Administration and Contract Management Sample Clauses

Administration and Contract Management. The HMO must comply, to the satisfaction of HHSC, with (1) all provisions set forth in this Contract, and (2) all applicable provisions of state and federal laws, rules, regulations, and waivers.
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Administration and Contract Management. The MCO must comply, to the satisfaction of HHSC, with: (1) all provisions set forth in this Contract, and (2) all applicable provisions of state and federal laws, rules, regulations, and waiver agreements with the Centers for Medicare and Medicaid Services (CMS).
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Administration and Contract Management. A. Organization, Staffing, and Key Personnel 1. Structure and Governance The Contractor shall: a. Meet the definition of an MCO, as set forth in Section 1; b. Be located within the United States;
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Administration and Contract Management. ‌ A. Managed Care Contact The PCC shall identify a Managed Care Contact to represent the PCC on all matters related to the fulfillment of the PCC Contract. B. Notification of PCC Changes 1. Notice to EOHHS The PCC shall notify EOHHS, in writing, at least 14 days prior to any changes affecting delivery of care, the administration of its PCC practice, or its performance of PCC Contract requirements. Such changes include, but are not limited to the following: a. Voluntarily withdrawing from the PCC Plan or the MassHealth program for any reason; b. A change in any information contained in the PCC Plan Provider application or other application submitted by the PCC to EOHHS; c. A change of address; d. A change in the Managed Care Contact required in Section 3.1.A.; and e. A change in the PCC’s hours of operation or designation of PCC specialty. 2. Notice to PCC Plan Enrollees The PCC shall provide notice to its PCC Plan Enrollees in advance of any changes listed in Section 3.1.B.1.a. and c. above.
Sample 1
Administration and Contract Management. ‌ EOHHS shall: A. Provide the PCC with information on how to contact relevant EOHHS units and vendors for assistance with issues such as billing, prior authorization, covered services and other PCC responsibilities; B. Conduct ongoing data and record reviews to help ensure the delivery of services in the most appropriate setting in accordance with medical standards and protocols; C. Conduct quality management activities such as HEDIS measurement and Member satisfaction surveys to assess the effectiveness of the PCC Plan performance and make the results available to PCCs; D. Pay the PCC an enhanced rate for certain Primary Care services provided to the PCC’s Enrollees (see Sections 5.1 and 5.2); E. Notify the PCC of all programmatic and policy changes that may affect the PCC's participation in MassHealth; and F. Reserve the right to change the current MassHealth program, including but not limited to covered services, Member eligibility, cost-sharing, or PCC Plan programmatic features upon written notice to the PCC of any such changes.
Sample 1
Administration and Contract Management. ‌ Organization, Staffing and Key Personnel‌ 1. Structure and Governance The Contractor shall: Meet the definition of an MCO, as set forth in Section 1; Be located within the United States; Not have, nor may any of the Contractor’s Material Subcontractors have, any financial, legal, contractual or other business interest in EOHHS’s enrollment broker, or in such vendor’s subcontractors, if any; Not have, nor may any of the Contractor’s Material Subcontractors have, any financial, legal, contractual or other business interest in EOHHS’s External Quality Review Organization Contractor, or in such vendor’s subcontractors, if any; Establish and maintain interdepartmental structures and processes to support the operation and management of its MassHealth line of business in a manner that fosters integration of physical and behavioral health service provision. The provision of all services shall be based on prevailing clinical knowledge and the study of data on the efficacy of treatment, when such data is available. The Contractor’s Behavioral Health Services and activities should be integral to the Plan, Enrollee-focused, and oriented to recovery and rehabilitation from behavioral health conditions. On an ad hoc basis when changes occur or as directed by EOHHS, the Contractor shall submit to EOHHS an overall organizational chart that includes senior and mid-level managers for the organization. The organizational chart must include the organizational staffing for Behavioral Health Services and activities. If such Behavioral Health Services and activities are provided by a Material Subcontractor, the Contractor shall submit the organizational chart of the behavioral health Material Subcontractor which clearly demonstrates the relationship with the Material Subcontractor and the Contractor’s oversight of the Material Subcontractor. For all organizational charts, the Contractor shall indicate any staff vacancies and provide a timeline for when such vacancies are anticipated to be filled; The Contractor shall submit to EOHHS a list of its Board of Directors as of the Contract Effective Date and an updated list of its Board of Directors whenever any changes are made. 2. Key Personnel and Other Staff The following roles shall be Key Personnel: 1) The Contractor’s MassHealth Executive Director, who shall have primary responsibility for the management of this contract and shall be authorized and empowered to represent the Contractor regarding all matters pertaining to this...
Sample 1

