Common use of PCP‐to Clause in Contracts

PCP‐to. Enrollee ratio. Contractor’s maximum PCP panel size shall be as set forth below. If Contractor does not satisfy the PCP requirements set forth below, Contractor may demonstrate compliance with these requirements by demonstrating that Contractor’s full‐time‐equivalent PCP ratios exceed ninety percent (90%) of the requirements set forth below, and that Covered Services are being provided in the Contracting Area in a manner that is timely and otherwise satisfactory. Contractor shall comply with Section 1932(b)(7) of the Social Security Act. 5.8.8.1 For the Families and Children Population and ACA Adult Enrollees, Contractor’s maximum PCP panel size shall be one‐ thousand eight‐hundred (1,800) Enrollees. An additional maximum of nine hundred (900) of such Enrollees is allowed for each resident Physician, nurse practitioner, Physician assistant, and APN who is one‐hundred percent (100%) full‐time equivalent employee or contractor. 5.8.8.2 For Seniors and Persons with Disabilities Enrollees, Contractor’s maximum PCP panel size shall be six hundred (600) Enrollees.

PCP‐to. Enrollee ratio. Contractor’s maximum PCP panel size shall be as set forth below. If Contractor does not satisfy the PCP requirements set forth below, Contractor may demonstrate compliance with these requirements by demonstrating that Contractor’s full‐time‐equivalent full-time-equivalent PCP ratios exceed ninety percent (90%) of the requirements set forth below, and that Covered Services are being provided in the Contracting Area in a manner that is timely and otherwise satisfactory. Contractor shall comply with Section 1932(b)(7) of the Social Security Act. 5.8.8.1 For the Families and Children Population and ACA Adult Enrollees, Contractor’s maximum PCP panel size shall be one‐ one- thousand eight‐hundred eight-hundred (1,800) Enrollees. An additional maximum of nine hundred (900) of such Enrollees is allowed for each resident Physician, nurse practitioner, Physician assistant, and APN who is one‐hundred one-hundred percent (100%) full‐time full-time equivalent employee or contractor. 5.8.8.2 For Seniors and Persons with Disabilities Enrollees, Contractor’s maximum PCP panel size shall be six hundred (600) Enrollees. An additional maximum of three hundred (300) of such Enrollees is allowed for each resident Physician, nurse practitioner, Physician assistant, and APN who is one-hundred percent (100%) full-time equivalent employee or contractor.