Common use of Administrative remedies Clause in Contracts

Administrative remedies. (1) At its discretion, HHSC may impose one (1) or more of the following remedies for each item of material noncompliance and will determine the scope and severity of the remedy on a case-by-case basis: (i) Assess liquidated damages in accordance with Attachment B-3, “Liquidated Damages Matrix;” (ii) Conduct accelerated monitoring of the MCO. Accelerated monitoring includes more frequent or more extensive monitoring by HHSC or its agent; (iii) Require additional, more detailed, financial and/or programmatic reports to be submitted by MCO; (iv) Require additional and/or more detailed financial and/or programmatic audits or other reviews of the MCO; (v) Decline to renew or extend the Contract; (vi) Appoint temporary management under the circumstances described in 42 C.F.R. §438.706; (vii) Initiate disenrollment of a Member or Members; (viii) Suspend enrollment of Members; (ix) Withhold or recoup payment to MCO; (x) Require forfeiture of all or part of the MCO’s bond; or (xi) Terminate the Contract in accordance with Section 12.03, “Termination by HHSC.” (2) For purposes of the Contract, an item of material noncompliance means a specific action of MCO that: (i) Violates a material provision of the Contract; (ii) Fails to meet an agreed measure of performance; or (iii) Represents a failure of MCO to be reasonably responsive to a reasonable request of HHSC relating to the Scope of Work for information, assistance, or support within the timeframe specified by HHSC. (3) HHSC will provide notice to MCO of the imposition of an administrative remedy in accordance with this Section, with the exception of accelerated monitoring, which may be unannounced. HHSC may require MCO to file a written response in accordance with this Section. (4) The Parties agree that a State or Federal statute, rule, regulation, or Federal guideline will prevail over the provisions of this Section unless the statute, rule, regulation, or guidelines can be read together with this Section to give effect to both.

Administrative remedies. (1) At its discretion, HHSC may impose one (1) or more of the following remedies for each item of material noncompliance and will determine the scope and severity of the remedy on a case-by-case basis: (iA) Assess liquidated damages in accordance with Attachment B-3B-5 to the HHSC Managed Care Contract, “Liquidated Damages Matrix;” (iiB) Conduct accelerated monitoring of the MCOHMO. Accelerated monitoring includes more frequent or more extensive monitoring by HHSC or its agent; (iiiC) Require additional, more detailed, financial and/or programmatic reports to be submitted by MCOHMO; (iv) Require additional and/or more detailed financial and/or programmatic audits or other reviews of the MCO; (vD) Decline to renew or extend the Contract; (viE) Appoint temporary management under the circumstances described in 42 C.F.R. §438.706management; (viiF) Initiate disenrollment of a Member or Members; (viiiG) Suspend enrollment of Members; (ixH) Withhold or recoup payment to MCOHMO; (xI) Require forfeiture of all or part of the MCOHMO’s bond; or (xiJ) Terminate the Contract in accordance with Section 12.03, (“Termination by HHSC”).” (2) For purposes of the Contract, an item of material noncompliance means a specific action of MCO HMO that: (iA) Violates a material provision of the Contract; (iiB) Fails to meet an agreed measure of performance; or (iiiC) Represents a failure of MCO HMO to be reasonably responsive to a reasonable request of HHSC relating to the Scope of Work Services for information, assistance, or support within the timeframe specified by HHSC. (3) HHSC will provide notice to MCO HMO of the imposition of an administrative remedy in accordance with this Section, with the exception of accelerated monitoring, which may be unannounced. HHSC may require MCO HMO to file a written response in accordance with this Section. (4) The Parties agree that a State or Federal statute, rule, regulation, or Federal guideline will prevail over the provisions of this Section unless the statute, rule, regulation, or guidelines can be read together with this Section to give effect to both.

Administrative remedies. (1) At its discretion, HHSC may impose one (1) or more of the following remedies for each item of material noncompliance and will determine the scope and severity of the remedy on a case-by-by- case basis: (i) Assess liquidated damages in accordance with Attachment B-3, the “Deliverables/Liquidated Damages Matrix;” (ii) Conduct accelerated monitoring of the MCO. Accelerated monitoring includes more frequent or more extensive monitoring by HHSC or its agent; (iii) Require additional, more detailed, financial and/or or programmatic reports to be submitted by MCO; (iv) Require additional and/or more detailed financial and/or programmatic audits or other reviews of the MCO; (v) Decline to renew or extend the Contract; (viv) Appoint temporary management under the circumstances described in 42 C.F.R. §§ 438.706; (viivi) Initiate disenrollment of a Member or Members; (viiivii) Suspend enrollment of Members; (ixviii) Withhold or recoup payment to MCO; (xix) Require forfeiture of all or part of the MCO’s bond; or (xix) Terminate the Contract in accordance with Section 12.03, (“Termination by HHSC”).” (2) For purposes of the Contract, an item of material noncompliance means a specific action of MCO that: (i) Violates a material provision of the Contract; (ii) Fails to meet an agreed measure of performance; or (iii) Represents a failure of MCO to be reasonably responsive to a reasonable request of HHSC relating to the Scope of Work Services for information, assistance, or support within the timeframe specified by HHSC. (3) HHSC will provide notice to MCO of the imposition of an administrative remedy in accordance with this Section, with the exception of accelerated monitoring, which may be unannounced. HHSC may require MCO to file a written response in accordance with this Section. (4) The Parties agree that a State or Federal statute, rule, regulation, or Federal guideline will prevail over the provisions of this Section unless the statute, rule, regulation, or guidelines can be read together with this Section to give effect to both.