Appeal time frames Sample Clauses

Appeal time frames. Enrollees, their authorized representatives, and providers for Medicare service appeals will have 90 days to file an appeal related to denial, reduction, or termination of authorized Medicare benefit coverage. Enrollees, their providers, or their authorized representatives will have 90 days to file an MCO/SNP appeal related to the denial of services or payment or the reduction or termination of previously authorized Medicaid or Medicare/Medicaid hybrid benefit coverage. The 90-day period extends the typical Medicare period by 30 days to allow for additional flexibility for Beneficiaries and to align the Medicaid and Medicare timelines.‌
Sample 1
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Appeal time frames. Enrollees, their authorized representatives, and providers for Medicare service appeals will have 90 days to file an appeal related to denial, reduction, or termination of authorized Medicare benefit coverage. Enrollees, their providers, or their authorized representatives will have 90 days to file an MCO/SNP appeal related to the denial of services or payment or the reduction or termination of previously authorized Medicaid or Medicare/Medicaid hybrid benefit coverage. The 90-day period extends the typical Medicare period by 30 days to allow for additional flexibility for Beneficiaries and to align the Medicaid and Medicare timelines. Unless otherwise described above or in Appendix 5, all relevant Medicare Advantage and Medicaid managed care requirements will remain in place. Part D appeals and grievances will continue to be managed under existing Part D rules, and non-Part D pharmacy appeals will be managed under the current State process including state fair hearings. CMS and the State will work to continue to coordinate grievances and appeals for pharmacy benefits.
Sample 1

Related to Appeal time frames

  • Time Frames The discipline process shall be completed within six months from the date of the first notification, or within such other extended period of time as is provided for in this Agreement.

  • Time Frame The bounded Party’s(ies’) duty to hold the Confidential Information in confidence shall remain in effect until such information no longer qualifies as a trade secret or written notice is given releasing such Party from this Agreement.

  • Time Deadlines Tenant shall use its best, good faith, efforts and all due diligence to cooperate with the Architect, the Engineers, and Landlord to complete all phases of the Construction Drawings and the permitting process and to receive the permits, and with Contractor for approval of the "Cost Proposal," as that term is defined in Section 4.2 of this Tenant Work Letter, as soon as possible after the execution of the Lease, and, in that regard, shall meet with Landlord on a scheduled basis to be determined by Landlord, to discuss Tenant's progress in connection with the same. The applicable dates for approval of items, plans and drawings as described in this Section 3, Section 4, below, and in this Tenant Work Letter are set forth and further elaborated upon in Schedule 1 (the "Time Deadlines"), attached hereto. Tenant agrees to comply with the Time Deadlines.

