Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. By: By: Sr. Vice President Deputy Commissioner Date: 3/24/2022 | 09:50 PDT Date: 3/24/2022 | 12:53 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General In fulfillment of this Contract, the CONSULTANT shall comply with the requirements of the appropriate regulations and requirements of the Indiana Department of Transportation (INDOT or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Services
Appears in 1 contract
Samples: Consulting Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Coordinated Care Corporation Indiana Indiana Family & Social Services Administration By:\s1\ Office of Medicaid Policy & Planning Title:\t1V\ice President Date:\d112\/11/2020 | 15:22 EST Title:\t2M\edicaid director Date:\d122\/11/2020 | 15:28 EST Electronically Approved by: (if applicable) Indiana Office of Technology By: By: Sr. Vice President Deputy Commissioner Date: 3/24/2022 | 09:50 PDT Date: 3/24/2022 | 12:53 EDT (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General In fulfillment of this Contract, the CONSULTANT shall comply with the requirements of the appropriate regulations and requirements of the Indiana Department of Transportation (INDOT or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase ServicesEXHIBIT 5.M CAPITATION RATES
Appears in 1 contract
Samples: Contract #0000000000000000000018227
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. By: By: Sr. Vice President Deputy Commissioner Date: 3/24/2022 xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Coordinated Care Corporation Indiana Indiana Family & Social Services Administration By:\s1\ By:\s2\ Title:\t1C\EO Date:\d31/\29/2021 | 09:50 PDT Date: 3/24/2022 15:13 CDT Title:\t2M\edicaid director Date:\d32/\29/2021 | 12:53 16:15 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General In fulfillment EXHIBIT 1 SCOPE OF WORK 1.0 Background 33 2.0 Administrative Requirements 33 2.1 State Licensure 33 2.2 National Committee for Quality Assurance (NCQA) Accreditation 33 2.3 Subcontracts 34 2.4 Financial Stability 36 2.4.1 Solvency 36 2.4.2 Insolvency and Receivership 36 2.4.3 Reinsurance 37 2.4.4 Performance Bond Requirements 38 2.4.5 Financial Accounting Requirements 38 2.4.6 Insurance Requirements 40 2.5 Maintenance of this Contract, the CONSULTANT shall comply with the requirements Records 40 2.6 Disclosures 40 2.6.1 Definition of the appropriate regulations a Party in Interest 40 2.6.2 Types of Transactions Which Must Be Disclosed 41 2.7 Debarred Individuals 41 2.8 Medical Loss Ratio 42 2.9 Health Insurance Providers Fee 43 2.10 Administrative and requirements Organizational Structure 43 2.10.1 Staffing 44 2.10.2 Key Staff 44 2.10.3 Other Required Staff Positions 50 2.10.4 Suggested Staff Positions 50 2.10.5 Staff Training and Qualifications 52 2.11 FSSA Meeting Requirements 53 2.12 Maintenance of the Indiana Department Written Policies and Procedures 53 2.13 Participation in Readiness Review 53 2.14 Confidentiality of Transportation (INDOT or Department) Member Medical Records and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase ServicesOther Information 54
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL By: CareSource Indiana, Inc. Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning Title: President, Indiana Market By: Sr. Vice President Deputy Commissioner Title: Medicaid director Date: 3/24/2022 12/28/2022 | 09:50 PDT 16:40 EST Date: 3/24/2022 12/28/2022 | 12:53 EDT 16:41 EST Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General In fulfillment 2.1 State Licensure and Compliance with Applicable Laws, Rules, and Regulations 33 2.2 National Committee for Quality Assurance (NCQA) Accreditation 34 2.3 Administrative and Organizational Structure 34 2.3.1 Staffing 35 2.3.2 Key Staff 35 2.3.3 Other Required Staff Positions 41 2.3.4 Suggested Staff Positions 43 2.3.5 Staff Training and Qualifications 44 2.3.6 Debarred Individuals 45 2.4 FSSA Meeting Requirements 46 2.5 Financial Stability 46 2.5.1 Solvency 46 2.5.2 Insurance Requirements 47 2.5.3 Reinsurance 47 2.5.4 Financial Accounting Requirements 48 2.5.5 Reporting Transactions with Parties of this ContractInterest 50 2.5.6 Medical Loss Ratio 51 2.5.7 Reserved 52 2.6 Subcontracts 52 2.7 Confidentiality of Member Medical Records and Other Information 56 2.8 Internet Quorum (IQ) Inquiries 56 2.9 Material Change to Operations 57 2.10 Future Program Guidance 57 2.11 Conflict of Interest 57 2.12 Capitation Related to a Vacated Program 57 2.13 Maintenance of Records 57 2.14 Maintenance of Written Policies and Procedures 58 2.15 Participation in Readiness Review 58 2.16 Dissemination of Information 58 2.17 FSSA Ongoing Monitoring 58 3.1 Covered Benefits and Services 59 3.2 Self-referral Services 60 3.3 Early and Periodic Screening, the CONSULTANT shall comply with the requirements of the appropriate regulations Diagnosis and requirements of the Indiana Department of Transportation Treatment (INDOT or DepartmentEPSDT) Services 62 3.4 Drug Coverage 62 3.4.1 Drug Rebates 63 3.4.2 Preferred Drug List Requirements 63 3.4.3 DUR Board and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design MHQAC Reporting Requirements 65 3.4.4 Dispensing and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase ServicesMonitoring Requirements 65 3.4.5 E-Prescribing 66
