Provider-Preventable Conditions. Pursuant to 42 CFR §438.3(g), the MCO must comply with 42 CFR §447.26 and Minnesota Statutes, §144.7065 (provider-preventable conditions or adverse health care events ) in the encounter data, as determined by the STATE. The STATE shall provide a quarterly report of the MCO’s incidents back to the MCO. In the event that an encounter is reported with any amount other than zero in the payment fields, the MCO shall review and appropriately recoup the payment from the provider, consistent with Minnesota Statutes, §§256.969, subd. 3b, (c) and 256B.0625, subd. 3.
Appears in 6 contracts
Samples: Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services
Provider-Preventable Conditions. Pursuant to 42 CFR §438.3(g), the MCO must comply with 42 CFR §447.26 and Minnesota Statutes, §144.7065 (provider-preventable conditions or adverse health care events events) in the encounter data, as determined by the STATE. The STATE shall provide a quarterly report of the MCO’s incidents back to the MCO. In the event that an encounter is reported with any amount other than zero in the payment fields, the MCO shall review and appropriately recoup the payment from the provider, consistent with Minnesota Statutes, §§256.969, subd. 3b, (c) and 256B.0625, subdSubd. 3.
Appears in 3 contracts
Samples: Special Needs Basiccare Program Services Contract, Special Needs Basiccare Program Services Contract, Contract for Special Needs Basiccare Program Services
Provider-Preventable Conditions. Pursuant to 42 CFR §438.3(g), the MCO must comply with 42 CFR §447.26 and Minnesota Statutes, §144.7065 (provider-preventable conditions or adverse health care events conditions) in the encounter data, as determined by the STATE. The STATE shall provide a quarterly report of the MCO’s incidents back to the MCO. In the event that an encounter is reported with any amount other than zero in the payment fields, the MCO shall review and appropriately recoup the payment from the provider, consistent with Minnesota Statutes, §§§ 256.969, subd. 3b, (c) and 256B.0625, subd. 3.
Appears in 2 contracts
Samples: Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services
Provider-Preventable Conditions. Pursuant to 42 CFR §438.3(g), the MCO must comply with 42 CFR §447.26 and Minnesota Statutes, §144.7065 (provider-preventable conditions or adverse health care events conditions) in the encounter data, as determined by the STATE. The STATE shall provide a quarterly report of the MCO’s incidents back to the MCO. In the event that an encounter is reported with any amount other than zero in the payment fields, the MCO shall review and appropriately recoup the payment from the provider, consistent with Minnesota Statutes, §§§ 256.969, subd. 3b, (c) and 256B.0625, subdSubd. 3.
Appears in 1 contract
Samples: Contract for Special Needs Basiccare Program Services
