Automatic Review Criteria Sample Clauses

Automatic Review Criteria. CD and DSS, in consultation with the Statewide Clinical Consultant and the Psychotropic Medication Advisory Committee (“PMAC” or “the Committee”), will establish, consistent with this Agreement, criteria for selecting cases for automatic review. The cases to receive automatic review shall be determined by applying the criteria to a quarterly pull of Medicaid claims data for all Children in xxxxxx care. a. These criteria shall initially include, as of the date that this Agreement is approved by the Court, the following: i. Use of an antipsychotic or atypical antipsychotic medication in a Child age four or younger; and ii. For a Child age five or older: a) Use of five or more concurrent Psychotropic Medications for 90 days or more; b) Use of two or more concurrent antipsychotic medications for 90 days or more; c) Multiple prescribers of any Psychotropic Medication for 90 days or more. b. Within twelve months from the date that this Agreement is approved by the Court, these criteria shall include the following: i. Use of any Psychotropic Medication for a Child age three or younger; ii. For a Child age four or older: a) Use of three or more Psychotropic Medications for 90 days or more; b) Use of two or more concurrent antipsychotic medications for 90 days or more; c) Multiple prescribers of any Psychotropic Medication for 90 days or more; and iii. A Child is prescribed a dose in excess of the guidelines described in Section III.G of this Agreement. c. The parties understand and agree that the criteria for identifying cases for automatic review can reasonably be expected to change over time, based on advancements in medical science and health care practice. The parties further understand that Defendants will consult at least annually with their own stakeholder community and medical professionals with respect to the review process and automatic review criteria to be utilized. Defendants may add additional criteria for automatic review at any time. d. In the event that Defendants wish to alter or discontinue any of the minimum criteria set forth in Sections III.D.4.a-b, except for the dosage criteria, Defendants will submit the proposed changes to the PMAC for study, review, and approval. No changes will be made without the written approval of the PMAC. Defendants may, in consultation with the PMAC, make necessary changes to the parameters of the dosage criteria as needed to reflect advancements in medical science and health care practice. Notice of changes to an...
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Related to Automatic Review Criteria

  • Evaluation Criteria 5.2.1. The responses will be evaluated based on the following: (edit evaluation criteria below as appropriate for your project)

  • Claims Review Methodology ‌‌ a. C laims Review Population. A description of the Population subject‌‌ to the Quarterly Claims Review.

  • Service Eligibility Criteria 5.3.4.1 High capacity EELs must comply with the following service eligibility requirements. <<customer_short_name>> must certify for each high-capacity EEL that all of the following service eligibility criteria are met: 5.3.4.1.1 <<customer_short_name>> has received state certification to provide local voice service in the area being served; 5.3.4.2 For each combined circuit, including each DS1 circuit, each DS1 EEL, and each DS1-equivalent circuit on a DS3 EEL: 5.3.4.2.1 1) Each circuit to be provided to each End User will be assigned a local number prior to the provision of service over that circuit; 5.3.4.2.2 2) Each DS1-equivalent circuit on a DS3 EEL must have its own local number assignment so that each DS3 must have at least twenty-eight (28) local voice numbers assigned to it; 5.3.4.2.3 3) Each circuit to be provided to each End User will have 911 or E911 capability prior to provision of service over that circuit; 5.3.4.2.4 4) Each circuit to be provided to each End User will terminate in a collocation arrangement that meets the requirements of 47 C.F.R. § 51.318(c); 5.3.4.2.4 5) Each circuit to be provided to each End User will be served by an interconnection trunk over which <<customer_short_name>> will transmit the calling party’s number in connection with calls exchanged over the trunk; 5.3.4.2.5 6) For each twenty-four (24) DS1 EELs or other facilities having equivalent capacity, <<customer_short_name>> will have at least one (1) active DS1 local service interconnection trunk over which <<customer_short_name>> will transmit the calling party’s number in connection with calls exchanged over the trunk; and 5.3.4.2.6 7) Each circuit to be provided to each End User will be served by a switch capable of switching local voice traffic. 5.3.4.3 BellSouth may, on an annual basis, audit <<customer_short_name>>’s records in order to verify compliance with the qualifying service eligibility criteria. The audit shall be conducted by a third party independent auditor, and the audit must be performed in accordance with the standards established by the American Institute for Certified Public Accountants (AICPA). To the extent the independent auditor’s report concludes that <<customer_short_name>> failed to comply with the service eligibility criteria, <<customer_short_name>> must true-up any difference in payments, convert all noncompliant circuits to the appropriate service, and make the correct payments on a going-forward basis. In the event the auditor’s report concludes that <<customer_short_name>> did not comply overall in any material respect with the service eligibility criteria, <<customer_short_name>> shall reimburse BellSouth for the cost of the independent auditor. To the extent the auditor’s report concludes that <<customer_short_name>> did comply in all material respects with the service eligibility criteria, BellSouth will reimburse <<customer_short_name>> for its reasonable and demonstrable costs associated with the audit. <<customer_short_name>> will maintain appropriate documentation to support its certifications. 5.3.4.4 In the event <<customer_short_name>> converts special access services to UNEs, <<customer_short_name>> shall be subject to the termination liability provisions in the applicable special access tariffs, if any.

