ACO Compliance Plan Sample Clauses

ACO Compliance Plan. 1. The ACO shall have a compliance plan that includes at least the following elements:
Sample 1
AutoNDA by SimpleDocs
ACO Compliance Plan. 93 Section 15.02 CMS Monitoring and Oversight Activities 94 Section 15.03 ACO Compliance with Monitoring and Oversight Activities 95 Section 15.04 Compliance with Laws 95 Section 15.05 Certification of Data and Information 96 ARTICLE XVI Audits and Record Retention 96 Section 16.01 Right to Audit 96 Section 16.02 Maintenance of Records 97 ARTICLE XVII Remedial Action and Termination 98 Section 17.01 Remedial Action 98 Section 17.02 Termination of Agreement by CMS 100 Section 17.03 Termination of Agreement Performance Period by ACO 101 Section 17.04 Financial Settlement upon Termination 101 Section 17.05 Notifications to Participant Providers, Preferred Providers, and Beneficiaries upon Termination 102 ARTICLE XVIII Limitation on Review and Dispute Resolution 103 Section 18.01 Limitations on Review 103 Section 18.02 Dispute Resolution 104 ARTICLE XIX Miscellaneous 106 Section 19.01 Notifications and Submission of Reports 106 Section 19.02 Notice of Bankruptcy 107 Section 19.03 Severability 108 Section 19.04 Entire Agreement; Amendment 108 Section 19.05 Survival 108 Section 19.06 Precedence 109 Section 19.07 Change of ACO Name 109 Section 19.08 Prohibition on Assignment 110 Section 19.09 Change in Control 110 Section 19.10 Change in TIN 110 Section 19.11 Certification 110 Section 19.12 Execution in Counterpart 111 Appendix A: Beneficiary Alignment 113 Appendix B: ACO REACH Model Financial Methodology 130 Appendix C: Signed Attestation-based Voluntary Alignment 204 Appendix D: Quality Measures 208 Appendix E: Capitation Payment Mechanism: PCC Payment 209 Appendix F: Advanced Payment Option 235 Appendix G: Capitation Payment Mechanism: TCC Payment 250 Appendix H: Financial Guarantee 270 Exhibit A 278 Appendix I: 3-Day SNF Rule Waiver Benefit Enhancement 279 Appendix J: Telehealth Benefit Enhancement 285 Appendix K: Payment for Telehealth Services under Section 1899(l) 290 Appendix L: Post-Discharge Home Visits Benefit Enhancement 293 Appendix M: Care Management Home Visits Benefit Enhancement 297 Appendix N: Home Health Homebound Waiver Benefit Enhancement 301 Appendix O: Concurrent Care for Beneficiaries that Elect Medicare Hospice Benefit Enhancement 304 Appendix P: Part B Cost-Sharing Support Beneficiary Engagement Incentive 309 Appendix Q: Chronic Disease Management Reward Beneficiary Engagement Incentive ................................................................................................................................... 314 Appendix R: Non-D...
Sample 1

Related to ACO Compliance Plan

  • HIPAA Compliance If this Contract involves services, activities or products subject to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Contractor covenants that it will appropriately safeguard Protected Health Information (defined in 45 CFR 160.103), and agrees that it is subject to, and shall comply with, the provisions of 45 CFR 164 Subpart E regarding use and disclosure of Protected Health Information.

  • SOX Compliance The Company has taken all actions it deems reasonably necessary or advisable to take on or prior to the date of this Agreement to assure that, upon and at all times after the Effective Date, it will be in compliance in all material respects with all applicable provisions of the Sxxxxxxx-Xxxxx Act of 2002 and all rules and regulations promulgated thereunder or implementing the provisions thereof. (the “Sxxxxxxx-Xxxxx Act”) that are then in effect and will take all action it deems reasonably necessary or advisable to assure that it will be in compliance in all material respects with other applicable provisions of the Sxxxxxxx-Xxxxx Act not currently in effect upon it and at all times after the effectiveness of such provisions.

  • Compliance Program The Company has established and administers a compliance program applicable to the Company, to assist the Company and the directors, officers and employees of the Company in complying with applicable regulatory guidelines (including, without limitation, those administered by the FDA, the EMA, and any other foreign, federal, state or local governmental or regulatory authority performing functions similar to those performed by the FDA or EMA); except where such noncompliance would not reasonably be expected to have a Material Adverse Effect.

