Exception for the Nurse Practitioner and Physician Assistant Services Benefit Enhancement Clause Samples

This clause establishes a specific exception related to the enhancement of benefits for services provided by nurse practitioners and physician assistants. It outlines circumstances under which the standard terms of the agreement do not apply to these enhanced benefits, such as when certain regulatory requirements or provider qualifications are met. By carving out this exception, the clause ensures that benefit enhancements for these healthcare professionals are handled distinctly, addressing unique regulatory or operational considerations and preventing unintended limitations or overlaps with other contract provisions.
Exception for the Nurse Practitioner and Physician Assistant Services Benefit Enhancement. Consistent with the provisions of Section 5.08.A and Section 5.08.B, and subject to compliance with Section IV.B.4 of Appendix T of the Agreement, beginning Performance Year 2023, the ACO may provide a Beneficiary Refund for certain services furnished pursuant to the Nurse Practitioner and Physician Assistant Services Benefit Enhancement.
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