and maintaining contracts with hospitals, medical providers, pharmacies and other provider networks to provide a discounted rate, and will make an electronic and hardcopy listing of providers available, at no additional cost, to City on a regular basis.
g. Contractor shall provide a designated customer service toll free phone number available during Business days and hours.
h. Contractor will provide web address and system access to electronically search and view participating providers and facilities in the MPN.
i. Contractor, at the request of City, will be required to provide hardcopy and electronic directories to City d...
