Examples of Payment Methodology in a sentence
If EOHHS has approved an Alternative Payment Methodology (APM) for the Contractor, EOHS shall apply an adjustment to the Contractor’s repriced paid claims comparable to the APM adjustment that EOHHS used with respect to the Contractor during Capitation Rate development for the Contract Year.
The Contractor submissions to EOHHS for “Alternative Payment Methodology Reporting Template for Managed Care Organizations” will be done in accordance with timeline on Reporting Calendar.
Such demonstration will be on the basis of quarterly submissions of the “Alternative Payment Methodology Reporting Template for Managed Care Organizations” (included as ATTACHMENT D to Transitioning to Alternative Payment Methodologies: Requirements for Medicaid Managed Care Partners and EOHHS review of the submitted report.
EOHHS will consider the withhold, for the prorated period of July 1, 2018 through December 31, 2018, as earned due to the Contractor’s efforts in advancing the development of APMs. The withheld amounts will be repaid as quarterly adjusting payments subject to the Contractor’s demonstration that it has achieved the threshold values in APM payments for the reporting period as set forth in Section 0.00.00.00.00 (Alternative Payment Methodology for Each Contract Period).
EXHIBIT 1 to ATTACHMENT C AHCCCS Disproportionate Share Hospital Payment Methodology Calculation of OBRA Limits for Governmentally-Operated Hospitals for the Purpose of Certified Public Expenditures Each governmentally-operated hospital certifying its expenditures for Disproportionate Share Hospital (DSH) payments shall compute and report its OBRA limit as prescribed by this Exhibit.
If the Contractor has sub-capitated or Alternative Payment Methodology (APM) arrangements with providers, the sub-capitated or APM payments to providers should be increased by the equivalent of the rate increases that would be required for fee for service payments as set forth in this section.
To replace Attachment E, Payment Methodology, with a new Attachment E that includes the state fiscal year (SFY) 2016 PMHP rates for the Contractor that CMS just approved.
An Alternative Payment Methodology means a payment methodology structured such that it provides economic incentives, rather than focusing on volume of services provided, focus upon such key areas as: • Improving quality of care; • Improving population health; • Impacting cost of care and/or cost of care growth; • Improving patient experience and engagement; and • Improving access to care.
Likewise, if KYOne HP has a Shared Loss Payment Obligation under an applicable Program Agreement, KYOne HP will satisfy the obligation in accordance with the Shared Loss Payment Methodology for the applicable Program Agreement adopted upon Board of Managers Approval in accordance with the KYOne HP Operating Agreement.
If CIN enters into a Commercial Program Agreement that has a Shared Loss Obligation, CIN will satisfy the obligation in accordance with the applicable Shared Loss Payment Methodology for such Commercial Program Agreement.