Examples of ACO Program Addendum in a sentence
To the extent a notice requirement in an ACO Program Addendum conflicts with or is more stringent than the notice requirements below, the shorter of the timeframes shall apply.
Participant and Preferred Provider shall participate in each ACO Program that qualifies for All Payer Model Scale Targets, that is designated by the Board as a Core Program and for which a Program Addendum is provided within the time frames set forth in paragraph 3.1 (“Core ACO Programs”) and that is offered by a Payer for which Participant or Preferred Provider is an enrolled provider and in good standing, by signing an ACO Program Addendum for each such ACO Program.
As more specifically set forth in each ACO Program Addendum, and consistent with the Core ACO Program requirements set forth in Paragraph 2.2 above, annually Participants and Preferred Providers may elect to terminate this Agreement or non-renew specific ACO Programs effective the first day of the next Performance Year by providing ACO with notice of termination or non-renewal before August 31st of the prior Performance Year (the “non-renewal” or “termination” deadline”).
In addition to the disclosures that are required in an ACO Program Addendum, Participant and Preferred Provider shall notify ACO and ACO shall notify Participant and Preferred Provider, in writing, as provided below.
The ACO may amend the Program of Payments consistent with the terms of each ACO Program Addendum which shall control in the event of a conflict with this Agreement.
Participant and Preferred Provider shall participate in each ACO Program that qualifies for All Payer Model Scale Targets, for which a Program Addendum is provided within the time frames set forth in paragraph 3.1 (“Core ACO Programs”) and that is offered by a Payer for which Participant or Preferred Provider is an enrolled provider and in good standing, by signing an ACO Program Addendum for each such ACO Program.
Failure to comply with the terms of this Agreement, the applicable ACO Program Addendum or ACO Policies may result in remedial processes and penalties including progressive discipline, reductions of payment, elimination of payments, offsets in payment for amounts owed or termination of this Agreement as to the Participant, Preferred Provider or a Provider.
In the event of any conflict between this Agreement and an ACO Program Addendum, the terms of the ACO Program Addendum shall control.
In the event an ACO Program Addendum varies from these definitions, the ACO Program Addendum definition will control for that ACO Program.
ACO may terminate this ACO Program Addendum if, after evaluating the network of participants and the final financial terms for the ACO Program from BCBSVT, it determines not to participate in the ACO Program and provides that notice to BCBSVT in accordance with their deadline for ACOs to decline participation.