REVISIONS TO THE PAYMENT SCHEDULE. 13.1 Revisions By Agreement The MSC shall adopt as part of the Payment Schedule additions to, deletions from or other modifications of the Guide to Fees, provided that: (a) either: (i) the Doctors of BC and the Government agree in writing to the additions, deletions or other modifications; or (ii) the Government and the Doctors of BC support in writing the recommendations of the joint review panel as contemplated by section 12.2(e); (b) the MSC agrees that such modifications are consistent with the requirements of the Medicare Protection Act and Regulations; (c) the MSC agrees that the services covered by a given fee item are medically necessary; and (d) the MSC agrees to the estimated projected net cost effect on the Total Claims Cost which would result from such recommended changes. 13.2 Revisions in the Absence of Agreement Where there is no agreement between the Doctors of BC and the Government on recommended changes to the Payment Schedule, the Doctors of BC and the Government may make separate recommendations to the MSC and the MSC will determine the changes, if any, to the Payment Schedule.
Appears in 2 contracts
Samples: Physician Master Agreement, Physician Master Agreement
REVISIONS TO THE PAYMENT SCHEDULE.
13.1 Revisions By Agreement The MSC shall adopt as part of the Payment Schedule additions to, deletions from or other modifications of the Guide to Fees, provided that:
(a) either:
(i) the Doctors of BC and the Government agree in writing to the additions, deletions or other modifications; oror
(ii) the Government and the Doctors of BC support in writing the recommendations of the joint review panel as contemplated by section 12.2(e);
(b) the MSC agrees that such modifications are consistent with the requirements of the Medicare Protection Act and Regulations;Regulations;
(c) the MSC agrees that the services covered by a given fee item are medically necessary; and
(d) the MSC agrees to the estimated projected net cost effect on the Total Claims Cost which would result from such recommended changes.
13.2 Revisions in the Absence of Agreement Where there is no agreement between the Doctors of BC and the Government on recommended changes to the Payment Schedule, the Doctors of BC and the Government may make separate recommendations to the MSC and the MSC will determine the changes, if any, to the Payment Schedule.
Appears in 1 contract
Samples: Physician Master Agreement
REVISIONS TO THE PAYMENT SCHEDULE.
13.1 Revisions By Agreement Agreement The MSC shall adopt as part of the Payment Schedule additions to, deletions from or other modifications of the Guide to Fees, provided that:
(a) either:
(i) the Doctors of BC and the Government agree in writing to the additions, deletions or other modifications; or
(ii) the Government and the Doctors of BC support in writing the recommendations of the joint review panel as contemplated by section 12.2(e);
(b) the MSC agrees that such modifications are consistent with the requirements of the Medicare Protection Act and Regulations;
(c) the MSC agrees that the services covered by a given fee item are medically necessary; and
(d) the MSC agrees to the estimated projected net cost effect on the Total Claims Cost which would result from such recommended changes.
13.2 Revisions in the Absence of Agreement Agreement Where there is no agreement between the Doctors of BC and the Government on recommended changes to the Payment Schedule, the Doctors of BC and the Government may make separate recommendations to the MSC and the MSC will determine the changes, if any, to the Payment Schedule.
Appears in 1 contract
Samples: Collective Bargaining Agreement