Related to Administration and Contract Management

  • Contract Management To ensure full performance of the Contract and compliance with applicable law, the System Agency may take actions including: a. Suspending all or part of the Contract; b. Requiring the Grantee to take specific corrective actions in order to remain in compliance with term of the Contract; c. Recouping payments made to the Grantee found to be in error; d. Suspending, limiting, or placing conditions on the continued performance of the Project; e. Imposing any other remedies authorized under this Contract; and f. Imposing any other remedies, sanctions or penalties permitted by federal or state statute, law, regulation, or rule.

  • Agreement Administration SBBC has delegated authority to the Superintendent of Schools or his/her designee to take any actions necessary to implement and administer this Agreement.

  • Administration and Risk Management Employees of Federated Advisory Services Company provide support to portfolio managers and other employees of affiliated advisers. Such services may include development of risk management programs, production of portfolio and compliance reports for clients and/or fund Boards, coordination of client portfolios and related fixed income trade execution implementation and administration, completion of required broker and custody documentation, development and documentation of operational procedures, coordination of proxy voting activities, on-site support of hardware and software, etc.”

  • Account Management 15.1 The Contractor is required to provide a dedicated Strategic Account Manager who will be the main point of contact for the Authority. The Strategic Account Manager will:  Attend quarterly, or as otherwise agreed, review meetings with the Authority, in person at the Authority’s premises or other locations as determined by the Authority  Attend regular catch-up meetings with the Authority, in person or by telephone/videoconference  Resolve any on-going operational issues which have not been resolved by the Contractor or Account Manager(s) and therefore require escalation  Ensure that the costs involved in delivering the Framework are as low as possible, whilst always meeting the required standards of service and quality. 15.2 The Contractor is also required to provide a dedicated Account Manager for every Framework Public Body using the Framework, if required by the Framework Public Body. The service to be provided will be agreed with each Framework Public Body and may include:  regular review meetings, which may be in person at the Framework Public Bodies’ premises, by video-conference, webinar or telephone  Regular catch-up meetings/telephone calls to discuss current and on-going issues  Work with the Framework Public Bodies Contract Manager to resolve any on-going operational issues  Work with the Framework Public Body ’s Contract Manager to pro-actively introduce initiatives to:  Create efficiencies in processes  Improve the environmental performance of the contract. 15.3 It is expected that end users will contact the Contractor in the first instance to resolve any operational issues. The Account Manager will act as a point of escalation to be contacted either by end users or by the Framework Public Body’s Contract Manager should there be issues that the Contractor needs to resolve. 15.4 Further details of the roles and responsibilities of the Contractor, Authority and Framework Public Bodies are provided in Schedule 4 – Management Arrangements

  • Administration Services When a medical prescription drug is administered by infusion, the administration of the prescription drug may be covered separately from the prescription drug. See Infusion Therapy - Administration Services in the Summary of Medical Benefits for benefit limits and the amount you pay. Prescription drugs that are self-administered are not covered as a medical benefit but may be covered as a pharmacy benefit. Please see Pharmacy Prescription Drugs and Diabetic Equipment or Supplies – Pharmacy Benefits section above for additional information. For some medical prescription drugs, after the first administration, coverage may be limited to certain locations (for example, a designated outpatient or ambulatory service facility, physician’s office, or your home), provided the location is appropriate based on your medical status. For a list of medical prescription drugs that are subject to this Site of Care Program, visit our website. Preauthorization may be required to determine medical necessity as well as appropriate site of care. If we deny your request for preauthorization, or you disagree with our determination for the appropriate site of care, you can submit a medical appeal. See Appeals in Section 5 for information on how to file a medical appeal.

