Downstream Care Partner definition

Downstream Care Partner means an individual who is a PGP Member of a PGP Care Partner and who (1) is enrolled in Medicare; (2) provides items and services to CRP Beneficiaries; (3) satisfies any applicable Care Partner Qualifications; (4) is identified on the Care Partner List; and (5) has a Downstream Care Partner Arrangement with its PGP Care Partner.
Sample 1Sample 2
Downstream Care Partner means an individual who is a PGP Member of a PGP Care Partner who (1) is enrolled in Medicare; (2) provides items and services to Maryland Medicare Beneficiaries; (3) satisfies any applicable Care Partner Qualifications; (4) is identified on the Care Partner List; and (5) has a Downstream Care Partner Arrangement with its PGP Care Partner.
Sample 1

Examples of Downstream Care Partner in a sentence

  • Any such requests shall be made in accordance with the procedures set forth in section 5.2, except that CMS need not conduct a Program Integrity Screening in the case of a request to make a late addition to the certified Care Partner List or a request to increase the number of CRP Tracks in which a Care Partner or Downstream Care Partner is participating.

  • CMS may reject any proposed Care Partner or Downstream Care Partner, or remove an individual or entity identified on the Care Partner List.

  • The Hospital shall include in the notice the date on which the individual or entity ceased to be a Care Partner or Downstream Care Partner, or ceased to participate in one or more CRP Tracks.

  • If any proposed Care Partner is a PGP, the proposed Care Partner List must identify each proposed Downstream Care Partner by the PGP name, billing TIN of the PGP, and the name and NPI of each proposed Downstream Care Partner who is a PGP Member of that PGP.

  • In a form and manner specified by CMS, the Hospital shall notify CMS no later than 30 days after an individual or entity has ceased to be a Care Partner or Downstream Care Partner, or ceased participation in one or more CRP Tracks.

  • The removal of the individual or entity from the Care Partner List or from the relevant CRP Track will be effective on the date the individual or entity ceased to be a Care Partner or Downstream Care Partner, or ceased to participate in the relevant CRP Track.

  • The arrangement shall also require the Downstream Care Partner to electronically transmit such summary to a state-designated health information exchange in more than 10 percent of the instances when the Care Partner transitions or refers a patient to another setting of care.

  • The Hospital shall require the PGP Care Partner to provide a copy of this Agreement and the Hospital’s relevant Approved Track Implementation Protocols to each Downstream Care Partner.

  • For purposes of this Agreement, an individual or entity ceases to be a Care Partner or Downstream Care Partner when they no longer satisfy the definition of “Care Partner” or “Downstream Care Partner” in Article II of this Agreement.

  • These terms include, but are not limited to, the following: Allowable CRP Interventions, Approved Track Implementation Protocol, Care Partner, Care Partner Arrangement, CRP Intervention, CRP Track, Downstream Care Partner, Downstream Care Partner Arrangement, Downstream Incentive Payment, Hospital, Incentive Payment, Incentive Payment Methodology, Incentive Payment Pool, Intervention Resource, Intervention Resource Allocation, Medicare FFS Beneficiary, Performance Period, PGP Care Partner, and PGP Member.

Related to Downstream Care Partner

  • APC means the Ambulatory Payment Classification system under 42 CFR 419.31 used by Medicare for grouping clinically and resource-similar procedures and services.

  • MPC means the Main Press Centre.

  • Service Partners means any successful vendor who is awarded the proposal or who entered into an agreement with CIPC and/or its clients to offer consulting services in areas such as but not limited to, strategic e-business consulting, evaluation, implementation and continuous improvement or system integration.

  • MP means Monongahela Power Company, an Ohio corporation.

