Part D Rewards and Incentives Programs Structure and Content Clause Samples

Part D Rewards and Incentives Programs Structure and Content. A. If the Part D Sponsor is implementing a Part D RI Program under the Model, the parties acknowledge that Part D Sponsor has submitted as part of its application for participation in the Part D Senior Savings Model, a proposal to offer one or more Part D RI Programs to Targeted Enrollees. B. Part D Sponsor shall identify Targeted Enrollees for the Part D RI Program without discrimination and using objective criteria that comply with the terms of the Addendum, including this Appendix 2, and are specified in the Approved Proposal or are otherwise approved in writing, in advance by CMS. Such objective criteria must identify the subset of enrollees who would receive the greatest health care value from receiving the benefits or participating in the activities associated with the particular reward or incentive in the Part D RI Program and must include that the enrollee have Diabetes or Pre-diabetes. C. The Part D Sponsor acknowledges that for each Part D RI Program the Approved Proposal contains the following: i. The goals of the Part D RI Program; ii. The list of Model PBPs in which the Part D RI Program will be implemented; iii. The nature and scope of the Part D RI Program, including the criteria for identifying Targeted Enrollees and the beneficiary engagement methodology; iv. The eligibility criteria that must be met for an individual Targeted Enrollee to qualify to receive the reward or incentive, including the healthcare activity that must be completed for the reward or incentive to be available, and, if eligibility includes an adherence metric, the specific criteria for measuring adherence and the evidence base to support the clinical appropriateness of the adherence criteria; v. The type and per unit value of each reward or incentive and the method for providing the reward or incentive to eligible Targeted Enrollees; vi. The maximum number and frequency of the rewards and incentives that may be obtained by an eligible Targeted Enrollee per year; and vii. The evidence base and theory of change used to develop the reward or incentive and the expected outcomes of the Part D RI Program(s). D. The Part D Sponsor shall: i. Provide the rewards and incentives only to eligible Targeted Enrollees and only in accordance with the Approved Proposal and this Addendum; ii. Comply with the standards for Rewards and Incentives as outlined in the Medicare Managed Care Manual Ch. 4 § 100 issued and effective April 22, 2016 at available at ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/Regulations-...
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Related to Part D Rewards and Incentives Programs Structure and Content

  • Physician Incentive Plans In the event Provider participates in a physician incentive plan (“PIP”) under the Agreement, Provider agrees that such PIPs must comply with 42 CFR 417.479, 42 CFR 438.3, 42 CFR 422.208, and 42 CFR 422.210, as may be amended from time to time. Neither United nor Provider may make a specific payment directly or indirectly under a PIP to a physician or physician group as an inducement to reduce or limit Medically Necessary services furnished to an individual Covered Person. PIPs must not contain provisions that provide incentives, monetary or otherwise, for the withholding of services that meet the definition of Medical Necessity.

  • PERFORMANCE MANAGEMENT SYSTEM 5.1 The Employee agrees to participate in the performance management system that the Employer adopted for the employees of the Employer; 5.2 The Employee accepts that the purpose of the performance management system will be to provide a comprehensive system with specific performance standards to assist the employees and service providers to perform to the standards required; 5.3 The Employer must consult the Employee about the specific performance standards and targets that will be included in the performance management system applicable to the Employee; 5.4 The Employee undertakes to actively focus on the promotion and implementation of the key performance indicators (including special projects relevant to the employee’s responsibilities) within the local government framework; 5.5 The criteria upon which the performance of the Employee shall be assessed shall consist of two components, Operational Performance and Competencies both of which shall be contained in the Performance Agreement; 5.6 The Employee’s assessment will be based on his performance in terms of the outputs/outcomes (performance indicators) identified as per attached Performance Plan, which are linked to the KPAs, and will constitute 80% of the overall assessment result as per the weightings agreed to between the Employer and Employee; 5.7 The Competencies will make up the other 20% of the Employee’s assessment score. The Competencies are spilt into two groups, leading competencies (indicated in blue on the graph below) that drive strategic intent and direction and core competencies (indicated in green on the graph below), which drive the execution of the leading competencies. Strategic direc on and leadership People management Program and project management Financial management Change leadership Governance leadersip Moral competence Planning and organising Analysis and innova on Knowledge and informa on management Communica on Results and quality focus

  • Incentive Programs During the Term of Employment, the ------------------ Executive shall be entitled to participate in any annual and long-term incentive programs adopted by the Company and which cover employees in positions comparable to that of the Executive.

  • Performance Incentives As a bonus, to supplement Associate Head Coach’s compensation, as set out herein, the University agrees to pay the following sums upon attainment of each specified goal, provided the Program is in compliance with all Governing Athletics Rules and University Rules, and there are no pending or active NCAA or __________ Conference investigations or major violations of which Associate Head Coach knew or should have known. Associate Head Coach must also complete the _________ [insert sport] season as Associate Head [Men’s/Women’s] [delete if sport is football] __________ Coach to receive any performance incentives for that season. Payment will be made to Associate Head Coach within 60 days after goal is accomplished. (a) $_________ in any contract year in which the team wins the __________ Conference championship. (b) $_________ in any contract year in which the team participates in post-season NCAA competition. (c) $_________ for each game that the team wins in NCAA post-season competition. (d) $_________ in any contract year in which the team wins the NCAA championship.]

  • Bonus Plans A bonus is a lump sum payment that is not a permanent increase to the base salary of the individual and may be granted at the discretion of the President. A bonus may be awarded at any time and may be used for a variety of salary adjustments including, but not limited to the following: