Common use of Availability of FFP Clause in Contracts

Availability of FFP. (A) Pursuant to Section 1903(i)(2), 42 CFR 438.808, 1001.1901(c), and 1002.3(b), FFP is not available for any amounts paid to the Contractor if: (1) the Contractor is controlled by a sanctioned individual as described in Section 1128(b)(8) of the Social Security Act; (2) the Contractor has a contractual relationship that provides for the administration, management or provision of medical services, or the establishment of policies, or the provision of operational support for the administration, management, or provision for medical services either directly or indirectly, with: (i) an individual Convicted of certain crimes as described in Section 1128(b)(8)(B) of the Social Security Act; (ii) any individual or entity that is (or is affiliated with a person/entity that is) debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549; or (iii) any individual or entity that is Excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Social Security Act. (3) the Contractor employs or contracts, directly or indirectly, for the furnishing of health care, utilization review, medical social work, or administrative services with: (i) any individual or entity Excluded from participation in Federal Health Care Programs under section 1128 or 1128A of the Social Security Act; (ii) any individual or entity that is (or is affiliated with a person/entity that is) debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549; or (iii) any entity that would provide those services through an individual or entity debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non-procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549 or an individual or entity excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Social Security Act.

Availability of FFP. (A) Pursuant to Section 1903(i)(2), 42 CFR §§438.808, 1001.1901(c), and 1002.3(b), FFP is not available for any amounts paid to the Contractor iffor any of the following reasons: (1) the Contractor is controlled by a sanctioned individual as described in Section 1128(b)(8) of the Social Security Act; (2) the Contractor has a contractual relationship that provides for the administration, management or provision of medical services, or the establishment of policies, or the provision of operational support for the administration, management, or provision for medical services either directly or indirectly, with: (i) an individual Convicted convicted of certain crimes as described in Section 1128(b)(8)(B) of the Social Security Act; (ii) any individual or entity that is (or is affiliated Affiliated with a person/entity that is) debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549; or (iii) any individual or entity that is Excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Social Security Act. (3) the The Contractor employs or contracts, directly or indirectly, for the furnishing of health care, utilization review, medical social work, or administrative services withwith any of the following: (i) any individual or entity Excluded from participation in Federal Health Care Programs under section 1128 or 1128A of the Social Security Act; (ii) any individual or entity that is (or is affiliated with a person/entity that is) debarred, Suspendedsuspended, or Excluded excluded from participating in procurement activities under the Federal Acquisition Regulation (FAR) or from participating in non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549; or (iii) any entity that would provide those services through an individual or entity debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non-non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549 or an individual or entity excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Social Security Act. (B) The Parties understand and agree that the Department shall ensure that no payment is made to a Network Provider other than by the Contractor for Covered Services, except when these payments are specifically required to be made by the Department in Title XIX of the Social Security Act, in Title 42 of the Code of Federal Regulations, or when the Department makes direct payments to Network Providers for graduate medical education costs approved under the State Plan.

Availability of FFP. (A) Pursuant to Section 1903(i)(2), 42 CFR §§438.808, 1001.1901(c), and 1002.3(b), FFP is not available for any amounts paid to the Contractor if: (1) the Contractor is controlled by a sanctioned individual as described in Section 1128(b)(8) of the Social Security Act; (2) the Contractor has a contractual relationship that provides for the administration, management or provision of medical services, or the establishment of policies, or the provision of operational support for the administration, management, or provision for medical services either directly or indirectly, with: (i) an individual Convicted of certain crimes as described in Section 1128(b)(8)(B) of the Social Security Act; (ii) any individual or entity that is (or is affiliated with a person/entity that is) debarred, Suspendedsuspended, or Excluded excluded from participating in procurement activities under the Federal Acquisition Regulation (FAR) or from participating in non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549; or (iii) any individual or entity that is Excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Social Security Act. (3) the Contractor employs or contracts, directly or indirectly, for the furnishing of health care, utilization review, medical social work, or administrative services withwith any of the following: (i) any individual or entity Excluded from participation in Federal Health Care Programs under section 1128 or 1128A of the Social Security Act; (ii) any individual or entity that is (or is affiliated with a person/entity that is) debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549; or (iii) any entity that would provide those services through an individual or entity debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non-non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549 or an individual or entity excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Social Security Act. (B) The Parties understand and agree that the Department must ensure that no payment is made to a Network Provider other than by the Contractor for Covered Services, except when these payments are specifically required to be made by the Department in Title XIX of the Social Security Act, in 42 CFR, or when the Department makes direct payments to Network Providers for graduate medical education costs approved under the State Plan.

