Payments to Nursing Facilities Sample Clauses

Payments to Nursing Facilities. ‌ In each CHC zone, and for 36 months after the Implementation Date, the CHC- MCO shall pay all NFs at a facility-specific payment rate that is not less than the facility-specific payment rate established by the Department. The Department will calculate the facility-specific payment rate as the average of the specific NF’s four quarterly rates that were calculated pursuant to 55 Pa. Code Chapter 1187 (non-public facilities) or Chapter 1189 (public nursing facilities), as applicable, and that were in effect in the four calendar quarters immediately preceding the Implementation Date in the NF’s zone. If the Department’s facility-specific payment rates increase during the 36-month period, the capitation rates will be adjusted as necessary to remain actuarially sound. The CHC-MCO is not required to increase the facility-specific rates if the Department’s rates increase during 36-month period, but the CHC-MCO must demonstrate to the Department that its NF payment rates have accounted for increased NF costs as a result of any mandates on staffing, wages, and related cost drivers that are imposed after the Implementation Date. Nothing in this provision should be construed to prohibit the CHC-MCO and the nursing facility to agree to a higher payment rate. The CHC-MCO shall pay nursing facilities the amount of Nursing Facility Access to Care Payments identified in Appendix 4 of this Agreement. The payments shall be included in the Capitation Rate, and the CHC-MCO shall use the funding to help ensure quality of and access to nursing facility services under CHC. The Department shall not establish the criteria for distributing the facility-specific payments. The CHC-MCOs will negotiate how the payments will be made to the nursing facilities based on contractual responsibilities for the delivery of services.
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Related to Payments to Nursing Facilities

  • Skilled Nursing Facilities a. The following Health Care Services may be Covered Services when you are a patient in a Skilled Nursing Facility: i. room and board;

  • Access to Facilities Each of the Company and each of its Subsidiaries will permit any representatives designated by the Purchaser (or any successor of the Purchaser), upon reasonable notice and during normal business hours, at such person's expense and accompanied by a representative of the Company, to:

  • Disbursements to Contractors to Pay Costs of the Project The Recipient shall require that as work on the Project and as specified in its contract is performed a Contractor shall promptly submit a detailed project specific invoice to the Project Manager. Within three (3) Business Days following receipt of such invoice from a Contractor, the Project Manager shall review the invoice and, if found to be accurate, shall so certify in writing, forwarding such certification together with a copy of the invoice to the Chief Fiscal Officer. Within five (5) Business Days following receipt of such invoice and certification from the Project Manager, the Chief Fiscal Officer shall conduct such reviews as he considers appropriate and, if he approves such invoice, shall submit to the Director a Disbursement Request together with the information and certifications required by this Section 6(b). The dollar amount set forth in the Disbursement Request shall be calculated based on the Participation Percentage as set forth originally in Appendix D of this Agreement or as may be adjusted from time to time to account for changed conditions in the project financing scheme. Within five (5) Business Days following receipt of the Disbursement Request and all required information and certifications, the Director shall, if such items are deemed by the Director to be accurate and completed, initiate a voucher in accordance with applicable State requirements for the payment of the amount set forth in the Disbursement Request. Upon receipt of a warrant from the Auditor of State drawn in connection with a voucher initiated in accordance with the terms of the preceding sentence, the Director shall forward it by regular first class United States mail or electronic funds transfer, to the contractor or other authorized recipient designated in the Disbursement Request. Prior to any disbursement from the Fund, the following documents shall be submitted to the Director by the Recipient:

  • Treatment of Passthru Payments and Gross Proceeds The Parties are committed to work together, along with Partner Jurisdictions, to develop a practical and effective alternative approach to achieve the policy objectives of foreign passthru payment and gross proceeds withholding that minimizes burden.

  • Coverage F – Medical Payments To Others We will pay the necessary medical expenses that are incurred or medically ascertained within three years from the date of an accident causing "bodily injury". Medical expenses means reasonable charges for medical, surgical, x-ray, dental, ambulance, hospital, professional nursing, prosthetic devices and funeral services. This coverage does not apply to you or regular residents of your household except "residence employees". As to others, this coverage applies only:

  • Skilled Care in a Nursing Facility This plan covers skilled nursing services in a skilled nursing facility if: • the services are prescribed by a physician: • your condition needs skilled nursing services, skilled rehabilitation services or skilled nursing observation; • the services are provided by or supervised by licensed technical or professional medical personnel; and • the services are not custodial care, respite care, day care, or for the purpose of assisting with activities of daily living.

  • Access to Facility 13.1 Each Party shall ensure that its facilities are secured at all times.

  • Use of State Facilities Resources and Equipment a. Meeting Space and Facilities. The Employer’s campuses and facilities may be used by the Union to hold meetings subject to the University’s policy and availability of the space. The Employer may provide private space for stewards and/or Union representatives to meet in confidence with those they represent on a space available basis. Staff representatives may reserve and utilize meeting rooms in accordance with University policy and procedure. Such requests will be subject to availability and all applicable fees.

  • Generating Facility The Interconnection Customer’s device for the production of electricity identified in the Interconnection Request, but shall not include the Interconnection Customer’s Interconnection Facilities.

  • State Facilities If the State makes space available to the Party in any State facility during the term of this Agreement for purposes of the Party’s performance under this Agreement, the Party shall only use the space in accordance with all policies and procedures governing access to and use of State facilities which shall be made available upon request. State facilities will be made available to Party on an “AS IS, WHERE IS” basis, with no warranties whatsoever.

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