Common use of Utilization Reports Clause in Contracts

Utilization Reports. Utilization Reports assist OMPP in monitoring the Contractor’s utilization trends to assess its stability and continued ability to offer health care services to its members. Examples of Utilization Reports to be submitted by the Contractor, in accordance with the terms of the MCE Reporting Manuals and this Scope of Work, including but are not limited to:  Program Integrity Plan;  Prior Authorization Report;  Emergency Department Co-payment Waivers obtained through the 24-Hour Nurse Call Line;  Pharmacy Utilization Reports (HIP only);  Capitation Rate Calculation Sheet; and  Maternity Capitation Rate Calculation Sheet.

Utilization Reports. Utilization Reports assist OMPP in monitoring the Contractor’s utilization trends to assess its stability and continued ability to offer health care services to its members. Examples of Utilization Reports to be submitted by the Contractor, in accordance with the terms of the MCE Reporting Manuals Manual and this Scope of Work, including but are not limited to:  Program Integrity Plan;  Prior Authorization Report;  Emergency Department Co-payment Waivers obtained through the 24-Hour Nurse Call Line;  Pharmacy Utilization Reports (HIP only);  Capitation Rate Calculation Sheet; and  Maternity Capitation Rate Calculation Sheet.