Provider Contract. The MCO’s provider contracts and addenda to provider contracts must abide by all federal regulations and must be consistent with the requirements of this statement of work. The MCO must also comply with the prohibitions on inappropriate physician incentives as specified in Article III, Section 2.8 of this contract. The MCO must resubmit the revised model provider contracts to BMS any time it makes substantive modifications to such agreements. At a minimum the MCO’s provider contracts and addenda must include the following provisions:
1. Enrollees will be held harmless for the costs of all Medicaid-covered services provided except for applicable cost-sharing obligations. The Contract must state that the providers must inform enrollees of the costs for non-covered services prior to rendering such services. The provider Contract must state that the MCO’s enrollees may not be held liable for the MCO’s debts in the event of the MCO’s insolvency;
2. Physicians will maintain adequate malpractice insurance with minimum coverage requirements of $1 million per individual episode and $1 million in the aggregate;
Provider Contract. The MCO’s provider contracts and addenda to provider contracts must abide by all federal regulations and must be consistent with the requirements of this statement of work and at a minimum must include the following provisions:
1. Enrollees will be held harmless for the costs of all Medicaid-covered services provided except for applicable cost-sharing obligations. The Contract must state that the providers must inform enrollees of the costs for non-covered services prior to rendering such services. The provider Contract must state that the MCO’s enrollees may not be held liable for the MCO’s debts in the event of the MCO’s insolvency;
2. Physicians will maintain adequate malpractice insurance with minimum coverage requirements of $1 million per individual episode and $1 million in the aggregate;
Provider Contract. The MCO’s provider contracts and addenda to provider contracts must abide by all federal regulations and must be consistent with the requirements of this statement of work. The MCO must also comply with the prohibitions on inappropriate provider incentives as specified in Article III, Section 3.8 of this contract. The Department will provide two (2) model provider contracts. One will be tailored to use with Medicaid service providers and the other will be tailored to use with SNS providers. The MCO must resubmit the revised model provider contracts to the Department any time it makes substantive modifications to such agreements.
Provider Contract. An agreement between the Contractor and a Provider for the provision of services.
Provider Contract. A contract entered into by a Provider and the STAR+PLUS MMP or a First Tier, Downstream or Related Entity for Covered Services. Also called "Network Provider Agreement."
Provider Contract. The JOB shall have veto authority over all managed care, PPO, HMO, Medicare risk and other provider contracts.
Provider Contract. An agreement between the Managed Care Plan and a health care provider to serve Managed Care Plan enrollees.
Provider Contract. A contract entered into by the PASSE with any provider of medical, pharmacy, HCBS, LTSS or any other service or benefit authorized under the PASSE program who agrees to furnish covered services to a member.
Provider Contract. An agreement between a MMP and a provider which describes the conditions under which the provider agrees to furnish covered services to Enrollees under this Contract. All provider contract templates for Medicaid-funded services between the Contractor and a provider must be approved by DMAS.
Provider Contract. The Provider Contract is the agreement entered into between the Trading Partner and Providers participating in the GHP.