  • Selection Criteria Each Contract is secured by a new or used Motorcycle. No Contract has a Contract Rate less than 1.00%. Each Contract amortizes the amount financed over an original term no greater than 84 months (excluding periods of deferral of first payment). Each Contract has a Principal Balance of at least $500.00 as of the Cutoff Date.

  • Claims Review Population A description of the Population subject to the Claims Review.

  • Peer Review Dental Group, after consultation with the Joint ----------- Operations Committee, shall implement, regularly review, modify as necessary or appropriate and obtain the commitment of Providers to actively participate in peer review procedures for Providers. Dental Group shall assist Manager in the production of periodic reports describing the results of such procedures. Dental Group shall provide Manager with prompt notice of any information that raises a reasonable risk to the health and safety of Group Patients or Beneficiaries. In any event, after consultation with the Joint Operations Committee, Dental Group shall take such action as may be reasonably warranted under the facts and circumstances.

  • Review Protocol A narrative description of how the Claims Review was conducted and what was evaluated.

  • Long Term Cost Evaluation Criterion 4. READ CAREFULLY and see in the RFP document under "Proposal Scoring and Evaluation". Points will be assigned to this criterion based on your answer to this Attribute. Points are awarded if you agree not increase your catalog prices (as defined herein) more than X% annually over the previous year for the life of the contract, unless an exigent circumstance exists in the marketplace and the excess price increase which exceeds X% annually is supported by documentation provided by you and your suppliers and shared with TIPS, if requested. If you agree NOT to increase prices more than 5%, except when justified by supporting documentation, you are awarded 10 points; if 6% to 14%, except when justified by supporting documentation, you receive 1 to 9 points incrementally. Price increases 14% or greater, except when justified by supporting documentation, receive 0 points. increases will be 5% or less annually per question Required Confidentiality Claim Form This completed form is required by TIPS. By submitting a response to this solicitation you agree to download from the “Attachments” section, complete according to the instructions on the form, then uploading the completed form, with any confidential attachments, if applicable, to the “Response Attachments” section titled “Confidentiality Form” in order to provide to TIPS the completed form titled, “CONFIDENTIALITY CLAIM FORM”. By completing this process, you provide us with the information we require to comply with the open record laws of the State of Texas as they may apply to your proposal submission. If you do not provide the form with your proposal, an award will not be made if your proposal is qualified for an award, until TIPS has an accurate, completed form from you. Read the form carefully before completing and if you have any questions, email Xxxx Xxxxxx at TIPS at xxxx.xxxxxx@xxxx-xxx.xxx If the vendor is awarded a contract with TIPS under this solicitation, the vendor agrees to make any Choice of Law clauses in any contract or agreement entered into between the awarded vendor and with a TIPS member entity to read as follows: "Choice of law shall be the laws of the state where the customer resides" or words to that effect.

