Provider Incentive Programs Sample Clauses

Provider Incentive Programs. 7.7.2.1 In addition to the Value-Based Incentive Program in Section 7.7.1, Contractor may establish incentives for its Participating Providers, Preferred Providers, and Participating Practices. Contractor will determine its own methodology for incentivizing Participating Providers, Participating Practices and Preferred Providers, subject to DVHA approval. Prior to implementation of any incentive programs, Contractor will provide DVHA with policies related to provider incentives, updates to policies related to the VMNG Program are also subject to DVHA approval. Contractor shall comply with federal regulations regarding physician incentive plans includes those in 42 CFR § 438.3(h). 7.7.2.2 Contractor will make no specific payment directly or indirectly to a provider or provider organization as an inducement to reduce or limit medically necessary services furnished to an individual Member.
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Provider Incentive Programs. Contractors shall establish a performance-based incentive system for its providers for the Contractor’s Hoosier Healthwise providers. The Contractor will determine its own methodology for incentivizing providers. The Contractor must obtain OMPP-approval prior to implementing its provider incentive program and before making any changes thereto. The State encourages creativity in designing pay for performance programs. If the Contractor offers financial incentives to providers, these payments shall be above and beyond the standard Medicaid fee-for-service fee schedule. Section 1876(i)(8) of the Social Security Act and federal regulations 42 CFR 438.6(h), 42 CFR 422.208 and 42 CFR 422.210 provide information regarding physician incentive plans. The Contractor shall comply with all federal regulations regarding the physician incentive plan and supply to OMPP information on its plan as required in the regulations and with sufficient detail to permit OMPP to determine whether the incentive plan complies with the federal requirements. The Contractor shall provide information concerning its physician incentive plan, upon request, to its members and in any marketing materials in accordance with the disclosure requirements stipulated in the federal regulations. Similar requirements apply to subcontracting arrangements with physician groups and intermediate entities. Physician incentive plans shall comply with the following requirements: The Contractor will make no specific payment directly or indirectly to a physician or physician group as an inducement to reduce or limit medically necessary services furnished to an individual member; and The Contractor meets requirements for stop-loss protection, member survey and disclosure requirements under 42 CFR 438.6(h).
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Related to Provider Incentive Programs

  • 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.

  • Incentive Program Members who are rated as either Level I, Level II or Level III in every phase of the Physical Fitness Test are eligible to participate in the Incentive Program.

  • Long-Term Incentive Program During the Term, the Employee shall participate in all long-term incentive plans and programs of the Group that are applicable to its senior executives in accordance with their terms and in a manner consistent with his position with the Company.

  • Bonus Programs Employee may participate in any incentive program which may be made available from time to time to Corporation’s employees at Employee’s level; provided, however, that Employee’s participation is subject to the applicable terms, conditions and eligibility requirements of the program, as they may exist from time to time.

  • In-Service Programs The parties to this collective agreement recognize the value of in-service education both to the employee and the Employer. A) The Employer reserves the right to identify specific in-service programs deemed compulsory. B) Employees required to attend such programs will be paid at the applicable rate of pay.