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Coordinated Care Corporation, Indiana Family and Social Services Administration, d.b.a Managed Health Services Office of Medicaid Policy and Planning By: By: Sr. Vice President Deputy Commissioner Title: CEO Title: Medicaid director Date: 3/24/2022 12/28/2022 | 09:50 PDT 15:29 PST Date: 3/24/2022 12/28/2022 | 12:53 EDT 18:32 EST Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General In fulfillment 2.1 State Licensure and Compliance with Applicable Laws, Rules, and Regulations 33 2.2 National Committee for Quality Assurance (NCQA) Accreditation 34 2.3 Administrative and Organizational Structure 34 2.3.1 Staffing 35 2.3.2 Key Staff 35 2.3.3 Other Required Staff Positions 41 2.3.4 Suggested Staff Positions 43 2.3.5 Staff Training and Qualifications 44 2.3.6 Debarred Individuals 45 2.4 FSSA Meeting Requirements 46 2.5 Financial Stability 46 2.5.1 Solvency 46 2.5.2 Insurance Requirements 47 2.5.3 Reinsurance 47 2.5.4 Financial Accounting Requirements 48 2.5.5 Reporting Transactions with Parties of this ContractInterest 50 2.5.6 Medical Loss Ratio 51 2.5.7 Reserved 52 2.6 Subcontracts 52 2.7 Confidentiality of Member Medical Records and Other Information 56 2.8 Internet Quorum (IQ) Inquiries 56 2.9 Material Change to Operations 56 2.10 Future Program Guidance 57 2.11 Conflict of Interest 57 2.12 Capitation Related to a Vacated Program 57 2.13 Maintenance of Records 57 2.14 Maintenance of Written Policies and Procedures 58 2.15 Participation in Readiness Review 58 2.16 Dissemination of Information 58 2.17 FSSA Ongoing Monitoring 58 3.1 Covered Benefits and Services 59 3.2 Self-referral Services 60 3.3 Early and Periodic Screening, the CONSULTANT shall comply with the requirements of the appropriate regulations Diagnosis and requirements of the Indiana Department of Transportation Treatment (INDOT or DepartmentEPSDT) Services 62 3.4 Drug Coverage 62 3.4.1 Drug Rebates 63 3.4.2 Preferred Drug List Requirements 63 3.4.3 DUR Board and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design MHQAC Reporting Requirements 65 3.4.4 Dispensing and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase ServicesMonitoring Requirements 65 3.4.5 E-Prescribing 66
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. By: By: Sr. Vice President Deputy xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date: 3/24/2022 Date:\d22/\12/2024 | 09:50 PDT Date: 3/24/2022 | 12:53 EDT 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General In fulfillment Federal Agency: Department of this ContractHealth and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the CONSULTANT Grantee shall comply arrange for a financial and compliance audit that complies with the requirements 45 C.F.R. 75.500 et. seq. if required by applicable provisions of the appropriate regulations 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and requirements of the Indiana Department of Transportation (INDOT or Department) and Federal Highway Administration (FHWAAudit Requirements). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Services.
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Anthem Insurance Companies, Inc., d.b.a Anthem Blue Cross and Blue Shield Indiana Family and Social Services Administration, Office of Medicaid Policy and By: Planning By: Sr. Vice President Deputy Commissioner Title: President, Anthem IN Medicaid Title: Medicaid director Date: 3/24/2022 2/14/2023 | 09:50 PDT 11:17 PST Date: 3/24/2022 2/15/2023 | 12:53 EDT 13:17 EST Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General In fulfillment of this Contract1.0 Background 31 2.0 Administrative Requirements 32 2.1 State Licensure and Compliance with Applicable Laws, the CONSULTANT shall comply with the requirements of the appropriate regulations Rules, and requirements of the Indiana Department of Transportation Regulations 32 2.2 National Committee for Quality Assurance (INDOT or DepartmentNCQA) Accreditation 32 2.3 Administrative and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design Organizational Structure 32 2.3.1 Staffing 33 2.3.2 Key Staff 33 2.3.3 Other Required Staff Positions 39 2.3.4 Suggested Staff Positions 41 2.3.5 Staff Training and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase ServicesQualifications 42 2.3.6 Debarred Individuals 43 2.4 FSSA Meeting Requirements 44 2.5 Financial Stability 44 2.5.1 Solvency 45 2.5.2 Insurance Requirements 45 2.5.3 Reinsurance 45 2.5.4 Financial Accounting Requirements 46
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ na Family & Social By: Coordinated Care Corporation India Services Administration By: Sr. Vice President Deputy Commissioner Title: CEO Title: Medicaid director Date: 3/24/2022 12/1/2022 | 09:50 PDT 16:56 CST Date: 3/24/2022 12/2/2022 | 12:53 EDT 09:19 EST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General In fulfillment Table of this Contract, the CONSULTANT shall comply with the requirements Contents 1.0 Background 11 2.0 Administrative Requirements 11 2.1 State Licensure 11 2.2 National Committee for Quality Assurance (NCQA) Accreditation 11 2.3 Subcontracts 12 2.4 Financial Stability 15 2.4.1 Solvency 15 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 16 2.4.4 Performance Bond Requirements 17 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of the appropriate regulations and requirements Records 20 2.6 Disclosures 20 2.6.1 Definition of the Indiana Department of Transportation (INDOT or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Servicesa Party in Interest 20
Appears in 1 contract
Samples: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUS TOM_APPS.SOI_PUBLIC_CNTRCT S.GBL By: CareSource Indiana, Inc. Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning Title: President, Indiana Market Title: Medicaid director Date: 2/14/2023 | 09:51 EST Date: 2/15/2023 | 13:17 EST Electronically Approved by: Indiana Office of Technology By: Sr. Vice President Deputy Commissioner Date: 3/24/2022 | 09:50 PDT Date: 3/24/2022 | 12:53 EDT (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General In fulfillment 1.0 Background 33 2.0 Administrative Requirements 34 2.1 State Licensure and Compliance with Applicable Laws, Rules, and Regulations 34 2.2 National Committee for Quality Assurance (NCQA) Accreditation 34 2.3 Administrative and Organizational Structure 34 2.3.1 Staffing 35 2.3.2 Key Staff 35 2.3.3 Other Required Staff Positions 41 2.3.4 Suggested Staff Positions 42 2.3.5 Staff Training and Qualifications 43 2.3.6 Debarred Individuals 44 2.4 FSSA Meeting Requirements 45 2.5 Financial Stability 46 2.5.1 Solvency 46 2.5.2 Insurance Requirements 46 2.5.3 Reinsurance 46 2.5.4 Financial Accounting Requirements 48 2.5.5 Reporting Transactions with Parties of this Contract, the CONSULTANT shall comply with the requirements of the appropriate regulations and requirements of the Indiana Department of Transportation Interest 49 2.5.6 Medical Loss Ratio (INDOT or DepartmentMLR) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Services50 2.5.7 Reserved 51 2.6 Subcontracts 51