Availability of FFP. (A) Pursuant to Section 1903(i)(2), 42 CFR §§438.808, 1001.1901(c), and 1002.3(b), FFP is not available for any amounts paid to the Contractor if: (1) the Contractor is controlled by a sanctioned individual as described in Section 1128(b)(8) of the Social Security Act; (2) the Contractor has a contractual relationship that provides for the administration, management or provision of medical services, or the establishment of policies, or the provision of operational support for the administration, management, or provision for medical services either directly or indirectly, with: (i) an individual Convicted convicted of certain crimes as described in Section 1128(b)(8)(B) of the Social Security Act; (ii) any individual or entity that is (or is affiliated Affiliated with a person/entity that is) debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549; or (iii) any individual or entity that is Excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Social Security Act. (3) the Contractor employs or contracts, directly or indirectly, for the furnishing of health care, utilization review, medical social work, or administrative services withwith any of the following: (i) any individual or entity Excluded from participation in Federal Health Care Programs under section 1128 or 1128A of the Social Security Act; (ii) any individual or entity that is (or is affiliated Affiliated with a person/entity that is) debarred, Suspendedsuspended, or Excluded excluded from participating in procurement activities under the Federal Acquisition Regulation (FAR) or from participating in non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549; or (iii) any entity that would provide those services through an individual or entity debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non-non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549 or an individual or entity excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Social Security Act. (B) The Parties understand and agree that the Department must ensure that no payment is made to a Network Provider other than by the Contractor for Covered Services, except when these payments are specifically required to be made by the Department in Title XIX of the Social Security Act, in 42 CFR, or when the Department makes direct payments to Network Providers for graduate medical education costs approved under the State Plan.

Availability of FFP. (A) Pursuant to Section 1903(i)(2), 42 CFR §§438.808, 1001.1901(c), and 1002.3(b1002.3(b)(3), FFP is not available for any amounts paid to the Contractor iffor any of the following reasons: (1) the Contractor is controlled by a sanctioned individual as described in Section 1128(b)(8) of the Social Security Act; (2) the Contractor has a contractual relationship that provides for the administration, management or provision of medical services, or the establishment of policies, or the provision of operational support for the administration, management, or provision for medical services either directly or indirectly, with: (i) an individual Convicted convicted of certain crimes as described in Section 1128(b)(8)(B) of the Social Security Act; (ii) any individual or entity that is (or is affiliated with a person/entity that is) debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549; or (iii) any individual or entity that is Excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Social Security Act. (3) the Contractor employs or contracts, directly or indirectly, for the furnishing of health care, utilization review, medical social work, or administrative services withwith any of the following: (i) any individual or entity Excluded from participation in Federal Health Care Programs under section 1128 or 1128A of the Social Security Act; (ii) any individual or entity that is (or is affiliated with a person/entity that is) debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549; or (iii) any entity that would provide those services through an individual or entity debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non-non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549 or an individual or entity excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Social Security Act. (B) The Parties understand and agree that the Department must ensure that no payment is made to a Network Provider other than by the Contractor for Covered Services, except when these payments are specifically required to be made by the Department in Title XIX of the Social Security Act, in 42 CFR, or when the Department makes direct payments to Network Providers for graduate medical education costs approved under the State Plan.

Availability of FFP. (A) Pursuant to Section 1903(i)(2), 42 CFR §§438.808, 1001.1901(c), and 1002.3(b), FFP is not available for any amounts paid to the Contractor iffor any of the following reasons: (1) the Contractor is controlled by a sanctioned individual as described in Section 1128(b)(8) of the Social Security Act; (2) the Contractor has a contractual relationship that provides for the administration, management or provision of medical services, or the establishment of policies, or the provision of operational support for the administration, management, or provision for medical services either directly or indirectly, with: (i) an individual Convicted convicted of certain crimes as described in Section 1128(b)(8)(B) of the Social Security Act; (ii) any individual or entity that is (or is affiliated Affiliated with a person/entity that is) debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549; or (iii) any individual or entity that is Excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Social Security Act. (3) the Contractor employs or contracts, directly or indirectly, for the furnishing of health care, utilization review, medical social work, or administrative services withwith any of the following: (i) any individual or entity Excluded from participation in Federal Health Care Programs under section 1128 or 1128A of the Social Security Act; (ii) any individual or entity that is (or is affiliated Affiliated with a person/entity that is) debarred, Suspendedsuspended, or Excluded excluded from participating in procurement activities under the Federal Acquisition Regulation (FAR) or from participating in non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549; or (iii) any entity that would provide those services through an individual or entity debarred, Suspended, or Excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non-non- procurement activities under regulation issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549 or an individual or entity excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Social Security Act. (B) The Parties understand and agree that the Department must ensure that no payment is made to a Network Provider other than by the Contractor for Covered Services, except when these payments are specifically required to be made by the Department in Title XIX of the Social Security Act, in 42 CFR, or when the Department makes direct payments to Network Providers for graduate medical education costs approved under the State Plan.