Participant Provider List definition

Participant Provider List means the list that identifies each Participant Provider that is approved by CMS for participation in the Model for a Performance Year that is established in accordance with Section 4.02 and updated from time to time in accordance with Sections 4.03 and 4.04.
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Examples of Participant Provider List in a sentence

  • If the ACO has selected to participate in the APO for the ACO’s first Performance Year, the ACO shall certify that each individual and entity listed on either the Proposed Participant Provider List or the Proposed Preferred Provider List as participating in the APO at the start of the ACO’s first Performance Year has agreed to an APO Fee Reduction that is a percentage within the range of 1% and 100%.

  • The ACO shall update the Participant Provider List and Preferred Provider List to reflect the relevant changes in Medicare enrollment information for individuals and entities identified on such lists.

  • For each Performance Year that the ACO selects to participate in the APO, the arrangement prohibits a Participant Provider that is added to the Participant Provider List during the Performance Year or a Preferred Provider that is added to the Preferred Provider List during a Performance Year from participating in the APO for the Performance Year in which the Participant Provider or the Preferred Provider is so added.

  • If the ACO selects to provide a Benefit Enhancement for a Performance Year, the ACO’s Participant Providers and Preferred Providers, as indicated on the relevant Participant Provider List and Preferred Provider List under Article IV, may submit claims for services furnished pursuant to such Benefit Enhancement as described in this Article X during the Performance Year for which the ACO selected to provide the Benefit Enhancement.

  • The removal of the individual or entity from the Participant Provider List or Preferred Provider List pursuant to this Section 4.03.B.2 will be effective as of the date the individual or entity lost eligibility to receive payment from Medicare.

  • For purposes of furnishing Benefit Enhancements and participating in the ACO’s selected Capitation Payment Mechanism, the removal of an individual or entity from the Participant Provider List or Preferred Provider List will be effective on the last day of the month the individual or entity ceases to meet the requirements of Section 4.01.A(1)-(5) or Section 4.01.B(1)-(5), as applicable.

  • By a date specified by CMS, the ACO shall furnish written notification to each individual or entity the ACO wishes to include on the Proposed Revised Participant Provider List.

  • By a date specified by CMS, the ACO shall furnish written notification to the executive of any TIN through which an individual or entity on the Proposed Revised Participant Provider List or Proposed Revised Preferred Provider List bills Medicare.

  • If the ACO has selected TCC Payment as its Capitation Payment Mechanism, the arrangement prohibits a Participant Provider that is added to the Participant Provider List during a Performance Year or a Preferred Provider that is added to the Preferred Provider List during a Performance Year from participating in the ACO’s selected Capitation Payment Mechanism for the Performance Year in which the Participant Provider or Preferred Provider is so added.

  • If the ACO has selected PCC Payment as its Capitation Payment Mechanism, the arrangement prohibits a Participant Provider that is added to the Participant Provider List during a Performance Year or a Preferred Provider that is added to the Preferred Provider List during a Performance Year from participating in the ACO’s selected Capitation Payment Mechanism for the Performance Year in which the Participant Provider or Preferred Provider is so added.

Related to Participant Provider List

  • Participant ID means each unique identifier assigned to a Participant other than a DMA Customer by BSEF for access to the SEF operated by BSEF.

  • Participant Account means that separate account maintained under the Plan to record the amount that a Participant has contributed to the Plan during an Offering Period.

  • Lower Tier Participant refers any participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants (such as subcontractors and suppliers).

  • L/C Participants the collective reference to all the Revolving Lenders other than the Issuing Lender.

  • Participant Group means you, each of your holding companies and subsidiaries and each subsidiary of each of your holding companies (as each such term is defined in the Companies Act 1985); and

  • L/C Participant shall have the meaning provided in Section 3.3(a).

  • Participant has the meaning specified in Section 10.06(d).

  • Enhanced Service Provider (ESP) means the provider of enhanced services, as those services are defined in 47 CFR Section 64.702.

  • Non-Administrator Provider means a Provider that does not meet the definition of Administrator Provider unless otherwise specified in the definition of a particular Provider.

  • Program participant means an individual certified by the secretary as a program participant under Iowa Code section 9E.3.

  • Other Participant means a cooperative project participant other than the United States.

  • Requesting Participant means a Participant initiating an RFQ.

  • Non-Participating Provider means an Administrator Hospital or Professional Provider which does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or a facility which has not been designated by the Claim Administrator as a Participating Provider.

  • Program Participants means, for any CRP, the Centers (other than the Lead Center for such CRP) and any Partner receiving funding for activities under such CRP that are funded by the CGIAR Fund.

  • First Tier Participant refers to the participant who has entered into a covered transaction with a grantee or subgrantee of Federal funds (such as the prime or general contractor). “Lower Tier Participant” refers any participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants (such as subcontractors and suppliers).

  • Participating Provider means an Administrator Hospital or Professional Provider which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or an Administrator facility which has been designated by the Claim Administrator as a Participating Provider.

  • Clearing Participant means a person admitted as a participant under the Clearing Rules.

  • Inactive Participant means each Participant (other than a Retired Participant, Deceased Participant or Disabled Participant) who is not in active service as an Outside Director and is not actively employed by a Participating Company.

  • Authorised Participant Agreement means, in respect of an Authorised Participant, the authorised participant agreement (as amended, supplemented, novated and/or replaced from time to time) entered into by the Issuer and such Authorised Participant.

  • Participant’s Account means an account maintained for each Participant’s participation in DSUs and/or RSUs under the Plan;

  • Individual account program means the defined contribution individual account program of

  • Retired Participant means a person who has been a Participant, but who has become entitled to retirement benefits under the Plan.

  • Participants is defined in Section 12.2.1.

  • Local Service Provider (LSP means the LEC that provides retail local Exchange Service to an End User. The LSP may or may not provide any physical network components to support the provision of that End User’s service.

  • Deferral Account means the Company's accounting of the Director's accumulated Deferrals plus accrued interest.

  • FTR Participant means any Market Participant that provides or is required to provide Collateral in order to participate in PJM’s FTR auctions.