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ na Family & Social By: Anthem insurance Companies Inc. India Services Administration By: Sr. Vice President Deputy Commissioner Title: President, Anthem IN Medicaid Title: Medicaid director Date: 3/24/2022 11/27/2022 | 09:50 PDT 14:52 PST Date: 3/24/2022 11/27/2022 | 12:53 EDT 21:02 EST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General In fulfillment Table of this Contract, the CONSULTANT shall comply with the requirements Contents 1.0 Background 11 2.0 Administrative Requirements 11 2.1 State Licensure 11 2.2 National Committee for Quality Assurance (NCQA) Accreditation 11 2.3 Subcontracts 12 2.4 Financial Stability 15 2.4.1 Solvency 15 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 16 2.4.4 Performance Bond Requirements 17 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of the appropriate regulations and requirements Records 20 2.6 Disclosures 20 2.6.1 Definition of the Indiana Department of Transportation (INDOT or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Servicesa Party in Interest 20
Appears in 1 contract
Samples: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUS TOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Anthem Insurance d.b.a Anthem Blue Companies, Inc., Cross and Blue Shield Indiana Family and Social Services Administration, Office of Medicaid and Policy Planning By: By: Sr. Vice President Deputy Commissioner Title: President, Anthem IN Medicaid Title: Medicaid director Date: 3/24/2022 12/29/2022 | 09:50 PDT 10:20 PST Date: 3/24/2022 12/29/2022 | 12:53 EDT 15:16 EST Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General In fulfillment 2.1 State Licensure and Compliance with Applicable Laws, Rules, and Regulations 33 2.2 National Committee for Quality Assurance (NCQA) Accreditation 34 2.3 Administrative and Organizational Structure 34 2.3.1 Staffing 35 2.3.2 Key Staff 35 2.3.3 Other Required Staff Positions 41 2.3.4 Suggested Staff Positions 43 2.3.5 Staff Training and Qualifications 44 2.3.6 Debarred Individuals 45 2.4 FSSA Meeting Requirements 46 2.5 Financial Stability 47 2.5.1 Solvency 47 2.5.2 Insurance Requirements 47 2.5.3 Reinsurance 48 2.5.4 Financial Accounting Requirements 49 2.5.5 Reporting Transactions with Parties of this Contract, the CONSULTANT shall comply with the requirements of the appropriate regulations and requirements of the Indiana Department of Transportation (INDOT or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase ServicesInterest 50 2.5.6 Medical Loss Ratio 52 2.5.7 Reserved 53 2.6 Subcontracts 53
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ THE MIND TRUST, INC. By: Indiana Department of Education By: Sr. Vice President Deputy Commissioner Title: CEO Title: Chief Financial Officer Date: 3/24/2022 8/15/2022 | 09:50 PDT 13:42 EDT Date: 3/24/2022 8/15/2022 | 12:53 20:31 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General In fulfillment of this Contract, The Mind Trust (TMT) is grateful for the CONSULTANT shall comply with the requirements of the appropriate regulations and requirements of opportunity to submit a proposal to the Indiana Department of Transportation Education (INDOT or DepartmentIDOE) and Federal Highway Administration to serve as the management team to administer the Student Enrichment Grants program defined by House Enrolled Act (FHWAHEA) 1251 (2022). Since 2006, The CONSULTANT shall Mind Trust has worked to transform Indianapolis’ K-12 education system so that every student, regardless of race or socioeconomic status, receives an equitable, high-quality education. Since launching in 2006, The Mind Trust has supported the launch of 41 schools that will collectively serve more than 15,000 students at scale alongside 13 education support nonprofit organizations. In July 2021, The Mind Trust launched Advancing Educational Equity—a six-year, equity-focused strategic plan aimed at tripling student proficiency across Center Township in Indianapolis. The Mind Trust will particularly emphasize improving outcomes for Black and Latino students and students from low-income households who have historically been excluded from educational opportunity. Advancing Educational Equity has racial equity at the forefront of each aspect of our work to ensure The Mind Trust is focused on equitably serving all Indianapolis children, families, and communities. The plan focuses on four key priorities—great schools, engaging community, racial equity, and thriving ecosystem. Since the onset of the COVID-19 pandemic, TMT has collaborated with funders, schools, and community partners to meet the elevated community needs stemming from the pandemic. We have led on three key initiatives that specifically sought to address the academic and social-emotional impacts of the pandemic on families, students, and educators over the past two years. ● TMT served as the project manager for the development of the Indiana eLearning Lab, a statewide initiative of the Indianapolis eLearning Fund that provided professional development and support to nearly 22,000 teachers statewide. After the initial design and launch of the eLearning Lab, The Mind Trust worked with funders and partners to coordinate a collaborative handoff of the project to its long-term home at the Indiana Department of Education as the Indiana Learning Lab. ● TMT launched and supported a total of 50 Community Learning Sites that served 1,278 students and supported students’ eLearning and social-emotional needs during the 2020-21 school year. These sites provided a safe, supportive environment for students to conduct eLearning and were created to alleviate the childcare crisis the pandemic caused for working families. Feedback across Community Learning Sites was consistently positive. One mother noted, “This eLearning site has been such a blessing for our family. My husband and I both work full time outside of the home and were unsure what to do when eLearning was announced. We have appreciated