  • Digital Cross Connect System or "DCS" is a function which provides automated Cross Connection of Digital Signal Level 0 (DS0) or higher transmission bit rate digital channels within physical interface facilities. Types of DCS include but are not limited to DCS 1/0s, DCS 3/1s, and DCS 3/3s, where the nomenclature 1/0 denotes interfaces typically at the DS1 rate or greater with Cross Connection typically at the DS0 rate. This same nomenclature, at the appropriate rate substitution, extends to the other types of DCS specifically cited as 3/1 and 3/3. Types of DCS that cross connect Synchronous Transport Signal level 1 (STS-1 s) or other Synchronous Optical Network (SONET) signals (e.g., STS-3) are also DCS, although not denoted by this same type of nomenclature. DCS may provide the functionality of more than one of the aforementioned DCS types (e.g., DCS 3/3/1 which combines functionality of DCS 3/3 and DCS 3/1). For such DCS, the requirements will be, at least, the aggregation of requirements on the "component" DCS. In locations where automated Cross Connection capability does not exist, DCS will be defined as the combination of the functionality provided by a Digital Signal Cross Connect (DSX) or Light Guide Cross Connect (LGX) patch panels and D4 channel banks or other DS0 and above multiplexing equipment used to provide the function of a manual Cross Connection. Interconnection is between a DSX or LGX to a Switch, another Cross Connection, or other service platform device.

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Business Partner means a legal entity that requires use of a Cloud Service in connection with Customer’s and its Affiliates’ internal business operations. These may include customers, distributors, service providers and/or suppliers of Customer.

  • SDS means safety data sheets;

  • Drug therapy management means the review of a drug therapy regimen of a patient by one or more pharmacists for the purpose of evaluating and rendering advice to one or more practitioners regarding adjustment of the regimen.

  • Acute care hospital means a Hospital that provides Acute Care Services. Adjudicate means to deny or pay a Clean Claim. Administrative Services see MCO Administrative Services. Administrative Services Contractor see HHSC Administrative Services Contractor.

  • CFPC means the College of Family Physicians of Canada.

  • Medical cannabis pharmacy means the same as that term is defined in Section 26-61a-102.

  • Outpatient hospital services means preventive, diagnostic, therapeutic, observation, rehabilitation, or palliative services provided to an outpatient by or under the direction of a physician, dentist, or other practitioner by an institution that:

  • Pioneer or the "Company" means Pioneer Natural Resources Company and its subsidiaries.

  • Family child care provider means a person who: (a) Provides

  • Distributor / Distribution Company means Company(ies), Firm(s), Sole Proprietorship concern(s), individual(s), Banks or any other Financial Institution appointed by the Management Company under intimation to the Trustee for performing any or all of the Distribution Functions and who are registered with MUFAP as Registered Service Providers. The Management Company may itself also performs the Distribution Function.

  • Health Care Operations shall have the meaning given to such term under the HIPAA 2 Privacy Rule in 45 CFR § 164.501.

  • Preventive services means preservation services, as defined

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • DS Electric generation service that is provided at retail pursuant to the Applicable Legal Authorities under the Company’s retail electric tariffs and under any other agreements or arrangements between the Company and Customers, to any Customer that is not being served by an EGS. Default Allocation Assessment – shall have the meaning ascribed to it under the PJM Agreements. Delivery Period – The delivery period specified in an Appendix C Transaction Confirmation. Delivery Point – Means the applicable zone of the Company as designated by PJM. DS Customer(s) – Retail customers who are provided Default Service pursuant to the terms of this Agreement, the Applicable Legal Authorities and the Company’s retail tariffs.

  • Hospice patient s family" means a hospice patient's immediate family members, including a spouse, brother, sister, child, or parent, and any other relative or individual who has significant personal ties to the patient and who is designated as a member of the patient's family by mutual agreement of the patient, the relative or individual, and the patient's interdisciplinary team.

  • PSC means the New York State Public Service Commission.

  • economic operators means the manufacturer, the authorised representative, the importer and the distributor;

  • Volunteer firefighter means a firefighter whose position normally requires less than 600

  • COVERED HEALTHCARE SERVICES means any service, treatment, procedure, facility, equipment, drug, device, or supply that we have reviewed and determined is eligible for reimbursement under this plan.