Physician Incentive Plan definition

Physician Incentive Plan means any compensation arrangement between the Contractor and a physician or physician group that may directly or indirectly have the effect of reducing or limiting services to enrollees under the terms of this Contract.

Physician Incentive Plan or "PIP" means any compensation arrangement between the Contractor or one of its contracting entities and a physician or physician group that may directly or indirectly have the effect of reducing or limiting services furnished to Medicaid recipients enrolled by the MCO.

Physician Incentive Plan or “PIP” means any compensation arrangement between the Contractor or one of its contracting entities and a physician or physician group that may directly or indirectly have the effect of reducing or limiting services furnished to the Contractor’s Enrollees.

Examples of Physician Incentive Plan in a sentence

• The Contractor shall provide information on its Physician Incentive Plan to any Enrollee upon request.

• If CONTRACTOR wants to institute a Physician Incentive Plan, CONTRACTOR shall submit the proposed plan to the COUNTY which will in turn submit the Plan to the State for approval, in accordance with the provisions of 42 C.F.R. § 438.6(c).

• The Contractor shall notify the Department if the Contractor plans to operate a Physician Incentive Plan.

• In accordance with 42 CFR 422.208, the Contractor may operate a Physician Incentive Plan only if the Contractor makes no specific payment, directly or indirectly, to a physician or physician group as an inducement to reduce or limit Medically Necessary services furnished to any particular Enrollee.

• The State shall approve the Contractor’s request for a Physician Incentive Plan only if the proposed Physician Plan complies with all applicable federal and state regulations.

More Definitions of Physician Incentive Plan

Physician Incentive Plan means any compensation arrangement to pay a physician or physician group that may directly or indirectly have the effect of reducing or limiting the services provided to any plan enrollee.

Physician Incentive Plan means any compensation between a contracting organization and a physician group that may directly or indirectly have the effect of reducing or limiting services provided with respect to Enrollees in the organization.

Physician Incentive Plan. Any compensation arrangement between the Contractor and a physician or physician group that is intended to advance Utilization Management. Plan: See definition of the MiSalud Plan. Post-Stabilization Services: Covered Services, relating to an Emergency Medical Condition, that are provided after an Enrollee is stabilized, in order to maintain the stabilized condition, or to improve or resolve the Enrollee’s condition.

Physician Incentive Plan. Any compensation arrangement to pay a physician or physician group that may directly or indirectly have the effect of reducing or limiting the services provided to any plan member.

Physician Incentive Plan has the meaning specified in 42 C.F.R. (S)417.479, as ------------------------ amended from time to time.

Physician Incentive Plan means “physician incentive plan” as defined in 42 CFR 422.208;

Physician Incentive Plan as Sections 22.8, 22.9. 22.10, 22.11. 22.12. 22.13. and 22.14 respectively.