  • Extension of time for completion (i) Without prejudice to any other provision of this Agreement for and in respect of extension of time, the Contractor shall be entitled to extension of time in the Project Completion Schedule (the “Time Extension”) to the extent that completion of any Project Milestone is or will be delayed by any of the following, namely: (a) delay in providing the Right of Way of Construction Zone, environmental clearances or approval of railway authorities, specified in Clause 3.1 (iv); (b) Change of Scope (unless an adjustment to the Scheduled Completion Date has been agreed under Article 13); (c) occurrence of a Force Majeure Event; (d) any delay, impediment or prevention caused by or attributable to the Authority, the Authority's personnel or the Authority's other contractors on the Site; and (e) any other cause or delay which entitles the Contractor to Time Extension in accordance with the provisions of this Agreement. (ii) The Contractor shall, no later than 15 (fifteen) business days from the occurrence of an event or circumstance specified in Clause 10.5 (i), inform the Authority’s Engineer by notice in writing, with a copy to the Authority, stating in reasonable detail with supporting particulars, the event or circumstances giving rise to the claim for Time Extension in accordance with the provisions of this Agreement. Provided that the period of 15 (fifteen) business days shall be calculated from the date on which the Contractor became aware, or should have become aware, of the occurrence of such an event or circumstance. Provided further that notwithstanding anything to the contrary contained in this Agreement, Time Extension shall be due and applicable only for the Works which are affected by the aforesaid events or circumstances and shall not in any manner affect the Project Completion Schedule for and in respect of the Works which are not affected hereunder. (iii) On the failure of the Contractor to issue to the Authority’s Engineer a notice in accordance with the provisions of Clause 10.5 (ii) within the time specified therein, the Contractor shall not be entitled to any Time Extension and shall forfeit its right for any such claims in future. For the avoidance of doubt, in the event of failure of the Contractor to issue notice as specified in this clause 10.5 (iii), the Authority shall be discharged from all liability in connection with the claim. (iv) The Authority’s Engineer shall, on receipt of the claim in accordance with the provisions of Clause 10.5 (ii), examine the claim expeditiously within the time frame specified herein. In the event the Authority’s Engineer requires any clarifications to examine the claim, the Authority’s Engineer shall seek the same within 15 (fifteen) days from the date of receiving the claim. The Contractor shall, on receipt of the communication of the Authority’s Engineer requesting for clarification, furnish the same to the Authority’s Engineer within 10 (ten) days thereof. The Authority’s Engineer shall, within a period of 30 (thirty) days from the date of receipt of such clarifications, forward in writing to the Contractor its determination of Time Extension. Provided that when determining each extension of time under this Clause 10.5, the Authority’s Engineer shall review previous determinations and may increase, but shall not decrease, the total Time Extension. (v) If the event or circumstance giving rise to the notice has a continuing effect: (a) a fully detailed claim shall be considered as interim; (b) the Contractor shall, no later than 10 (ten) days after the close of each month, send further interim claims specifying the accumulated delay, the extension of time claimed, and such further particulars as the Authority’s Engineer may reasonably require; and (c) the Contractor shall send a final claim within 30 (thirty) days after the effect of the event or the circumstance ceases. Upon receipt of the claim hereunder, the Authority’s Engineer shall examine the same in accordance with the provisions of Clause 10.5 (iv) within a period of 30 (thirty) days of the receipt thereof

  • Response Times Qubit bases its response times and the actions it takes to resolve problems on an assessment of the impact of the reported technical issue. The more serious the impact, the higher the assigned priority. For all support issues relating to Customer, Qubit will respond in accordance with Table 1: P1 1 hour 4 hours P2 1 hour 8 hours P3 4 hours 72 hours P4 1 business day Next or a later major release **The Priority Levels are defined in Section II(2) below.

  • Service Commencement Date The date the Transmission Provider begins to provide service pursuant to the terms of an executed Service Agreement, or the date the Transmission Provider begins to provide service in accordance with Section 15.3 or Section 29.1 under the Tariff.

  • More Time Needed If the Engineer determines or reasonably anticipates that the work authorized in a work authorization cannot be completed before the specified completion date, the Engineer shall promptly notify the State. The State may, at its sole discretion, extend the work authorization period by execution of supplemental authorization, using the form attached hereto as Attachment D. F-2. Changes in Scope. Changes that would modify the scope of the work authorized in a work authorization must be enacted by a written supplemental work authorization. The Engineer must allow adequate time for the State to review and approve any request for a time extension prior to expiration of the work authorization. If the change in scope affects the amount payable under the work authorization, the Engineer shall prepare a revised work authorization budget for the State's approval.

  • DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION § 3.1 The date of commencement of the Work shall be: § 3.2 The Contract Time shall be measured from the date of commencement of the Work.

  • Optional Xactimate Response Attachment (Part 2)

  • Deadline On-time submission requires that electronic applications be error-free and made available to SAMHSA for processing from the NIH eRA system on or before the application due date and time. Applications must be submitted to and validated successfully by Xxxxxx.xxx and eRA Commons no later than 11:59 PM Eastern Time on the application due date. Applications submitted in Xxxxxx.xxx after the application due date will not be considered for review.

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