Selective Reporting Requirements Clause Samples

Selective Reporting Requirements. Amend the second paragraph to read: The HMO shall fully comply with the physician incentive plan requirements specified in 42 CFR s. 417.479(d) through (g) and the requirements relating to subcontracts set forth in 42 CFR s. 417.479(i), as those provisions may be amended from time to time. HMO contracts must provide for compliance with the requirements set forth in 422.208 and 422.210. HMO disclosures of physician incentive plans to the Department shall be in a format to be determined by the Department. Add as a new third paragraph: If the physician/group is at substantial financial risk, the HMO must report proof the physician/group has adequate stop loss coverage, including amount and type of stop-loss.