the availability, the location, and the staff. We feel our child was safe and cared for throughout his time here.” Conversations with parents also found an appreciation for the many benefits Community Learning Sites afforded students, including structure and social interaction; tutoring support; and a safe, distraction-free environment. Parents emphasized an increase in academic engagement from their child after they began attending a Community Learning Site compared to when they were participating in eLearning at home. ● The Mind Trust partnered with United Way of Central Indiana to launch Indy Summer Learning Labs (ISLL) in June 2021. XXXX served students across Indianapolis who were impacted by lost learning opportunities resulting from COVID-19. Thirty-nine sites spread across Indianapolis supported over 3,000 students in first through ninth grades who engaged in full-day academic and enrichment programming. The Mind Trust supported the recruitment of over 200 in-person, licensed teachers and teacher aids and 54 virtual teachers to staff the sites. Post-assessment results from the 2021 ISLL were promising. Students grew in English Language Arts by 12 percentage points after participating in ISLL with 41% of students achieving proficiency. Math performance grew by 17 percentage points with 45% of students proficient according to post-assessment data. Parent and family surveys also indicated strong satisfaction across all sites with 91.5% of parents reporting “good” or “great” satisfaction with the program and their student’s experience. Family demand for free, accessible summer programming remains high, which is one of many reasons ISLL will take place again in summer 2022. This year’s ISLL will be responsible held at more than 40 schools, churches, and community organizations across Center Township, serving as many as 5,000 students who are entering first through ninth grades. TMT’s experience and success leading initiatives that specifically address the academic and social-emotional needs of students and families positions us to effectively lead and deliver on the promise of the Student Enrichment Grants program being offered by the IDOE. HEA 1251 outlines the requirements for performing IDOE to establish criteria and develop processes to administer the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design program. TMT proposes to manage the development of the program design for IDOE while working alongside relevant stakeholders and Plan Development partners to ensure broad adoption and strong family buy-in to the program throughout the state of Indiana. Through the development of a project team, alongside the expertise of key TMT personnel, TMT is well positioned to support the IDOE in meeting the requirements of HEA 1251, including (including Signing, Lighting but not limited to): establishing final criteria to identify enrichment students; determining the amount of funds available and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right the number of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Servicesgrants to be awarded; developing the program forms; coordinating the identification and certification of participating entities; and managing the initiative’s partners and vendors; and secure data needed to contact the student and/or family and/or school.
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL Learfield Communications Inc Indiana Utility Regulatory Commission By: By: Sr. Vice President Deputy Commissioner Title: General Manager Title: Chairman Date: 3/24/2022 8/13/2021 | 09:50 PDT 11:56 CDT Date: 3/24/2022 8/20/2021 | 12:53 15:09 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General In fulfillment of this ContractThe Contractor will provide a public awareness concerning underground plant protection, also referred to as excavation damage prevention, as required by Ind. Code § 8-1-26-24(a)(1). Specifically, the CONSULTANT Contractor shall comply with provide the requirements following: Kick-off Campaign on August 11th (8-11 day) o MAKE A SPLASH! A landing page will be built essentially restricting fans before they enter xxx.xxxxxxxxxx.xxx and xxx.xxxxxxxxxxxx.xxx announcing Indiana 811 day and educating fans on the importance of calling before you dig. o Website Takeover - The websites above will have Indiana 811 for all ad elements on August 11, including but not limited to ad banners, displays, and logos. o Mobile App Takeover - All initial ads on each respective mobile app will be related to using the Indiana 811 service. o A push notification will be sent to all app user fans announcing Indiana 811 day. o Contractor will create organic posts and tweets from each respective school on Facebook/Twitter recognizing Indiana 811 day. Football Game Sponsorships o Away Game for XX Xxxxxxxx MAKE A SPLASH! A landing page will be built essentially restricting fans before they enter xxx.xxxxxxxxxx.xxx and xxx.xxxxxxxxxxxx.xxx announcing Indiana 811 day and educating them on the importance of calling before you dig. Website Takeover - The websites above will have Indiana 811 for all ad elements on August 11, including but not limited to ad banners, displays, and logos. Mobile App Takeover - All initial ads on each respective mobile app will be related to using the Indiana 811 service. A push notification will be sent to all app user fans announcing Indiana 811 day. Contractor will create organic posts and tweets from each respective school on Facebook/Twitter recognizing Indiana 811 day. Contractor will add the logo on the cover of the appropriate regulations and requirements of Digital Gameday Program. The Digital Gameday Program will include one full page ad. Two additional (2) :30 second radio spots on the Indiana Department of Transportation IU Radio Network One additional (INDOT or Department1) and Federal Highway Administration :10 second live read during the broadcast. One (FHWA)1) two-minute interview during the halftime radio show. The CONSULTANT shall be responsible for performing Logo recognition on social media that is promoting the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Servicesgame.
