Participating Plan Risk Arrangements Sample Clauses
The Participating Plan Risk Arrangements clause defines how financial risk and responsibility are shared between parties involved in a health plan, such as providers and insurers. Typically, this clause outlines the methods for allocating costs, setting performance benchmarks, and determining payments or penalties based on the actual healthcare expenses incurred by plan participants. By establishing clear rules for risk-sharing, the clause helps align incentives, manage costs, and reduce disputes over financial obligations within the health plan arrangement.
Participating Plan Risk Arrangements. CMS and the Commonwealth shall require each Participating Plan to provide a detailed description of its risk arrangements with providers under subcontract with the Participating Plan. This description shall be made available to Plan Enrollees upon request. It will not be permissible for any incentive arrangements to include any payment or other inducement that serves to withhold, limit or reduce necessary medical or non-medical services to Enrollees.
Participating Plan Risk Arrangements. CMS and California shall require each Participating Plan to provide a detailed description of its risk arrangements with providers under subcontract with the Participating Plan. This description shall be made available to plan enrollees upon request. It will not be permissible for any incentive arrangements to include any payment or other inducement that serves to withhold, limit or reduce necessary medical or non-medical services to enrollees.
Participating Plan Risk Arrangements. CMS and DMAS shall require each Participating Plan to provide a detailed description of its risk arrangements with providers under subcontract with the Participating Plan. This description shall be made available to Plan Enrollees upon request. It will not be permissible for any incentive arrangements to include