Affirmative Statement
MedPOINT Management, on behalf of its contracted IPAs and hospital groups, affirms that it encourages appropriate utilization of medically necessary member care and discourages under-utilization of services by the following statements:
- UM decision making is based only on appropriateness of care and services and existence of coverage
- MPM does not specifically reward practitioners or other individuals for issuing denials of coverage or service care
- Financial incentives for UM decision makers do not encourage decisions that result in under-utilization
- Providers and practitioners are not prohibited from acting on behalf of the member
- Physicians cannot be penalized in any manner for requesting or authorizing appropriate medical care
- Practitioners are ensured independence and impartiality in making referral decisions that will not influence: hiring, compensation, termination, promotion or any similar matters