Common use of Panel Capacity Clause in Contracts

Panel Capacity. A. PROVIDER shall specify a capacity of Choice members he/she is willing to accept under ADDENDUM 1. The maximum capacity is two thousand five hundred (2,500) for a full-time Choice physician. If PROVIDER is a medical resident, his/her enrollment shall not exceed eight hundred seventy-five (875) members. If PROVIDER is also an O-EPIC-IP PCP, PROVIDER shall not exceed these capacities for both panels combined. B. PROVIDER shall not be a primary supervising physician for more than two mid-level practitioners who are Choice and/or O-EPIC IP PCP’s, whether nurse practitioners or physician assistants. Mid-level practitioners rendering care to PROVIDER’s panel shall be individually contracted with OHCA. C. OHCA does not guarantee PROVIDER an enrollment level nor will OHCA pay for members who are not eligible or excluded from enrollment. D. PROVIDER may request a change in his/her capacity by submitting a written request signed by PROVIDER. This request is subject to review according to program standards. In the event PROVIDER requests a lower capacity, OHCA may lower the capacity by disenrolling members to achieve that number or allowing the capacity to adjust as members change their PCP/CM or lose eligibility.

Panel Capacity. A. PROVIDER shall specify a capacity of Choice O-EPIC IP members he/she is willing to accept under ADDENDUM 1II. The maximum capacity is two thousand five hundred (2,500) for a full-time Choice O-EPIC IP physician. If PROVIDER is a medical resident, his/her enrollment shall not exceed eight hundred seventy-five (875) members. If PROVIDER is also an O-EPIC-IP a Choice PCP, PROVIDER shall not exceed these capacities for both panels combined. B. PROVIDER shall not be a primary supervising physician for more than two mid-level practitioners who are Choice and/or O-EPIC IP and/or Choice PCP’s, whether nurse practitioners or physician assistants. Mid-level practitioners rendering care to PROVIDER’s panel shall be individually contracted with OHCA. C. OHCA does not guarantee PROVIDER an enrollment level nor will OHCA pay for members who are not eligible or excluded from enrollment. D. PROVIDER may request a change in his/her capacity by submitting a written request signed by PROVIDER. This request is subject to review according to program standards. In the event PROVIDER requests a lower capacity, OHCA may lower the capacity by disenrolling members to achieve that number or allowing the capacity to adjust as members change their PCP/CM PCP or lose eligibility.