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. By: By: Sr. Vice President Deputy Commissioner Date: 3/24/2022 xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Anthem Insurance Companies Inc. Indiana Family & Social Services Administration By:\s1\ By:\s2\ Title:\t1P\resident, Anthem IN Medicaid Date:\d31/\29/2021 | 09:50 PDT Date: 3/24/2022 15:54 EDT Title:\t2M\edicaid director Date:\d32/\29/2021 | 12:53 15:58 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General In fulfillment EXHIBIT 1 SCOPE OF WORK 1.0 Background 34 2.0 Administrative Requirements 34 2.1 State Licensure 34 2.2 National Committee for Quality Assurance (NCQA) Accreditation 34 2.3 Subcontracts 35 2.4 Financial Stability 37 2.4.1 Solvency 37 2.4.2 Insolvency and Receivership 37 2.4.3 Reinsurance 38 2.4.4 Performance Bond Requirements 39 2.4.5 Financial Accounting Requirements 39 2.4.6 Insurance Requirements 41 2.5 Maintenance of this ContractRecords 41 2.6 Disclosures 41 2.6.1 Definition of a Party in Interest 41 2.6.2 Types of Transactions Which Must Be Disclosed 42 2.7 Debarred Individuals 42 2.8 Medical Loss Ratio 43 2.9 Health Insurance Providers Fee 44 2.10 Administrative and Organizational Structure 44 2.10.1 Staffing 45 2.10.2 Key Staff 45 2.10.3 Other Required Staff Positions 51 2.10.4 Suggested Staff Positions 51 2.10.5 Staff Training and Qualifications 52 2.11 FSSA Meeting Requirements 54 2.12 Maintenance of Written Policies and Procedures 54 2.13 Participation in Readiness Review 54 2.14 Confidentiality of Member Medical Records and Other Information 55 2.15 Material Change to Operations 55 2.16 Response to State Inquiries & Requests for Information 55 2.17 Dissemination of Information 55 2.18 FSSA Ongoing Monitoring 56 2.19 Future Program Guidance 56 2.20 Dual Eligible Special Needs Plans (D-SNPs) Requirements 56 2.21 Capitation Related to a Vacated Program 57 EXHIBIT 1 SCOPE OF WORK 3.0 Covered Benefits 58 3.1 Self-Referral Services 59 3.2 Early and Periodic Screening, the CONSULTANT shall comply with the requirements Diagnosis and Treatment (EPSDT) Services 60 3.3 Emergency Services 61 3.3.1 Emergency Room Services Copayment 62 3.3.2 Post-Stabilization Services 63 3.4 Inpatient Services 64 3.5 Care Conference Coverage 64 3.6 Medication Therapy Management Services 64 3.6.1 Goals of the appropriate regulations and requirements of the Indiana Department of Transportation (INDOT or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase ServicesMTM Program 64 3.6.2 General Requirements 65 3.6.3 Target Members 66 3.6.4 Reporting 66 3.7 Diabetes Supplies Coverage 67 3.8 Drug Coverage 67 3.8.1 Drug Rebates 67 3.8.2 Preferred Drug List Requirements 68
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ Learfield Communications Inc. Indiana Utility Regulatory Commission By: By: Sr. Vice President Deputy Commissioner Title: Senior Manager-Business Development Title: Chairman Date: 3/24/2022 7/21/2023 | 09:50 PDT 15:27 EDT Date: 3/24/2022 7/27/2023 | 12:53 15:50 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General In fulfillment Submitted to: (Vendor name) Learfield Contact: Xxxxx Xxxxxx Date: 05/16/2023 E-mail address: XxxxXxxxxx@xxx.xx.xxx Phone: 317-234- 5157 Vendor respectfully declines (please state reason): Media Budget (inclusive of this Contract, the CONSULTANT shall comply with the requirements of the appropriate regulations and requirements of the Indiana Department of Transportation agency costs/commission): $290,000 Creative Agency (INDOT if known): Xxxxxxxx Xxxxxxx creative run by Xxxxxxxxx State Agency Contact: Xxxxx Xxxxxx Creative Agency Contact: Xxxxx Xxxxxxxx Email: XxxxXxxxxx@xxx.xx.xxx Email: xxxxxxxxx@xxxxxxxxxxxxxxxxxxxxxx.xx m P.O. Number (if known): State Agency Billing Contact: Xxxx Xxxxx 000-000-0000 XxXxxxx@xxx.xx.xxx Funding Source: Underground Plant Protection Account (UPPA) Fund General Fund or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activitiesor Dedicated Dedicated PeopleSoft Fund ID: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Services48691
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL By: By: Sr. Vice Xxxxxxx Xxxxxx Title: President Deputy Commissioner and CEO Title: Medicaid Director Date: 3/24/2022 | 09:50 PDT March 09, 2020 Date: 3/24/2022 | 12:53 EDT March 9, 2020 Electronically Approved by: Indiana Office of Technology By: (for) Xxxxxx Xxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General In fulfillment of this Contract, the CONSULTANT shall comply with the requirements of the appropriate regulations 2.1 State Licensure 12 2.2 National Committee for Quality Assurance (NCQA) Accreditation 12 2.3 Administrative and requirements of the Indiana Department of Transportation (INDOT or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • ROrganizational Structure 12 2.4 Staffing 13 2.4.1 Key Staff 13 2.4.2 Staff Positions 19 2.4.3 Training 21 2.4.4 Debarred Individuals 22 2.5 FSSA/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase ServicesOMPP Meeting Requirements 23 2.6 Financial Stability 23 2.6.1 Solvency 23 2.6.2 Insurance 24 2.6.3 Reinsurance 24 2.6.4 Financial Accounting Requirements 26
