Risk contract definition

Risk contract means a contract between OHCA and an MCO, prepaid inpatient health plan (PIHP), or prepaid ambulatory health plan (PAHP), as those terms are defined at 42 C.F.R. § 438.2, under which the contractor assumes risk for the cost of the services covered under the contract and incurs loss if the cost of furnishing the services exceeds the payments under the contract.

Risk contract. A Contract under which the Contractor assumes financial risk for the cost of the services covered under the Contract, and may incur a loss if the cost of providing services exceeds the payments made by DCH to the Contractor for services covered under the Contract. Routine Care: Treatment of a Condition that would have no adverse effects if not treated within twenty-four (24) hours or could be treated in a less acute setting (e.g., physicians office) or by the patient. Rural Health Clinic (RHC): A clinic certified to receive special Medicare and Medicaid reimbursement. The purpose of the RHC program is improving access to primary care in underserved rural areas. RHCs are required to use a team approach of physicians and midlevel practitioners (nurse practitioners, physician assistants, and certified nurse midwives) to provide services. The clinic must be staffed at least 50% of the time with a midlevel practitioner. RHCs may also provide other health care services, such as mental health or vision services, but reimbursement for those services may not be based on their allowable costs.

Risk contract. A Contract under which the Contractor assumes financial risk for the cost of the services covered under the Contract, and may incur a loss if the cost of providing services exceeds the payments made by DCH to the Contractor for services covered under the Contract. Routine Care: Treatment of a Condition that would have no adverse effects if not treated within twenty-four (24) hours or could be treated in a less acute setting (e.g, physicians office) or by the patient.

Examples of Risk contract in a sentence

• All contractor (and subcontractor) personnel proposed to be employed under a Low Risk contract shall undergo security processing by the Department's Office of Security before being eligible to work on the premises of any Department of Commerce owned, leased, or controlled facility in the United States or overseas, or to obtain access to a Department of Commerce IT system.

• All contractor (and subcontractor) personnel proposed to be employed under a High or Moderate Risk contract shall undergo security processing by the Department's Office of Security before being eligible to work on the premises of any Department of Commerce owned, leased, or controlled facility in the United States or overseas, or to obtain access to a Department of Commerce IT system.

• It is the intent of the Owner to utilize a Construction Management at Risk contract for the Cost of the Work plus a Fixed Fee with a Guaranteed Maximum Price (GMP).

• This Construction Management at Risk contract was initially awarded for pre-construction early in the design phase.

• The Oklahoma State Regents for Higher Education (OSRHE) shall appoint a Chief Information Officer (CIO) for the Oklahoma State System of Higher Education.

More Definitions of Risk contract

Risk contract means a contract between a Payer and an ACO under which the ACO is responsible for the full or partial expense, as defined by the contract, of treating or arranging for the treatment of a group of patients, if that expense exceeds an agreed-upon amount.

Risk contract means a contract between a Payer and an ACO under which the ACO is responsible for either the full or partial expense, as defined by the contract, of treating or arranging for the treatment of a group of patients, that exceeds a certain amount (e.g., a Benchmark or Capitation Payment).

Risk contract means a contract which includes the possibility that loss may be incurred because the cost of providing services may exceed the payments made for services covered under the contract.

Risk contract. A contract under which the contractor: 1) assume risk for the cost of the services covered under the contract; and 2) incurs loss if the cost of furnishing the service exceeds the payments under the contract.

Risk contract means a contract under which the contractor assumes risk for the cost of the services

Risk contract means a contract under which the contractor assumes risk for the cost of the services covered under the contract; and incurs loss if the cost of furnishing the services exceeds the payments under the contract.

Risk contract. A contract under which the contractor: 1) assumes risk for the cost of the services covered under the contract; and 2) incurs loss if the cost of furnishing the services exceeds the payments under the contract. This contract is a risk contract because MCO assumes the risk that the cost of providing Covered Services to Enrollees may exceed the capitation rate paid by DMA. Routine Need (Mental Health): A condition in which the person describes signs and symptoms resulting in impaired behavioral, mental or emotional functioning which has impacted the person’s ability to participate in daily living or markedly decreased the person’s quality of life. Routine Need (Substance Abuse): A condition in which the person describes signs and symptoms consequent to substance use resulting in a level of impairment which can likely be diagnosed as a substance use disorder according to the current version of the Diagnostic and Statistical Manual.