Provider Incentive Programs Sample Clauses

Provider Incentive Programs. Contractors shall establish a performance-based incentive system for its providers for the Contractor’s HIP providers. Different provider incentives may be established for the different Medicaid lines of business. The Contractor will determine its own methodology for incentivizing providers. The Contractor shall obtain OMPP-approval prior to implementing its provider incentive program and before making any changes thereto. The State encourages creativity in designing pay for performance programs. If the Contractor offers financial incentives to providers, these payments shall be above and beyond the standard Medicare fee-for-service schedule. Section 1876(i)(8) of the Social Security Act and federal regulations 42 CFR 438.6(h), 42 CFR 422.208 and 42 CFR 422.210 provide information regarding physician incentive plans. The Contractor shall comply with all federal regulations regarding the physician incentive plan and supply to OMPP information on its plan as required in the regulations and with sufficient detail to permit OMPP to determine whether the incentive plan complies with the federal requirements. The Contractor shall provide information concerning its physician incentive plan, upon request, to its members and in any marketing materials in accordance with the disclosure requirements stipulated in the federal regulations. Similar requirements apply to subcontracting arrangements with physician groups and intermediate entities. Physician incentive plans shall comply with the following requirements:  The Contractor will make no specific payment directly or indirectly to a physician or physician group as an inducement to reduce or limit medically necessary services furnished to an individual member; and  The Contractor meets requirements for stop-loss protection, member survey and disclosure requirements under 42 CFR 438.6(h).
Sample 1
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Provider Incentive Programs. 7.7.2.1 In addition to the Value-Based Incentive Program in Section 7.7.1, Contractor may establish incentives for its Participating Providers, Preferred Providers, and Participating Practices. Contractor will determine its own methodology for incentivizing Participating Providers, Participating Practices and Preferred Providers, subject to DVHA approval. Prior to implementation of any incentive programs, Contractor will provide DVHA with policies related to provider incentives, updates to policies related to the VMNG Program are also subject to DVHA approval. Contractor shall comply with federal regulations regarding physician incentive plans includes those in 42 CFR § 438.3(h).
Sample 1
Provider Incentive Programs. 7.7.2.1 In addition to the Value-Based Incentive Program in Section 7.7.1, Contractor may establish incentives for its Participating Providers and Participating Practices. Contractor will determine its own methodology for incentivizing Participating Providers and Participating Practices, subject to DVHA approval. Prior to implementation of any incentive programs, Contractor will provide DVHA with policies related to provider incentives, updates to policies related to the VMNG Program are also subject to DVHA approval. Contractor shall comply with federal regulations regarding physician incentive plans includes those in 42 CFR § 438.3(h).
Sample 1

Related to Provider Incentive Programs

  • Educational Incentive Program 15.2.1 A regular monthly classified unit member covered by this Agreement shall be granted a one-step increase (up to a step maximum of step G for Office/Technical unit members) on the first (1st) of the month following verification of satisfactory completion (grade of “C” or above) of twelve (12) semester units of credit from an accredited institution. Courses must have been enrolled in and credits must have been earned subsequent to the unit member's employment with the District. Official transcripts verifying a grade of “C” or above will be considered proof of satisfactory completion, in addition to the Educational Incentive Program Request for Salary Advancement Form, shall be provided by the eligible unit member and forwarded to the Office of Human Resources. Units of credit obtained prior to promotion must be applied toward step movement within sixty (60) calendar days of effective promotion date. The unit member shall ensure that the Compensation department is aware of these additional credits within this sixty (60) day period.

  • Incentive Program Members who are rated as either Level I, Level II or Level III in every phase of the Physical Fitness Test are eligible to participate in the Incentive Program.

  • Sick Leave Incentive Program MSUAASF and Minnesota State may develop a sick leave incentive program through the establishment of a joint committee.

  • RETIREMENT INCENTIVE PROGRAM A. A Retirement Incentive Program will be provided by the District based upon the conditions stipulated below:

  • EDUCATIONAL INCENTIVES As part of the District’s commitment to enhance the knowledge, skills, abilities and opportunities for promotion of its classified employees, the District offers the following programs:

  • In-Service Programs The parties to this collective agreement recognize the value of in-service education both to the employee and the Employer.

  • Attendance Incentive Program In January of the year following any year in which a minimum of sixty (60) days of leave for illness or injury is accrued, and each January thereafter, any eligible employee may exercise an option to receive remuneration for unused leave for illness or injury accumulated in the previous year at a rate equal to one (1) day of monetary compensation of the employee for each four (4) full days of accrued leave for illness or injury in excess of sixty (60) days. Leave for illness or injury for which compensation has been received shall be deducted from accrued leave for illness or injury at the rate of four (4) days for every one (1) day of monetary compensation; provided, however, no employee shall receive compensation under this section for any portion of leave for illness or injury accumulated at a rate in excess of one (1) day per month. At the time of separation from school district employment due to retirement or death an eligible employee or the employee's estate shall receive remuneration at a rate equal to one (1) day of current monetary compensation of the employee for each four (4) full days accrued leave for illness or injury. The provisions of this section shall be administered in accordance with state law and applicable state rules and regulations. Should the legislature revoke any benefits granted under this section, no affected employee shall be entitled thereafter to receive such benefits as matter of contractual right.

  • SICK LEAVE PROGRAM An employee may be eligible to receive donations of paid leave to be included in the employee's sick leave balance if s/he has suffered a catastrophic illness or injury which prevents the employee from being able to work or from being able to work his/her regularly scheduled number of hours. Catastrophic illness or injury is defined as a critical medical condition considered to be terminal, or a long-term major physical impairment or disability.

  • Physician Incentive Plans In the event Provider participates in a physician incentive plan (“PIP”) under the Agreement, Provider agrees that such PIPs must comply with 42 CFR 417.479, 42 CFR 438.3, 42 CFR 422.208, and 42 CFR 422.210, as may be amended from time to time. Neither United nor Provider may make a specific payment directly or indirectly under a PIP to a physician or physician group as an inducement to reduce or limit Medically Necessary services furnished to an individual Covered Person. PIPs must not contain provisions that provide incentives, monetary or otherwise, for the withholding of services that meet the definition of Medical Necessity.

  • Education Incentive A. The following monthly education incentive pay will be paid to each employee upon completing the listed degree and providing proof of completion to the Agency. Associate Degree Two percent (2%) Bachelor Degree Four percent (4%)

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