Appears in 1 contract
Samples: Contract for Providing Risk Based Managed Care Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_XXXXXXX.XX L Coordinated Care Corporation Indiana Family and Social Services Administration, d.b.a Managed Health Services Office of Medicaid Policy and Planning By: By: Sr. Vice President Deputy Commissioner Title: CEO Title: Medicaid director Date: 3/24/2022 2/9/2023 | 09:50 PDT 08:55 PST Date: 3/24/2022 2/10/2023 | 12:53 EDT 12:23 EST Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General In fulfillment 1.0 Background 30 2.0 Administrative Requirements 31 2.1 State Licensure and Compliance with Applicable Laws, Rules, and Regulations 31 2.2 National Committee for Quality Assurance (NCQA) Accreditation 31 2.3 Administrative and Organizational Structure 31 2.3.1 Staffing 32 2.3.2 Key Staff 32 2.3.3 Other Required Staff Positions 38 2.3.4 Suggested Staff Positions 39 2.3.5 Staff Training and Qualifications 40 2.3.6 Debarred Individuals 41 2.4 FSSA Meeting Requirements 42 2.5 Financial Stability 43 2.5.1 Solvency 43 2.5.2 Insurance Requirements 43 2.5.3 Reinsurance 43 2.5.4 Financial Accounting Requirements 45 2.5.5 Reporting Transactions with Parties of this ContractInterest 46 2.5.6 Medical Loss Ratio (MLR) 47 2.5.7 Reserved 48 2.6 Subcontracts 48 2.7 Confidentiality of Member Medical Records and Other Information 52 2.8 Internet Quorum (IQ) Inquiries 52 2.9 Material Change to Operations 52 2.10 Future Program Guidance 52 2.11 Conflict of Interest 53 2.12 Capitation Related to a Vacated Program 53 2.13 Maintenance of Records 53 2.14 Maintenance of Written Policies and Procedures 53 2.15 Participation in Readiness Review 53 2.16 Dissemination of Information 54 2.17 FSSA Ongoing Monitoring 54 3.0 Covered Benefits and Services 54 3.1 Covered Benefits and Services 54 3.2 Self-referral Services 56 3.3 Early and Periodic Screening, the CONSULTANT shall comply with the requirements of the appropriate regulations Diagnosis and requirements of the Indiana Department of Transportation Treatment (INDOT or DepartmentEPSDT) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Services57 3.4 Drug Coverage 58
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ na Family & Social By: United Healthcare Insurance Company India Services Administration By: Sr. Vice President Deputy Commissioner Title: Chief Executive Officer Title: Medicaid director Date: 3/24/2022 12/1/2022 | 09:50 PDT 18:36 EST Date: 3/24/2022 12/2/2022 | 12:53 EDT 09:23 EST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General In fulfillment Table of this Contract, the CONSULTANT shall comply with the requirements Contents 1.0 Background 11 2.0 Administrative Requirements 11 2.1 State Licensure 11 2.2 National Committee for Quality Assurance (NCQA) Accreditation 11 2.3 Subcontracts 12 2.4 Financial Stability 15 2.4.1 Solvency 15 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 16 2.4.4 Performance Bond Requirements 17 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of the appropriate regulations and requirements Records 20 2.6 Disclosures 20 2.6.1 Definition of the Indiana Department of Transportation (INDOT or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Servicesa Party in Interest 20
Appears in 1 contract
Samples: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. By: By: Sr. Vice President Deputy Commissioner Date: 3/24/2022 xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ Tippecanoe County Government Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irector, Div Aging Date:\d31/\16/2023 | 09:50 06:23 PDT Date: 3/24/2022 Date:\d32/\20/2023 | 12:53 10:23 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General In fulfillment EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of this Contractcare less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the CONSULTANT shall comply Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the requirements AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the appropriate regulations and requirements RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the Indiana Department level of Transportation (INDOT or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Servicescare assessment.
