SUD Services – Cost Settlement. For SUD program funds, a cost settlement process will be utilized. A comparison of allowable costs to reimbursement received; if the costs exceed reimbursement received, a settlement is received; if the costs are less than the reimbursement received, it is required that the difference be paid back. Cost- Settlement means that total cost estimate is determined before contract work commences. PROVIDER cannot exceed the maximum without written approval of MSHN. The final pricing is determined when PROVIDER submits Financial Statement Report, as detailed by Mid-State Health Network, including year-end settlement and reconciliation. Performance Bonus Incentive Funds. Any performance bonus incentive funds earned by the PIHP will be fully distributed as restricted local funding to the participating PROVIDERs in the region consistent with EXHIBIT A (PROVIDER SERVICES & RESPONSIBILITIES AND DELEGATION GRID), the operating agreement and related MSHN policies and procedures. J. Implementation of or Continuing Participation in Pooled Funding Arrangements. Pursuant to the MDHHS/PIHP Contract, Medicaid subcapitation funds received from the Payor under this Agreement may be utilized by the Provider for the implementation of or continuing participation in locally established multi-agency pooled funding arrangements developed to address the needs of beneficiaries served through multiple public systems. Medicaid funds supplied or expensed to such pooled funding arrangements must reflect the expected cost of covered Medicaid services for Medicaid eligibles participating in or referred to the multi-agency arrangement or project. Services provided in Pooled Funding arrangements must be reported to MDHHS through the encounter data reporting system. Medicaid funds cannot be used to supplant or replace the service or funding obligation of other public programs.
SUD Services – Cost Settlement. For SUD program funds, a cost settlement process will be utilized. A comparison of allowable costs to reimbursement received; if the costs exceed reimbursement received, a settlement is received; if the costs are less than the reimbursement received, it is required that the difference be paid back. Cost-Settlement means that total cost estimate is determined before contract work commences. PROVIDER cannot exceed the maximum without written approval of MSHN. The final pricing is determined when PROVIDER submits Financial Statement Report, as detailed by Mid-State Health Network, including year-end settlement and reconciliation. J. Implementation of or Continuing Participation in Pooled Funding Arrangements. Pursuant to the MDHHS/PIHP Contract, Medicaid subcapitation funds received from the Payor under this Agreement may be utilized by the Provider for the implementation of or continuing participation in locally established multi-agency pooled funding arrangements developed to address the needs of beneficiaries served through multiple public systems. Medicaid funds supplied or expensed to such pooled funding arrangements must reflect the expected cost of covered Medicaid services for Medicaid eligibles participating in or referred to the multi-agency arrangement or project. Services provided in Pooled Funding arrangements must be reported to MDHHS through the encounter data reporting system. Medicaid funds cannot be used to supplant or replace the service or funding obligation of other public programs.
SUD Services – Cost Settlement. For SUD program funds, a cost settlement process will be utilized. A comparison of allowable costs to reimbursement received; if the costs exceed reimbursement received, a settlement is received; if the costs are less than the reimbursement received, it is required that the difference be paid back. Cost-Settlement means that total cost estimate is determined before contract work commences. PROVIDER cannot exceed the maximum without written approval of MSHN. The final pricing is determined when PROVIDER submits Financial Statement Report, as detailed by Mid-State Health Network, including year-end settlement and reconciliation.
