Physician Incentive Plans definition

Physician Incentive Plans mean 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.
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Physician Incentive Plans means, collectively, the AUS Physician Incentive Plan and the EUR Physician Incentive Plan.
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Examples of Physician Incentive Plans in a sentence

  • Pursuant to 42 CFR Part 422, subpart E, the MCO shall comply with all applicable Provider requirements for MSHO in that section, including, but not limited to: Provider certification requirements; anti-discrimination requirements; Provider participation and consultation requirements; the prohibition on interference with Provider advice; limits on Provider indemnification; rules governing payments to Providers; Medicare cost sharing; and limits on Physician Incentive Plans.

  • Contractor shall provide additional information that is available upon request by the Member, including information on Contractor’s structure and operations, and Physician Incentive Plans.

  • The Contractor shall reimburse all contracted Providers at a rate no less than the prevailing Medicaid Fee-for-Service delivery system fee schedule with the exception of capitation and other incentive arrangements under Section 7.K, Physician Incentive Plans, of this Contract.

  • Contractor's agreement to comply with County’s policies and procedures on advance directives and County’s obligations for Physician Incentive Plans, if applicable based on the services provided under the subcontract.

  • Prohibited Affiliations 273 5.1.6. Disclosure Requirements 273 5.1.7. Physician Incentive Plans 274 5.1.8. Physician Identifier 275 5.1.9. Timely Provider Payments 276 5.1.10.

  • If this Agreement results in Participating Provider’s being at substantial financial risk as defined by CMS, Participating Provider must obtain either aggregate or per patient stop-loss insurance protection and comply with such other requirements governing Physician Incentive Plans, as set forth by federal law or regulation.

  • In making payments on an incentive basis, DVHA (and IGA partners) shall comply as applicable with the requirements set forth in 422.208 and 422.210 regarding Physician Incentive Plans.

  • Physician Incentive Plans Contractor shall obtain approval from County prior to implementing a Physician Incentive Plan as described by Title 42, CFR, Section 438.6(h).

  • Upon request of any Member, Contractor shall provide additional information that Contractor has created that has been pre-approved by OHA and is otherwise available, including information on Contractor’s structure and operations, and Physician Incentive Plans.

  • To the extent applicable to Contractor’s performance of its obligations hereunder, Contractor shall comply with the Department of Behavioral Wellness’ Policy #3.004 on advance directives and the County's obligations for Physician Incentive Plans, as applicable.