Examples of Vermont Medicaid in a sentence
This Program Addendum will automatically terminate if the Agreement terminates or if the Participant or Preferred Provider becomes ineligible to participate in Vermont Medicaid, for any reason.
Participant warrants that it has the authority to and does bind itself and its employees, including each Provider with an NPI number billing under its TIN who is included on the Vermont Medicaid Next Generation Participant List to the Agreement and this Program Addendum.
ACO has entered into an agreement with DVHA through which the ACO will participate in the Vermont Medicaid Next Generation Model (the “Program”), an alternative payment and population health management program with Medicaid, as described in Vermont Medicaid Next Generation Participation Agreement that will be available on the ACO Provider Portal and is incorporated by reference into this ACO Program Addendum.
Participant and Preferred Provider agree to participate in the Program, to engage in ACO Activities, to comply with the applicable terms of the Program as set forth in the Vermont Medicaid Next Generation Participation Agreement between ACO and DVHA and to comply with all applicable laws and regulations.
Participants whose TIN includes NPIs of a “Primary Care Practitioner” who bills “Qualified Evaluation and Management Services” (as both terms are defined by the Vermont Medicaid Next Generation Participation Agreement) may not participate in more than one Medicaid Next Generation Model Program, or any other Medicaid ACO- based payment reform program or with any other accountable care organization in which they attribute or align lives.
THIRD-PARTY PAYMENT Although we are not required to, the FSCH accepts payment from Vermont Medicaid under the Assistive Community Care Services (ACCS) and the Choices for Care Enhanced Residential Care (ERC) Programs, provided however, that the resident understands they are still responsible for their monthly R & B.
Additionally, as described in section 15.a, Vermont shall provide CMS Vermont Medicaid claims data, and Vermont Commercial Plans claims data, and Vermont Self-insured Plan claims data to support CMS’s monitoring and evaluation of the Model.
In Performance Year 3, the State must work toward maximizing the percent of children and adolescents enrolled in Vermont Medicaid who have a well-care visit and establish a 2020 baseline.
In Performance Years 1 and 2, the State must achieve the 50th percentile, as compared to Medicaid plans nationally, for percentage of Vermont adolescents enrolled in Vermont Medicaid who have a well-care visit.
In addition to receiving and maintaining the historical files noted above, and in recognition of the importance of historical data to the effective performance of an ACO year over year, Contractor may maintain data provided to it by DVHA pursuant to the VMNG and Vermont Medicaid Shared Saving Program agreements in prior years.