Reporting Provider Payment Rates Sample Clauses

The "Reporting Provider Payment Rates" clause requires parties to disclose the rates at which providers are compensated for their services. Typically, this involves regular submission of payment schedules or rate summaries to a designated party, ensuring transparency in financial arrangements. By mandating the reporting of payment rates, the clause promotes accountability and helps prevent disputes over compensation, ultimately ensuring all parties have a clear understanding of provider remuneration.
Reporting Provider Payment Rates. (1) According to guidelines developed by the State, in consultation with health care providers and MCOs, each MCO must annually provide to the State information on reimbursement rates paid by the MCO to providers and vendors for administrative services under contract with the MCO, pursuant to Minnesota Statutes, § 256B.69, subd. 9b. In addition, each MCO must provide to the State in the form and manner specified by the State: (a) The amount of the payment made to the MCO under this section that is paid to health care providers for patient care; (b) Aggregate provider payment data, categorized by inpatient payments and outpatient payments, with the outpatient payments categorized by payments to primary care providers and non-primary care providers; (c) The process by which increases or decreases in payments made to the MCO under this section, that are based on actuarial analysis related to provider cost increases or decreases, or that are required by legislative action, are passed through to health care providers, categorized by payments to primary care providers and non-primary care providers; and (d) Specific information on the methodology used to establish provider reimbursement rates paid by the MCO. (2) The MCO agrees to participate in a workgroup with the STATE to provide input on the data collection format and parameters for the reporting requirements under 3.5.2.T (1). The scope of the data collection will include detailed provider reimbursement data, aggregate expenditure data based on service groupings, and narrative information. The MCO will submit the first phase of the provider payment data reporting beginning no later than July 1, 2010 and will include information on aggregate provider payment data, information on legislatively-mandated provider rate changes, and information and data on provider reimbursement rates and rate methodologies.
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Reporting Provider Payment Rates. (1) According to guidelines developed by the State, in consultation with health care providers and MCOs, each MCO must annually provide to the State information on reimbursement rates paid by the MCO to provider and vendors for administrative services under contract with the plan, pursuant to Minnesota Statutes, § 256B.69, subd. 9b (b). In addition, each MCO must provide to the State in the form and manner specified by the State: (2) The amount of the payment received from the STATE under this contract that is paid to health care providers for patient care; (3) Aggregate provider payment data, categorized by inpatient payments and outpatient payments, with the outpatient payments categorized by payments to primary care providers and nonprimary care providers; (4) The process by which increases or decreases in payments made to the plan under this section, that are based on actuarial analysis related to provider cost increases or decreases, or that are required by legislative action, are passed through to health care providers, categorized by payments to primary care providers and nonprimary care providers; and (5) Specific information on the methodology used to establish provider reimbursement rates paid by the MCO. (6) The MCO will submit the provider payment data report on August 15 of the Contract Year. This report will include aggregate provider payment data, information on legislatively mandated provider rate changes, and information and data on provider reimbursement rates and rate methodologies. (U) Dental CHIPRA Data Files Submission. In accordance with section 501(e) of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) to promote and improve access to dental services for children, the MCO shall submit quarterly data files to the STATE that include information about dental providers in the MCO’s network. The MCO must provide certification of the quarterly data at the same time that it submits the data or by the 5th day of the month following the month of submission. If for any reason the data needs to be corrected, a new data certification will be required. The data files shall comply with the specifications and submission guide outlined in the document entitled, “Insure Kids Now (IKN) Provider Data Submission Technical Information” modified by the STATE and posted on the DHS managed care website.
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Reporting Provider Payment Rates. According to guidelines developed by the State, in consultation with health care providers and MCOs, each MCO must annually provide to the State information on reimbursement rates paid by the MCO to provider types and vendors for administrative services under contract with the plan, pursuant to Minnesota Statutes, § 256B.69, subd. 9b. In addition, each MCO must provide to the State in the form and manner specified by the State: (A) The amount of the payment made to the plan under this section that is paid to health care providers for patient care; (B) Aggregate provider payment data, categorized by inpatient payments and outpatient payments, with the outpatient payments categorized by payments to primary care providers and non-primary care providers; (C) The process by which increases or decreases in payments made to the plan under this section, that are based on actuarial analysis related to provider cost increases or decreases, or that are required by legislative action, are passed through to health care providers, categorized by payments to primary care providers and non-primary care providers; and (D) Specific information on the methodology used to establish provider reimbursement rates paid by the MCO.‌
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Reporting Provider Payment Rates. According to guidelines developed by the STATE, in consultation with health care providers and MCOs, each MCO must annually provide to the STATE the following information: (1) Administrative expenses by category and subcategory consistent with administrative expense reporting to other state and federal regulatory agencies, by program; (2) Revenues by program, including investment income; (3) Non-administrative service payments, provider payments, and reimbursement rates by provider type or service category, by program, paid by the managed care plan under this section or the county-based purchasing plan under Minnesota Statutes, § 256B.692 to providers and vendors for administrative services under contract with the plan, including but not limited to: (a) Individual-level provider payment and reimbursement rate data; (b) Provider reimbursement rate methodologies by provider type, by program, including a description of alternative payment arrangements and payments outside the claims process; (c) Data on implementation of legislatively mandated provider rate changes; and (d) Individual-level provider payment and reimbursement rate data and plan- specific provider reimbursement rate methodologies by provider type, by program, including alternative payment arrangements and payments outside the claims process, provided to the STATE under this subdivision are nonpublic data as defined in Minnesota Statutes, § 13.02; (4) Data on the amount of reinsurance or transfer of risk by program; and (5) Contribution to reserve, by program. (6) The MCO will submit the provider payment data report by August 15 of the Contract Year in a form and manner determined by the STATE in accordance with Minnesota Statutes, § 256B.69, subd. 9c. (7) In the event a report is published or released based on data provided under this subdivision, the STATE shall provide the report to the MCO thirty (30) days prior to the publication or release of the report. The MCO shall have thirty (30) days to review the report and provide comment to the STATE.
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Related to Reporting Provider Payment Rates

