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.
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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.
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Examples of Downstream Care Partner in a sentence

  • 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.

  • 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.

  • 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 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 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 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.

  • If a Care Partner or Downstream Care Partner is excluded from participation in Medicare, Medicaid, or any other federal health care program, the Care Partner or Downstream Care Partner is removed from the Care Partner List effective no later than the effective date of exclusion.

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.