Common use of BASIS FOR TERMINATION OF AGREEMENT BY TMA Clause in Contracts

BASIS FOR TERMINATION OF AGREEMENT BY TMA. (a) In addition to any authority under the TRICARE regulation to terminate or exclude a provider, the Deputy Director, TMA, or a designee may terminate this agreement for cause, upon 30 days’ written notice, if the SUDRF: (1) Is not in compliance with the requirements of the Dependents Medical Care Act, as amended (10 USC 1071 et seq.), the TRICARE regulation (32 CFR 199), the TRICARE/CHAMPUS Standards for Inpatient Rehabilitation and Partial Hospitalization for Treatment of Substance Use Disorders, or with performance provisions stated in Article 3 of this participation agreement. (2) Fails to comply with payment provisions set forth in Article 4 of this agreement. (3) Fails to allow audits/reviews and/or to provide records as required by Article 5 of this agreement. (4) Fails to comply with nondiscrimination provisions of Article 6 of this agreement. (5) Changes ownership as set forth in Article 8 of this agreement. (6) Fails to provide incident reports, disaster or emergency reports, or reports of SUDRF changes, as set forth in Article 9 of this agreement. (7) Initiates a program change without written approval by TMA or a designee; program changes include but are not limited to: changes in the physical location, population served, capacity, type of license, expansion of program(s), or development of new program(s). (8) Does not admit a TRICARE beneficiary during any consecutive 24-month period. (9) Suspends operations for a period of 120 days or more. (10) Is determined to be involved in provider fraud or abuse, as established by TRICARE regulation (32 CFR 199.9). This includes the submission of falsified or altered TRICARE claims or medical records which misrepresent the type, frequency, or duration of services or supplies. (b) The Deputy Director, TMA may terminate this agreement without prior notice in the event that the SUDRF’s failure to comply with the TRICARE/CHAMPUS Standards for Inpatient Rehabilitation and Partial Hospitalization for Treatment of Substance Use Disorders presents an immediate danger to life, health, or safety.