Common use of Requirements for Medicaid Managed Care Partners Clause in Contracts

Requirements for Medicaid Managed Care Partners. Submit to EOHHS a Schedule of Project Based Metrics and Payment for EOHHS Approval o Within 30 days of an AE being certified by EOHHS, the Contractor must submit for approval to EOHHS project-based metrics and associated incentive payment per each AE contract. Evidence of AE attestation must be included with submission. As described in Transitioning to Alternative Payment Methodologies: Requirements for Medicaid Managed Care Partners, both the AE and MCOs must agree to a defined set of project-based measures and targets for three AE project as delineated in the AEs HSTP project plan submitted to EOHHS as part of the AEs annual certification. Each project should have at minimum 2 measures per project, one of the three projects shall focus on behavioral health integration and one on social determinants of health. Project- based measure are metrics the AE and MCOs use to track and monitor project implementation and progress. MCO/AE specific performance targets implemented for Performance Year 1 and 2 outcome metrics performance areas can be considered. • Assess AE Performance to Determine Whether Incentive Payments Have Been Earned o Contractor will review and evaluate AE progress in achieving AEIP performance targets and determine whether AE performance warrants incentive payments. o The Contractor must certify that an AE has met its approved metrics as a condition for its release of associated AEIP funds to the AE.

Appears in 7 contracts

Samples: Medicaid Managed Care Services Agreement, Medicaid Managed Care Services Agreement, Medicaid Managed Care Services Agreement

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Requirements for Medicaid Managed Care Partners. Submit to EOHHS a Schedule of Project Based Metrics and Payment for EOHHS Approval o Within 30 days of an AE being certified by EOHHS, the Contractor must submit for approval to EOHHS project-based metrics and associated incentive payment per each AE contract. Evidence of AE attestation must be included with submission. As described in Transitioning to Alternative Payment Methodologies: Requirements for Medicaid Managed Care Partners, both the AE and MCOs must agree to a defined set of project-based measures and targets for three AE project as delineated in the AEs HSTP project plan submitted to EOHHS as part of the AEs annual certification. Each project should have at minimum 2 measures per project, one of the three projects shall focus on behavioral health integration and one on social determinants of health. Project- based measure are metrics the AE and MCOs use to track and monitor project implementation and progress. MCO/AE specific performance targets implemented for Performance Year 1 and 2 outcome metrics performance areas can be considered. Assess AE Performance to Determine Whether Incentive Payments Have Been Earned o Contractor will review and evaluate AE progress in achieving AEIP performance targets and determine whether AE performance warrants incentive payments. o The Contractor must certify that an AE has met its approved metrics as a condition for its release of associated AEIP funds to the AE..  Make payments to the AE’s on a timely basis

Appears in 3 contracts

Samples: Medicaid Managed Care Services Agreement, Medicaid Managed Care Services Agreement, Medicaid Managed Care Services Agreement

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