Specific Pre-Determined Penalties. I.1. Adequate network-minimum provider panel requirements- Compliance with provider panel requirements will be assessed quarterly. Any deficiencies in the MCP’s provider network as specified in Appendix H of the Agreement or by ODJFS, will result in the assessment of a $1,000 nonrefundable fine for each category (practitioners, PCP capacity, hospitals), for each county, and for each population (e.g., ABD, CFC). For example if the MCP did not meet the following minimum panel requirements, the MCP would be assessed (1) a $3,000 nonrefundable fine for the failure to meet CFC panel requirements; and, (2) a $1,000 nonrefundable fine for the failure to meet ABD panel requirements). · practitioner requirements in Franklin county for the CFC population · practitioner requirements in Franklin county for the ABD population · hospital requirements in Franklin county for the CFC population · PCP capacity requirements in Fairfield county for the CFC population In addition to the pre-determined penalties, ODJFS may assess additional penalties pursuant to this Appendix (e.g. CAPs, points, fines) if member specific access issues are identified resulting from provider panel noncompliance.
Appears in 3 contracts
Samples: Provider Agreement (Wellcare Health Plans, Inc.), Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.), Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.)
Specific Pre-Determined Penalties. I.1. Adequate network-minimum provider panel requirements- requirements — Compliance with provider panel requirements will be assessed quarterly. Any deficiencies in the MCP’s provider network as specified in Appendix H of the Agreement or by ODJFS, will result in the assessment of a $1,000 nonrefundable fine for each category (practitioners, PCP capacity, hospitals), for each county, and for each population (e.g., ABD, CFC). For example if the MCP did not meet the following minimum panel requirements, the MCP would be assessed (1) a $3,000 nonrefundable fine for the failure to meet CFC panel requirements; and, (2) a $1,000 nonrefundable fine for the failure to meet ABD panel requirements). · • practitioner requirements in Franklin county for the CFC population · • practitioner requirements in Franklin county for the ABD population · • hospital requirements in Franklin county for the CFC population · • PCP capacity requirements in Fairfield county for the CFC population In addition to the pre-determined penalties, ODJFS may assess additional penalties pursuant to this Appendix (e.g. CAPs, points, fines) if member specific access issues are identified resulting from provider panel noncompliance.
Appears in 1 contract
Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Molina Healthcare Inc)
Specific Pre-Determined Penalties. I.1. Adequate network-minimum provider panel requirements- requirements - Compliance with provider panel requirements will be assessed quarterly. Any deficiencies in the MCP’s provider network as specified in Appendix H of the Agreement or by ODJFS, will result in the assessment of a $1,000 nonrefundable fine for each category (practitioners, PCP capacity, hospitals), for each county, and for each population (e.g., ABD, CFC). For example if the MCP did not meet the following minimum panel requirements, the MCP would be assessed (1) a $3,000 nonrefundable fine for the failure to meet CFC panel requirements; and, (2) a $1,000 nonrefundable fine for the failure to meet ABD panel requirements). · practitioner requirements in Franklin county for the CFC population · practitioner requirements in Franklin county for the ABD population · hospital requirements in Franklin county for the CFC population · PCP capacity requirements in Fairfield county for the CFC population In addition to the pre-determined penalties, ODJFS may assess additional penalties pursuant to this Appendix (e.g. CAPs, points, fines) if member specific access issues are identified resulting from provider panel noncompliance.
Appears in 1 contract
Specific Pre-Determined Penalties. I.1. Adequate network-minimum provider panel requirements- requirements - Compliance with provider panel requirements will be assessed quarterly. Any deficiencies in the MCP’s provider network as specified in Appendix H of the Agreement or by ODJFS, will result in the assessment of a $1,000 nonrefundable fine for each category (practitioners, PCP capacity, hospitals), for each county, and for each population (e.g., ABD, CFC). For example if the MCP did not meet the following minimum panel requirements, the MCP would be assessed (1) a $3,000 nonrefundable fine for the failure to meet CFC panel requirements; and, (2) a $1,000 nonrefundable fine for the failure to meet ABD panel requirements). · practitioner requirements in Franklin county for the CFC population · practitioner requirements in Franklin county for the ABD population · hospital requirements in Franklin county for the CFC population · PCP capacity requirements in Fairfield county for the CFC population In addition to the pre-determined penalties, ODJFS may assess additional penalties pursuant to this Appendix (e.g. CAPs, points, fines) if member specific access issues are identified resulting from provider panel noncompliance.
Appears in 1 contract
Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.)
