Provider incentive plan definition

Provider incentive plan means any compensation arrangement between a health
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Provider incentive plan means any compensation arrangement between a health care entity or health plan and a provider or provider group that may directly or indirectly have the effect of reducing or limiting services provided with respect to an individual enrolled in a health plan.
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Examples of Provider incentive plan in a sentence

  • If the Dental Contractor implements a Provider incentive plan under 42 C.F.R. § 438.6(h), the plan must comply with all applicable law, including 42 C.F.R. §§ 422.208 and 422.210.

  • If the Provider incentive plan places a Provider or Provider group at a substantial financial risk for services not provided by the Provider or Provider group, the Dental Contractor must ensure adequate stop-loss protection and conduct and submit annual Dental Member surveys no later than five Business Days after the Dental Contractor finalizes the survey results.

  • Whether the Provider incentive plan covers services that are not furnished by a Provider or Provider group.

  • Provider incentive plan amounts will be included in the Medical Loss Ratio calculation.

  • The Dental Contractor must not make payments under a Provider incentive plan if the payments are designed to induce Providers to reduce or limit Medically Necessary Covered Dental Services to Dental Members.

Related to Provider incentive plan

  • Equity Incentive Plan means an incentive plan, or portion of an incentive plan, under which awards are granted and that falls within the scope of IFRS 2 Share-based Payment;

  • incentive plan award means compensation awarded, earned, paid, or payable under an incentive plan;

  • Company Equity Incentive Plan means the Company’s omnibus equity plan, last approved by Company Shareholders on November 6, 2018 and as proposed to be amended at the Company’s May 7, 2019 shareholders’ meeting.

  • Incentive Plan means any plan providing compensation that depends on achieving certain performance goals or similar conditions within a specified period;

  • non-equity incentive plan means an incentive plan or portion of an incentive plan that is not an equity incentive plan;

  • Equity Award means all incentive stock options, non-statutory stock options, shares of restricted stock, restricted stock units or other incentive equity awards in respect of shares of the Company’s equity securities that have been or will be granted to you by the Company.

  • Basic health plan model plan means a health plan as required in RCW 70.47.060(2)(e).