  • Long Term Cost Evaluation Criterion # 4 READ CAREFULLY and see in the RFP document under "Proposal Scoring and Evaluation". Points will be assigned to this criterion based on your answer to this Attribute. Points are awarded if you agree not i ncrease your catalog prices (as defined herein) more than X% annually over the previous year for years two and thr ee and potentially year four, unless an exigent circumstance exists in the marketplace and the excess price increase which exceeds X% annually is supported by documentation provided by you and your suppliers and shared with TIP S, if requested. If you agree NOT to increase prices more than 5%, except when justified by supporting documentati on, you are awarded 10 points; if 6% to 14%, except when justified by supporting documentation, you receive 1 to 9 points incrementally. Price increases 14% or greater, except when justified by supporting documentation, receive 0 points. increases will be 5% or less annually per question Required Confidentiality Claim Form This completed form is required by TIPS. By submitting a response to this solicitation you agree to download from th e “Attachments” section, complete according to the instructions on the form, then uploading the completed form, wit h any confidential attachments, if applicable, to the “Response Attachments” section titled “Confidentiality Form” in order to provide to TIPS the completed form titled, “CONFIDENTIALITY CLAIM FORM”. By completing this process, you provide us with the information we require to comply with the open record laws of the State of Texas as they ma y apply to your proposal submission. If you do not provide the form with your proposal, an award will not be made if your proposal is qualified for an award, until TIPS has an accurate, completed form from you. Read the form carefully before completing and if you have any questions, email Xxxx Xxxxxx at TIPS at xxxx.xxxxxx@t xxx-xxx.xxx

  • Eligibility Criteria Students seeking college credit through this bilateral articulation agreement must meet the following criteria/requirements: • The student must have completed the secondary Tech Prep competencies (academic and technical) relevant to the Central Ohio Technical College courses, with a grade of A, B, or C. • An application and subsequent matriculation to Engineering Technology at Central Ohio Technical College must occur within 3 years of the Adult Education completion date. • The student must meet all college entrance, general admission and program specific requirements and complete the Accuplacer or ACT assessment. • The student is responsible to inform college admissions personnel of his/her eligibility for articulated college credit and verify that appropriate documentation has been provided to the college by the secondary school. • Secondary instructors are required to have the appropriate teaching credential as defined by the Ohio Department of Education. • For the purpose of compliance with state, program or regional accreditation standards, Central Ohio Technical College reserves the right to review, validate and copy the credentials (e.g., college transcripts and resumes) of the instructors of articulated courses for external auditing purposes. • The secondary instructor(s) will complete an Instructor Recommendation Form for each student upon completion which will be maintained in the student’s secondary permanent file. An Instructor Recommendation Form must be submitted to the Records and Registration Office prior to receiving credit. • The college and secondary school will develop methods of publicizing the agreement to encourage students to take advantage of seamless transitions and advanced placement opportunities. • There will be no charge for college credit awarded through this agreement. • Student eligibility for technical or related credit is primarily determined by high school teachers evaluation based upon predetermined criteria set by the college. In certain cases, record of relevant student external certification, college proficiency testing, review of portfolios, or other forms of assessment may also be required. • Placement in Central Ohio Technical College’s courses is determined by the student’s scores on the college’s required placement test(s). Credit is available only for the technical courses specified on the attached list of articulated courses. • Articulated courses are recorded on the student’s permanent records after a student enrolls in and completes a non-articulated college credit course at Central Ohio Technical College. The administrators and faculty of the program at both levels pledge their commitment and support to continuing this relationship and to promoting these articulation opportunities to the students.

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