Library: Policy

317:25-9-3. Reimbursement

Issued 7-1-10

(a) In order to be eligible for payment, HAN's must have on file with OHCA, an approved Provider Agreement. Through this agreement, the HAN assures that OHCA's requirements are met and assures compliance with all applicable Federal and State regulations.  These agreements are renewed annually with each provider.

(b) The HAN will be reimbursed a per member per month (PMPM) rate based on the number of member months paid to the PCPs affiliated with the HAN.  OHCA reserves the right to limit reimbursement based on availability of funds.