Regional Generic Provider Agreement - Ohio Department of Job and ...

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APPENDIX F REGIONAL RATES 1. PREMIUM RATES WITHOUT THE AT-RISK PAYMENT AMOUNTS FOR 01/01/08 THROUGH 06/30/08 SHALL BE AS FOLLOWS: An at-risk amount of 1% is applied to the MCP rates. The status of the at-risk amount is determined in accordance with Appendix O, performance incentives. MCP: SAMPLE SERVICE REGIONAL HF/HST HF/HST HF/HST HF/HST HF/HST HF HF HF HST Delivery ENROLLMENT STATUS Age < 1 Age 1 Age 2-13 Age 14-18 Age 14-18 Age 19-44 Age 19-44 Age 45 Age 19-64 Payment AREA Male Female Male Female and over Female Southwest Mandatory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 West Central Mandatory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 List of Eligible Assistance Groups (AGs) Healthy Families: - MA-C Categorically eligible due to TANF cash - MA-T Children under 21 - MA-Y Transitional Medicaid Healthy Start: - MA-P Pregnant Women and Children For the SFY 2008 contract period, MCPs will be put-at risk for a portion of the premiums received for members in counties they served as of January 1, 2006, provided the MCP has participated in the program for more than twenty-four months. MCPs will be put at-risk for a portion of the premiums received for members in counties they began serving after January 1, 2006, beginning with the MCP's twenty-fifth month of membership in each county's region. MCP's regional counties at risk: Butler and Hamilton. Page 1 of 6
APPENDIX F REGIONAL RATES 2. AT-RISK AMOUNTS FOR 01/01/08 THROUGH 06/30/08 SHALL BE AS FOLLOWS: An at-risk amount of 1% is applied to the MCP rates. The status of the at-risk amount is determined in accordance with Appendix O, performance incentives MCP: SAMPLE SERVICE REGIONAL HF/HST HF/HST HF/HST HF/HST HF/HST HF HF HF HST Delivery ENROLLMENT STATUS Age < 1 Age 1 Age 2-13 Age 14-18 Age 14-18 Age 19-44 Age 19-44 Age 45 Age 19-64 Payment AREA Male Female Male Female and over Female Southwest Mandatory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 West Central Mandatory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 List of Eligible Assistance Groups (AGs) Healthy Families: - MA-C Categorically eligible due to TANF cash - MA-T Children under 21 - MA-Y Transitional Medicaid Healthy Start: - MA-P Pregnant Women and Children For the SFY 2008 contract period, MCPs will be put-at risk for a portion of the premiums received for members in counties they served as of January 1, 2006, provided the MCP has participated in the program for more than twenty-four months. MCPs will be put at-risk for a portion of the premiums received for members in counties they began serving after January 1, 2006, beginning with the MCP's twenty-fifth month of membership in each county's region. MCP's regional counties at risk: Butler and Hamilton. Page 2 of 6
Page 1 and 2: Baseline Covered Families and Child
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Page 45: APPENDIX E RATE METHODOLOGY CFC ELI
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Appendix H Covered Families and Chi
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Appendix H Covered Families and Chi
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Appendix H Page 10 ensure that the
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General Hospital 1 Hospital System
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Minimum Provider Panel Requirements
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Minimum Provider Panel Requirements
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General Hospital 1 Total Required H
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PCPs Capacity 1 North East Central
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County Capacity 1 Central Region -
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PCPs Capacity 1 Total Required Adam
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County Capacity 1 North West Region
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Provider Types Pediatricians 4 Nort
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Provider Types Pediatricians 4 Tota
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Provider Types Pediatricians 4 Sout
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Provider Types Pediatricians 4 Nort
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Appendix I Covered Families and Chi
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Appendix I Covered Families and Chi
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Appendix J Page 2 h. Prompt Pay Rep
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Appendix J Page 4 If the financial
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Appendix J Page 6 Penalty for nonco
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Appendix J Page 8 6. NOTIFICATION O
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Appendix K Covered Families and Chi
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Appendix L Covered Families and Chi
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Appendix M Covered Families and Chi
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Appendix N Covered Families and Chi
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Appendix O Covered Families and Chi
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Appendix P Covered Families and Chi
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Appendix P Covered Families and Chi
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Regional Generic Provider Agreement - Ohio Department of Job and ...

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