HPHC_contract_nov2010

3/20/2013

applicable to the services rendered to covered members. 20. Section 7 requires compliance with the Plan’s … with the Provider Manual and other Plan Policies and Procedures. Section 1.25 of Appendix A indicates how … request. Note that the Plan requires the Group to provide at least 60 days notice of a Provider’s …

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FallonAnalysis2007

3/20/2013

compliance with all Fallon policies and procedures, including the Plan Provider Manual (Manual). Note … the impact of this requirement on those relationships. 17. Section 2.38 requires compliance with the Plan … are participating with the Plan. 20. Section 2.45 requires compliance with Fallon’s Utilization Review programs …

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NetworkHealthAnalysis2007

3/20/2013

while accepting new patients from other plans. 15. Article VI requires compliance with the Plan’s … Agreement with Network Health (“Plan”). It is not the purpose of this document to make recommendations … traditionally offered a plan for Medicaid enrollees known as MassHealth, pursuant to a demonstration waiver …

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Tufts_Analysis_2012

3/20/2013

Analysis 2012 (00075041).DOC Summary And Analysis Of The Tufts Health Plan Physician/Nurse …. SUMMARY AND ANALYSIS OF THE TUFTS HEALTH PLAN PHYSICIAN/NURSE PRACTITIONER HEALTH SERVICES … Practitioner Agreement with Tufts Health Plan (Tufts). It is not the purpose of this document to make …

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Aetna_analysis_2012

3/20/2013

. Section 5.0 – Compliance with Policies. 1. Section 5.1 obligates the physician to comply with Plan … with Aetna Health Inc. (the “Plan” or “Aetna”). It is not the purpose of this document to make …., a commercial insurer, offers benefit plans under which enrollees are entitled to receive coverage for health …

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CIGNA_analysis_2012

3/20/2013

of the Addendum do not apply to services covered under self-funded plans. Clarification is warranted as to how … providers are advised by Cigna that a patient is a participant in a self-funded plan and therefore exempt … paragraph of this Agreement requires compliance with the terms of both the Agreement and Cigna’s …

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Prescription Monitoring Program: Proposed Regulations (pdf)

2/15/2013

Enhancement of the Massachusetts PMP is a prominent goal of the Commonwealth’s Substance Abuse Strategic Plan … in the Commonwealth. DCP plans to hold a public hearing on the proposed amendments in March 2013 … by the Commissioner or designee to ensure compliance with the requirements of 105 CMR 700.012(D) and (E). (4 …

/Advocacy/State-Advocacy/Prescription-Monitoring-Program--Proposed-Regulations-(pdf)/

Multiple Fee Schedules, Waivers, and Cash Discounts (Word)

2/14/2013

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Success Story: Professional Boundaries

1/21/2013

with unfailing support to all requests with respect to credentialing renewals and verification of compliance … major managed care plans, including two of the most important. On my appeal and with the help of PHS …, these plans reversed their initial decisions to deny my credentials. I was accepted as a contracted provider …

/Physician_Health_Services/Helping_Yourself_and_Others/Success_Story__Professional_Boundaries/

RosenbergPres2012 (PDF)

11/16/2012

duties? Marketing? Teaching? Research?  Location – are there multiple sites now? Or planned …/compliance/physician-education/index.asp 23 BENEFITS  Professional expenses – typically, state … share of premiums  Individual, 2-person, or family plan, p , y p  Retirement plans …

/Continuing-Education-and-Events/Conference-Proceeding-Archive/RosenbergPres2012-(PDF)/