  • STATEWIDE CONTRACT MANAGEMENT SYSTEM If the maximum amount payable to Contractor under this Contract is $100,000 or greater, either on the Effective Date or at any time thereafter, this section shall apply. Contractor agrees to be governed by and comply with the provisions of §§00-000-000, 00-000-000, 00-000-000, and 00- 000-000, C.R.S. regarding the monitoring of vendor performance and the reporting of contract information in the State’s contract management system (“Contract Management System” or “CMS”). Contractor’s performance shall be subject to evaluation and review in accordance with the terms and conditions of this Contract, Colorado statutes governing CMS, and State Fiscal Rules and State Controller policies.

  • Agreement Administration and Communications A. Under this Agreement, either of the representatives of the Judicial Council identified below will monitor the Work and act as the Judicial Council’s liaisons with the Contractor: i. The Meeting Planner will be MPname. B. The Judicial Council may reallocate funds between the estimated amounts set forth in Exhibit G, without an Amendment to this Agreement, as long as the total amount to be paid under this Agreement does not exceed the Contract Amount. C. All requests and communications about the Work to be performed under this Agreement, including signing of any BEO’s, shall be made through the Meeting Planner or his or her designee or successor. D. Any Notice from the Contractor to the Judicial Council shall be delivered to the following address: MP name, Meeting Planner Judicial Council of California 000 Xxxxxx Xxxx Xxxxxx Xxx Xxxxxxxxx, XX 00000-0000 E. Notice to the Contractor shall be directed to the Contractor’s liaison, Attn, or his or her designee or successor, at the following address: Attn: Ktr DifferentAddress1 DifferentAddress2

  • Program Administration An activity relating to the general management, oversight and coordination of community development programs. Costs directly related to carrying out eligible activities are not included.

  • Program Management 1.1.01 Implement and operate an Immunization Program as a Responsible Entity 1.1.02 Identify at least one individual to act as the program contact in the following areas: 1. Immunization Program Manager;

  • Construction Management Services a. A-E may be required to review and recommend approval of submittals, shop drawings, Request for Information (RFI) and/or calculations for temporary structures such as trench shoring, false work and other temporary structural forms. b. A-E may be required to review and advise the County Representative on the overall project schedule, including staging and completion dates, duration, milestones, and interfaces. Immediately notify Representative if the proposed work schedule does not conform to the contract documents, including the plans, specifications, and permits or that may require special inspection or testing, or work stoppage. c. Review on a monthly basis the project schedule and/or Critical Path Method (CPM) schedule submitted by the Construction Contractor. Make recommendations concerning the Construction Contractor’s adherence thereto. Recommend possible solutions to scheduling problems so as to complete the project on time, within budget, and in accordance with the contract drawings and specifications. d. Review scope of work and identify potential contract change orders. Prepare independent cost estimates for any changes resulting from design revisions or change in field conditions. Prepare and recommend for approval all contract change orders. e. Evaluate the merit of any potential claims or requests for equitable adjustment submitted by the Construction Contractor. Prepare analysis of potential claims include recommendations regarding settlement of the claims. f. Assist County staff in project related issues with other Agencies, or departments, engineering and material testing support firms, CEQA consultants, utilities agencies, etc. g. Assist in community outreach meetings and media relations h. Review for acceptance/approval of Storm Water Pollution Prevention Plan (SWPPP) in accordance with the general Permit of Discharges of Storm Water Associated with Construction Activity (Construction General Permit, including dewatering/diversion plans per the State’s DeMinimus Permit).

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