N.C. Gen. Stat. § 131E-277. Direct or indirect sharing of substantial financial risk: Provider Sponsored Organization Licensing – North Carolina

Status: Enacted
Year Enacted: 1998
File: Download

In order for sponsoring providers to directly or indirectly share substantial financial risk in the PSO, the PSO shall either provide services under its Medicare contract at a capitated rate, provide designated services or classes of services under its Medicare contract for a predetermined percentage of premium or revenue from the Medicare program, use significant financial incentives for its sponsoring providers, as a group to achieve specified cost-containment and utilization management goals, agree to provide a complex or extended course of treatment that requires the substantial coordination of care, or agree to any other arrangement that the Division determines to provide for the sharing of substantial financial risk.


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