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xx.xxxx.xx.xxx/psp/paprd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST FEDRESULTS INC Indiana Department of Administration By: By: Sr. Vice President Deputy Commissioner Title: Date: 3/24/2022 | 09:50 PDT Xxxxx Xxxxx 9/20/2019 Title: Date: 3/24/2022 | 12:53 EDT Electronically Approved by: Indiana Office of Technology By: (for) Xxxxxx Xxxxx, Chief Information Officer Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General In fulfillment of this Contract, Refer to Electronic Approval History found after the CONSULTANT shall comply with the requirements final page of the appropriate regulations and requirements Executed Contract for details. 1331111.1803 Creator - License - 1 Year $840.00 $833.74 $672.00 1331113.1803 Creator - License - License Renewal 1 year $840.00 $833.74 $672.00* 1231111.1803 Explorer - License - 1 Year $420.00 $416.87 $336.00 1231113.1803 Explorer - License - License Renewal 1 year $420.00 $416.87 $336.00* 1131111.1803 Viewer- License - 1 Year $144.00 $142.93 $115.20 1131113.1803 Viewer - License - License Renewal 1 year $144.00 $142.93 $115.20* 1050111.1803 Server - Core Term License $21,875.00 $21,711.90 $17,500.00 1050413.1703 Server-Core Enterprise Term License Renewal, 1 year $21,875.00 $21,711.90 $17,500.00* *QPA discount applies to Renewals of Licenses that were purchased through the Indiana Department QPA contract. Legacy renewals stay at existing rate for life of Transportation (INDOT or Department) and Federal Highway Administration (FHWA)contract. The CONSULTANT shall be responsible Vendor Part No Description List Price GSA Contract Price QPA18197 Discount Price 1331150.1803 Creator - License - Converted License Multi Year, 1 Year $840.00 $833.74 $672.00 1331119.1803 Creator - License - License Renewal Multi Year, 1 year $840.00 $833.74 $672.00* 1231150.1803 Explorer - License - Converted License Multi Year, 1 Year $420.00 $416.87 $336.00 1231119.1803 Explorer - License - License Renewal Multi Year, 1 year $420.00 $416.87 $336.00* 1131150.1803 Viewer - License - Converted License Multi Year, 1 Year $144.00 $142.93 $115.20 1131119.1803 Viewer - License - License Renewal Multi Year, 1 year $144.00 $142.93 $115.20* 1550311.1901 Data Management - Resource Core - License, 1 year $4,000.00 $3,970.18 $3,200.00 1550312.1901 Data Management - Resource Core - License AddOn, 1 year $4,000.00 $3,970.18 $3,200.00 1550313.1901 Data Management - Resource Core - License Renewal, 1 year $4,000.00 $3,970.18 $3,200.00 1550326.1901 Data Management - Resource Core - License - Multi Yr $4,000.00 $3,970.18 $3,200.00 1550317.1901 Data Management - Resource Core - License - Multi Yr AddOn $4,000.00 $3,970.18 $3,200.00 1550319.1901 Data Management - Resource Core - License Renewal - Multi Yr $4,000.00 $3,970.18 $3,200.00 1550111.1901 Data Management - Core - Platform License, 1 year $4,500.00 $4,466.45 $3,600.00 1550112.1901 Data Management - Core - Platform License AddOn, 1 year $4,500.00 $4,466.45 $3,600.00 1550113.1901 Data Management - Core - Platform License Renewal, 1 year $4,500.00 $4,466.45 $3,600.00 1550126.1901 Data Management - Core - Platform License - Multi Yr $4,500.00 $4,466.45 $3,600.00 1550117.1901 Data Management - Core - Platform License - Multi Yr AddOn $4,500.00 $4,466.45 $3,600.00 1550119.1901 Data Management - Core - Platform License Renewal - Multi Yr $4,500.00 $4,466.45 $3,600.00 *QPA discount applies to Renewals of Licenses that were purchased through the QPA contract. Legacy renewals stay at existing rate for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right life of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Servicescontract.
Appears in 1 contract
Samples: Quantity Purchase Agreement (Qpa) for Tableau Products and Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Anthem Insurance Companies, Inc. Indiana Family & Social Services Administration By:\s1\ Office of Medicaid Policy & Planning Title:\t1P\resident, Anthem IN Medicaid Date:\d112\/10/2020 | 13:20 EST Title:\t2M\edicaid director Date:\d122\/10/2020 | 13:29 EST Electronically Approved by: (if applicable) Indiana Office of Technology By: By: Sr. Vice President Deputy Commissioner Date: 3/24/2022 | 09:50 PDT Date: 3/24/2022 | 12:53 EDT (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General In fulfillment of this Contract, the CONSULTANT shall comply with the requirements of the appropriate regulations and requirements of the Indiana Department of Transportation (INDOT or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase ServicesEXHIBIT 5.M CAPITATION RATES
Appears in 1 contract