  • FCPA Compliance The Company has not and, to the Company’s actual knowledge, none of its employees or agents at any time during the last five years have (i) made any unlawful contribution to any candidate for foreign office, or failed to disclose fully any contribution in violation of law, or (ii) made any payment to any federal or state governmental officer or official, or other person charged with similar public or quasi-public duties, other than payments required or permitted by the laws of the United States or any jurisdiction thereof.

  • FDA Compliance The Company: (A) is and at all times has been in material compliance with all statutes, rules or regulations of the FDA and other comparable governmental entities applicable to the ownership, testing, development, manufacture, packaging, processing, use, distribution, marketing, labeling, promotion, sale, offer for sale, storage, import, export or disposal of any product under development, manufactured or distributed by the Company (“Applicable Laws”); (B) has not received any FDA Form 483, notice of adverse finding, warning letter, untitled letter or other correspondence or notice from the FDA or any governmental entity alleging or asserting material noncompliance with any Applicable Laws or any licenses, certificates, approvals, clearances, exemptions, authorizations, permits and supplements or amendments thereto required by any such Applicable Laws (“Authorizations”); (C) possesses all material Authorizations and such Authorizations are valid and in full force and effect and the Company is not in material violation of any term of any such Authorizations; (D) has not received notice of any claim, action, suit, proceeding, hearing, enforcement, investigation, arbitration or other action from the FDA or any governmental entity or third party alleging that any product operation or activity is in material violation of any Applicable Laws or Authorizations and has no knowledge that the FDA or any governmental entity or third party is considering any such claim, litigation, arbitration, action, suit, investigation or proceeding; (E) has not received notice that the FDA or any governmental entity has taken, is taking or intends to take action to limit, suspend, modify or revoke any material Authorizations and has no knowledge that the FDA or any governmental entity is considering such action; and (F) has filed, obtained, maintained or submitted all material reports, documents, forms, notices, applications, records, claims, submissions and supplements or amendments as required by any Applicable Laws or Authorizations and that all such reports, documents, forms, notices, applications, records, claims, submissions and supplements or amendments were materially complete and correct on the date filed (or were corrected or supplemented by a subsequent submission).

  • ADA Compliance A. The Americans with Disabilities Act (42 U.S.C. § 12101, et seq.) and the regulations thereunder (28 C.F.R. § 35.130) (“ADA”) prohibit discrimination against persons with disabilities by the State, whether directly or through contractual arrangements, in the provision of any aid, benefit, or service. As a condition of receiving this Agreement, the Company certifies that services, programs, and activities provided under this Agreement are and will continue to be in compliance with the ADA.

  • AML Compliance The Dealer Manager represents to the Company that it has established and implemented anti-money laundering compliance programs in accordance with applicable law, including applicable FINRA Conduct Rules, Exchange Act Regulations and the USA PATRIOT Act, specifically including, but not limited to, Section 352 of the International Money Laundering Abatement and Anti-Terrorist Financing Act of 2001 (the “Money Laundering Abatement Act,” and together with the USA PATRIOT Act, the “AML Rules”) reasonably expected to detect and cause the reporting of suspicious transactions in connection with the offering and sale of the Offered Shares. The Dealer Manager further represents that it is currently in compliance with all AML Rules, specifically including, but not limited to, the Customer Identification Program requirements under Section 326 of the Money Laundering Abatement Act, and the Dealer Manager hereby covenants to remain in compliance with such requirements and shall, upon request by the Company, provide a certification to the Company that, as of the date of such certification (a) its AML Program is consistent with the AML Rules and (b) it is currently in compliance with all AML Rules, specifically including, but not limited to, the Customer Identification Program requirements under Section 326 of the Money Laundering Abatement Act.

  • Anti-Corruption Compliance (a) For the past three (3) years, neither the Company nor any of its Subsidiaries, nor, to the knowledge of the Company, any director, officer, employee or agent acting on behalf of the Company or any of the Company’s Subsidiaries, has offered or given anything of value to: (i) any official or employee of a Governmental Authority, any political party or official thereof, or any candidate for political office or (ii) any other Person, in any such case while knowing that all or a portion of such money or thing of value will be offered, given or promised, directly or indirectly, to any official or employee of a Governmental Authority or candidate for political office, in each case in violation of the Anti-Bribery Laws.

Time is Money Join Law Insider Premium to draft better contracts faster.