IPA-Specific Provisions Sample Clauses
IPA-Specific Provisions. 1. Any reference to IPA quality assurance (QA) activities within this Agreement is limited to the IPA’s analysis of utilization patterns and quality of care on its own behalf and as a service to its contract providers.
IPA-Specific Provisions. 1. To the extent that an IPA is otherwise authorized by this agreement to perform pre-authorization of services and concurrent utilization of services and concurrent utilization review, the standards employed by the IPA shall be those of the HMO or approved by the HMO. All denials of services, and all determinations on appeals of such denials, shall be made by HMO. Where the IPA's determination on concurrent review is inconsistent with the results of the HMO's own concurrent review, the HMO's review and determination shall control.
2. Any reference to IPA quality assurance (QA) activities within this agreement is limited to the IPA's analysis of utilization patterns and quality of care on its own behalf and as a service to its contract providers. EXHIBIT B
IPA-Specific Provisions. 1. Any reference to IPA quality assurance (QA) activities within this Agreement is limited to the IPA’s analysis of utilization patterns and quality of care on its own behalf and as a service to its contract providers.
1. To the extent that arbitration or alternative dispute resolution is authorized elsewhere in this Agreement, the parties to this Agreement acknowledge that the Commissioner of Health is not bound by arbitration or mediation decisions. Arbitration or mediation shall occur within New York State, and the Commissioner of Health will be given notice of all issues going to arbitration or mediation, and copies of all decisions.