Provider P4P Program Payments to Providers Clause Samples

Provider P4P Program Payments to Providers. All Provider P4P funds received from the Department for this HealthChoices Agreement should be paid to network providers in accordance with the approved QPP above. HealthChoices Physical Health Agreement effective July 1, 2013 ALL MCOs The PH-MCO is required to develop and maintain a separate accounting process of the receipts and disbursements of Provider P4P funds. The PH-MCO must be able to separately identify and track each payment to a provider on a per-claim basis for each specific mandatory and optional HEDIS Quality Measure identified in the QPP. If the Department has approved the use of Provider P4P funds for Community Based Care Management in the QPP above, the PH-MCO must be able to provide acceptable source documentation that demonstrates total funds expended per selected facility and/or PCP office. Each PH-MCO may determine the frequency of issuing payments to its providers. However, the Department recommends, at a minimum, quarterly payouts. The PH- MCO must issue Provider P4P payments to its providers for services rendered under approved terms of this Exhibit B (3) to be paid out in full no later than June 30 of the subsequent calendar year.
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