Common use of Inter-Plan Medicare Advantage Program Clause in Contracts

Inter-Plan Medicare Advantage Program. Determination of Compliance: 1. Guidelines Subject to Immediate Termination 1.1 None 2. Guidelines Subject to Mediation/Arbitration 2.1 BlueCard Program and ITS — A controlled affiliate shall fully participate in ITS and the BlueCard Program through compliance with all BlueCard Program Policies and Provisions and all applicable Inter-Plan Programs Policies and Provisions, unless an exemption has been granted by the Inter-Plan Programs Committee (IPPC) in accordance with those Policies and Provisions. 2.1.a Compliance determined by periodic reviews or audits and by reviews initiated by evidence of problems. 2.1. b Mediation/Arbitration shall be commenced only upon a finding by IPPC that such action is warranted and a referral of the matter from IPPC to the PPFSC and the BCBSA Board of Directors for their action.

Inter-Plan Medicare Advantage Program. Determination of Compliance: 1. Guidelines Subject to Immediate Termination 1.1 None 2. Guidelines Subject to Mediation/Arbitration 2.1 BlueCard Program and ITS — A controlled affiliate Plan shall fully participate in ITS and the BlueCard Program through compliance with all BlueCard Program Policies and Provisions and all applicable Inter-Plan Programs Policies and Provisions, unless an exemption has been granted by the Inter-Plan Programs Committee (IPPC) in accordance with those Policies and Provisions. 2.1.a Compliance determined by periodic reviews or audits and by reviews initiated by evidence of problems. 2.1. b Mediation/Arbitration shall be commenced only upon a finding by IPPC that such action is warranted and a referral of the matter from IPPC to the PPFSC and the BCBSA Board of Directors for their action.