30A. The Contractor must comply with any final decision upon judicial review. The Contractor must designate an appeal coordinator to act as a liaison between the Contractor and Board of Hearings. 3. If an Appeal is filed with both the IRE and the Board of Hearings, any determination in favor of the Enrollee will bind the Contractor and will require payment by the Contractor for the service or item in question granted in the Enrollee’s favor which is closest to the Enrollee’s relief requested on Appeal.
Appears in 4 contracts
Samples: Three Way Contract for Capitated Model, Three Way Contract for Capitated Model, Three Way Contract for Capitated Model
