Utilization Management Incentives. The PIHP must assure that compensation to individuals or entities that conduct utilization management activities is not structured so as to provide incentives for the individual or entity to deny, limit, or discontinue medically necessary services to any beneficiary.
Appears in 6 contracts
Samples: Medicaid Managed Specialty Supports and Services Concurrent Waiver Program Agreement, Medicaid Managed Specialty Supports and Services Concurrent Waiver Program Agreement, Michigan Abw Non Pregnant Childless Adults Waiver (Adult Benefits Waiver) Section 1115 Demonstration
