Medicare risk definition
Examples of Medicare risk in a sentence
A mandatory Medicare risk HMO for retirees (currently those in the Health First coverage area of Greater New York).
Health maintenance organizations (HMOs) and other types of managed care plans have long participated in the Medicare program, beginning with private health plan contracts in the 1970s and the Medicare risk contract program in the 1980s.
The Joint Practice Management Board shall approve, disapprove, or amend all managed care, PPO, HMO, Medicare risk and other provider contracts negotiated by INMD.
If the retiree opts to enroll in such a plan, the District’s contribution to the premium shall be limited to the cost of the most expensive Medicare risk HMO the District provides to retirees within the CLPCCD service area.
As an overview, the Master Agreement describes the contractual relationships which may exist between NHN and NAMM regarding the relationships between NAMM and NHN-affiliated general Hospitals and/or affiliated Physician Organizations and Physician Hospital Organizations ("PHOs") for the purpose of Medicare risk contracting.
If the retiree opts to enroll in such a plan, the District’s contribution to the premium shall be limited to the cost of the most expensive Medicare risk Health Maintenance Organization (HMO) plan the District provides to retirees within the ▇▇▇▇▇▇-Las Positas Community College District Service Area.
The parties acknowledge and agree that, during the two (2) year period following the Commencement Date of this Agreement, Health Plan may reasonably withhold its consent if the proposed sale or change of control is to an individual, entity or group that operates HMOs or holds Medicare risk contracts with HCFA.
The JOB shall have veto authority over all managed care, PPO, HMO, Medicare risk and other provider contracts.
In the event Client chooses to have Inovalon serve as its CMS third-party Risk Adjustment Data Submitter as outlined under Section 2(a), for processing, formatting, and submission of Client’s Medicare risk adjustment data, Inovalon shall charge Client a monthly fee (the “Monthly RAPS File Submission Fee”) equal to $5,700.
During the term of this Agreement, including any renewal term, Medical Group and its Participating Providers agree not to, directly or indirectly, seek or obtain a contract with the Health Care Finance Administration for the purpose of offering a Medicare- risk program or benefit plan.