  • Interest Rates and Letter of Credit Fee Rates Payments and Calculations (a) Interest Rates. Except as provided in Section 2.13(c) and Section 2.15(a), all Obligations (except for the undrawn portion of the face amount of Letters of Credit) that have been charged to the Loan Account pursuant to the terms hereof shall bear interest at a per annum rate equal to the lesser of (i) the LIBOR Rate plus the Applicable Margin, or (ii) the maximum rate of interest allowed by applicable laws; provided, that following notice to Borrower in accordance with Section 2.15(a) hereof, all Obligations that have been charged to the Loan Account pursuant to the terms hereof shall bear interest at a per annum rate equal, during the duration of the circumstances described in Section 2.15(a), to the lesser of (A) the Base Rate plus the Applicable Margin as calculated pursuant to Section 2.15(a) or (B) the maximum rate of interest allowable by applicable laws.

  • Interest Rates; Benchmark Notification The interest rate on a Loan denominated in dollars may be derived from an interest rate benchmark that may be discontinued or is, or may in the future become, the subject of regulatory reform. Upon the occurrence of a Benchmark Transition Event, Section 2.14(b) provides a mechanism for determining an alternative rate of interest. The Administrative Agent does not warrant or accept any responsibility for, and shall not have any liability with respect to, the administration, submission, performance or any other matter related to any interest rate used in this Agreement, or with respect to any alternative or successor rate thereto, or replacement rate thereof, including without limitation, whether the composition or characteristics of any such alternative, successor or replacement reference rate will be similar to, or produce the same value or economic equivalence of, the existing interest rate being replaced or have the same volume or liquidity as did any existing interest rate prior to its discontinuance or unavailability. The Administrative Agent and its affiliates and/or other related entities may engage in transactions that affect the calculation of any interest rate used in this Agreement or any alternative, successor or alternative rate (including any Benchmark Replacement) and/or any relevant adjustments thereto, in each case, in a manner adverse to the Borrower. The Administrative Agent may select information sources or services in its reasonable discretion to ascertain any interest rate used in this Agreement, any component thereof, or rates referenced in the definition thereof, in each case pursuant to the terms of this Agreement, and shall have no liability to the Borrower, any Lender or any other person or entity for damages of any kind, including direct or indirect, special, punitive, incidental or consequential damages, costs, losses or expenses (whether in tort, contract or otherwise and whether at law or in equity), for any error or calculation of any such rate (or component thereof) provided by any such information source or service.

  • Non-Student Rates The Residence Fees payable under this Agreement are a special student rate for full-time students of the Institution. If the Resident ceases to be a full-time student of the Institution, and wishes to continue to occupy a Room: (i) the Resident must deliver a written request to the Manager no later than two (2) business days after ceasing to be a full-time student of the Institution, which the Manager may accept or reject in its sole and unfettered discretion, and (ii) if the request is accepted by the Manager, the Resident must pay within two (2) business days of receiving notice of that acceptance (a) any unpaid Residence Fees (whether or not otherwise due) and (b) a supplementary fee equal to the difference between (1) the product of the number of days remaining in the Term as of two (2) business days after the date on which the Resident ceases to be a full-time student of the Institution and the daily conference rate then charged by the Manager for rooms in the Residence, minus (2) the Residence Fees.

  • Interest Rates and Payment Dates (a) Each Eurodollar Loan shall bear interest for each day during each Interest Period with respect thereto at a rate per annum equal to the Eurodollar Rate determined for such day plus the Applicable Margin. (b) Each ABR Loan shall bear interest at a rate per annum equal to the ABR plus the Applicable Margin. (i) If all or a portion of the principal amount of any Loan or Reimbursement Obligation shall not be paid when due (whether at the stated maturity, by acceleration or otherwise), all outstanding Loans and Reimbursement Obligations (whether or not overdue) shall bear interest at a rate per annum equal to (x) in the case of the Loans, the rate that would otherwise be applicable thereto pursuant to the foregoing provisions of this Section plus 2% or (y) in the case of Reimbursement Obligations, the rate applicable to ABR Loans under the Revolving Facility plus 2%, and (ii) if all or a portion of any interest payable on any Loan or Reimbursement Obligation or any commitment fee or other amount payable hereunder shall not be paid when due (whether at the stated maturity, by acceleration or otherwise), such overdue amount shall bear interest at a rate per annum equal to the rate then applicable to ABR Loans under the relevant Facility plus 2% (or, in the case of any such other amounts that do not relate to a particular Facility, the rate then applicable to ABR Loans under the Revolving Facility plus 2%), in each case, with respect to clauses (i) and (ii) above, from the date of such non-payment until such amount is paid in full (as well after as before judgment). (d) Interest shall be payable in arrears on each Interest Payment Date, provided that interest accruing pursuant to paragraph (c) of this Section shall be payable from time to time on demand.

  • Interest Rates Payments and Calculations (a) Interest Rates. From the Effective Date, all Obligations charged to the Loan Account with respect to the Loans shall, subject to Section 2.5(c)(ii), bear interest payable in cash on the Outstanding Amount at a rate per annum equal to ABR plus the Applicable Margin and shall be payable in accordance with Section 2.5(c).