Samples: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. By: By: Sr. Vice President Deputy Commissioner Date: 3/24/2022 xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL United Healthcare Insurance Indiana Family & Social Services Administration By:\s1\ By:\s2\ Title:\t1C\EO, Indiana M&R Title:\t2M\edicaid director Date:\d31/\29/2021 | 09:50 PDT Date: 3/24/2022 09:16 CDT Date:\d32/\29/2021 | 12:53 16:16 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General In fulfillment EXHIBIT 1 SCOPE OF WORK 1.0 Background 34 2.0 Administrative Requirements 34 2.1 State Licensure 34 2.2 National Committee for Quality Assurance (NCQA) Accreditation 34 2.3 Subcontracts 35 2.4 Financial Stability 37 2.4.1 Solvency 37 2.4.2 Insolvency and Receivership 37 2.4.3 Reinsurance 38 2.4.4 Performance Bond Requirements 39 2.4.5 Financial Accounting Requirements 39 2.4.6 Insurance Requirements 41 2.5 Maintenance of this ContractRecords 41 2.6 Disclosures 41 2.6.1 Definition of a Party in Interest 41 2.6.2 Types of Transactions Which Must Be Disclosed 42 2.7 Debarred Individuals 42 2.8 Medical Loss Ratio 43 2.9 Health Insurance Providers Fee 44 2.10 Administrative and Organizational Structure 44 2.10.1 Staffing 45 2.10.2 Key Staff 45 2.10.3 Other Required Staff Positions 51 2.10.4 Suggested Staff Positions 51 2.10.5 Staff Training and Qualifications 52 2.11 FSSA Meeting Requirements 54 2.12 Maintenance of Written Policies and Procedures 54 2.13 Participation in Readiness Review 54 2.14 Confidentiality of Member Medical Records and Other Information 55 2.15 Material Change to Operations 55 2.16 Response to State Inquiries & Requests for Information 55 2.17 Dissemination of Information 55 2.18 FSSA Ongoing Monitoring 56 2.19 Future Program Guidance 56 2.20 Dual Eligible Special Needs Plans (D-SNPs) Requirements 56 2.21 Capitation Related to a Vacated Program 57 EXHIBIT 1 SCOPE OF WORK 3.0 Covered Benefits 58 3.1 Self-Referral Services 59 3.2 Early and Periodic Screening, the CONSULTANT shall comply with the requirements Diagnosis and Treatment (EPSDT) Services 60 3.3 Emergency Services 61 3.3.1 Emergency Room Services Copayment 62 3.3.2 Post-Stabilization Services 63 3.4 Inpatient Services 64 3.5 Care Conference Coverage 64 3.6 Medication Therapy Management Services 64 3.6.1 Goals of the appropriate regulations and requirements of the Indiana Department of Transportation (INDOT or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase ServicesMTM Program 64 3.6.2 General Requirements 65 3.6.3 Target Members 66 3.6.4 Reporting 66 3.7 Diabetes Supplies Coverage 67 3.8 Drug Coverage 67 3.8.1 Drug Rebates 67 3.8.2 Preferred Drug List Requirements 68
Appears in 1 contract
Samples: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. By: By: Sr. Vice President Deputy Commissioner Date: 3/24/2022 By:\s1\ By:\s2\ Title:\t1A\dministrator Title:\tI2\DOH Chief of Staff Date:\d41/\13/2022 | 09:50 PDT Date: 3/24/2022 10:44 EDT Date:\d42/\13/2022 | 12:53 11:07 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaxxxx, Commissioner Electronically Approved by: State Budget Agency Approved as to Form and Legality: Office of Attorney General By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to (for) Form and Legality by: approval hasbeen granted by the Office of the Attorney General By: pursuant to IC 4-13-2-14.3(e) on M arch 15, 2022 FA 22-18 The local health department (for"LHD") Xxxxxxxx X Xxxxxxshall complete the 2021 Local Health Department Annual Survey on or before May 6, Attorney General In fulfillment of this Contract, 2022. Upon acceptance by the CONSULTANT shall comply with the requirements Local Health Department Outreach Division ("LHDOD") of the appropriate regulations and requirements of the Indiana Department of Transportation 2021 LHD Annual Survey (INDOT or Department"Survey") and Federal Highway Administration approval of a contract for services the local health department shall be paid the sum of One Thousand Dollars and No Cents (FHWA$1,000). The CONSULTANT Survey is accessible online via RedCap. The LHD shall access the Survey via a unique link and code to be responsible provided by the LHDOD. Name of Organization: XXXXX COUNTY Program Description: 2021 Annual Survey Budget Period: 1/1/2022 - 5/6/2022 Salaries and Wages $ 1,000.00 Fringe Benefits $ - Consultants $ - Contractual $ - Supplies $ - Equipment $ - Travel $ - Other Operating Total Budget $ 1,000.00 Federal Agency: Department of Health and Human Services CFDA Number: 93.354 Grant Award Number: NU90TP922179 Award Name: Cooperative Agreement for performing the following activitiesemergency Response: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase ServicesHealth Crisis Response
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. By: By: Sr. Vice President Deputy Commissioner Date: 3/24/2022 United Healthcare Insurance Indiana Family & Social Services Administration By:\s1\ By:\s2\ Title:\t1C\EO, Indiana M&R Title:\t2M\edicaid director Date:\d112\/22/2021 | 09:50 PDT Date: 3/24/2022 10:57 CST Date:\d122\/23/2021 | 12:53 EDT 10:31 EST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx Holw erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General In fulfillment EXHIBIT 1.A. SCOPE OF WORK Table of this Contract, the CONSULTANT shall comply with the requirements Contents 1.0 Background 13 2.0 Administrative Requirements 13 2.1 State Licensure 13 2.2 National Committee for Quality Assurance (NCQA) Accreditation 13 2.3 Subcontracts 14 2.4 Financial Stability 16 2.4.1 Solvency 16 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 17 2.4.4 Performance Bond Requirements 18 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of the appropriate regulations and requirements Records 20 2.6 Disclosures 20 2.6.1 Definition of the Indiana Department of Transportation (INDOT or Department) and Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services Task 5 Road Design and Plan Development (including Signing, Lighting and Signal Plan Development, if applicable) Task 6 Pavement Design Services Task 7 Right of Way Plan Development • R/W Engineering • Title Research • R/W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Servicesa Party in Interest 20
Appears in 1 contract
Samples: Contract