CMS Data Sharing Sample Clauses

CMS Data Sharing. Over the Performance Period of the Model, CMS is willing to accept requests from the GMCB for Medicare data necessary to achieve the purposes of the Model. This Medicare data may include individually-identifiable Medicare eligibility status and demographic information of all Medicare FFS beneficiaries residing in Vermont, and claim and claim line data for services furnished by Medicare-enrolled providers and suppliers to Medicare FFS beneficiaries residing in Vermont. CMS may, upon request of the GMCB, provide additional reports that include the following: utilization, expenditures, quality of care, Medicare FFS eligibility type, VMA ACO alignment, and performance summary comparisons to other states. The GMCB may request individually- identifiable health information that is necessary for carrying out health oversight activities under 45 C.F.R. § 164.512(d)(1). All such requests for individually- identifiable health information must clearly state the HIPAA basis for the requested disclosure and include an assertion that the data requested constitutes the minimum necessary to carry out those activities. CMS will make best efforts to approve, deny, or request additional information regarding data requests within 60 calendar days after the State’s request. CMS will accept or reject such requests on a case-by-case basis and at CMS’s sole discretion. All information will be provided consistent with all applicable laws and regulations, including HIPAA and the regulations governing the confidentiality of substance use disorder patient records under 42 C.F.R. part 2. Appropriate privacy and security protections will be required for any data disclosed under this Agreement.
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CMS Data Sharing. Over the Performance Period of the Model, CMS is willing to accept requests from the GMCB for Medicare data necessary to achieve the purposes of the Model. This Medicare data may include individually identifiable Medicare eligibility status and demographic information of all Medicare FFS beneficiaries residing in Vermont, and claim and claim line data for services furnished by Medicare-enrolled providers and suppliers to Medicare FFS beneficiaries residing in Vermont. Additional reports may be provided upon request that include the following: utilization, expenditures, quality of care, Medicare FFS eligibility type, VMA ACO alignment, and performance summary comparisons to other states. All such requests for individually-identifiable health information must clearly state the HIPAA basis for requested disclosure (e.g., for research purposes under 45 C.F.R. § 164.512(i), to enable GMCB to analyze healthcare utilization, quality, expenditures, and system performance under the Vermont All- payer ACO Model). CMS will make best efforts to approve, deny, or request additional information regarding data requests within a reasonable amount of time. All information will be provided consistent with all applicable laws and regulations, including HIPAA and the Part 2 regulations governing the use of information regarding diagnosis and treatment for substance abuse. Appropriate privacy and security protections will be required for any data disclosed under this Model.
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CMS Data Sharing i. During the Agreement Term, CMS will offer the State an opportunity to request certain Medicare data and reports using a data request process to be determined in a form, manner, and time by CMS. All such requests for beneficiary-identifiable information must clearly state which provision under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule permits the requested disclosure (e.g., for health oversight activities under 45 C.F.R. § 164.512(d)). The State will ensure that each request for data is limited to the minimum data necessary to accomplish the task. CMS will provide this Medicare data to the State in a manner consistent with all applicable laws and regulations, including HIPAA. CMS will make best efforts to approve, deny, or request additional information within 30 days of receipt. CMS will accept or reject such requests on a case-by-case basis and at CMS’ sole discretion. ii. Medicare data requests may include information that has been de-identified in accordance with the HIPAA Privacy Rule requirements in 45 C.F.R. § 164.514(b). Such Medicare data may also include certain beneficiary-identifiable Medicare eligibility status and demographic information of all Medicare FFS beneficiaries residing in the State and claim line data for items and services furnished to those beneficiaries. CMS may provide additional reports that include the following: utilization, expenditures, quality of care, Medicare eligibility type, and performance summary comparisons to other states.
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Related to CMS Data Sharing

  • Data Sharing The GRANTEE BENEFICIARY agrees to share data with the AGENCY as deemed necessary by AGENCY, in its sole discretion, for expenditure validation, trend review, and performance monitoring.

  • Cost Sharing a) With respect to the funding in C6.1a), should there be an amount of employee co-pay, the Trust shall advise boards what that amount shall be. Unless advised otherwise, there will be no deductions upon the Participation Date. b) Any further cost sharing or funding arrangements as per previous local collective agreements in effect as of August 31, 2014 remain status quo.

  • Information Sharing (a) HHSC will provide the MA Dual SNP with resources regarding the LTSS covered by Medicaid in accordance with this section. (b) Texas Medicaid benefits are described in Attachment B, Texas Medicaid Summary of Benefits. The MA Dual SNP must include the Texas Medicaid Summary of Benefits in its Member Handbook for the MA Product. (c) HHSC and the MA Dual SNP will identify and share information, such as the following: (1) HHSC will provide the MA Dual SNP with links to online Medicaid LTSS provider information for the traditional fee-for-service and STAR+PLUS programs. Within thirty (30) business days after receiving such information, the MA Dual SNP must post a link to this information on its website. (2) The MA Dual SNP must: A) Notify Dual Eligible Members and Other Dual SNP Members, via its member communication materials that information concerning Medicaid provider participation is available on the MA Dual SNP’s website; and B) Notify Dual Eligible Members and Other Dual SNP Members that they may request written copies of Medicaid Provider directories by contacting their STAR+PLUS MCO, C) Assist the Dual Eligible Members and Other Dual SNP Members in obtaining printed copies of Medicaid Provider directories from their STAR+PLUS MCO, and D) Verify that the Dual Eligible Members and Other Dual SNP Member received the requested directory. (3) The MA Dual SNP must notify Network Providers that information concerning Medicaid provider participation is available on the MA Dual SNP’s website. The MA Dual SNP must provide this notice in the Network Provider agreement, Network Provider manuals, bulletins, faxes, policies and procedures, provider manual updates, or other contractual documents. (4) The MA Dual SNP must have written procedures for ensuring that Dual Eligible Members and Other Dual SNP Members have access to the services identified in the MA Product, including policies regarding network adequacy that are consistent with the requirements of the MA Agreement. The MA Dual SNP must provide HHSC with a copy of these policies no later than 5 business days after a request. (d) The MA Dual SNP must encourage Network Provider SNF to electronically submit to the HHSC Medicaid claims administrator a resident transaction notice within 72 hours after a Dual Eligible Member’s admission or discharge from the nursing facility, in accordance with 40 Tex. Admin. Code § 19.2615. (e) The MA Dual SNP is required to notify HHSC of significant changes to the terms of its CMS contract within 10 business days of such changes, which may include but is not limited to the following: changes in the services areas; plan benefit package (PBP) changes; non-renewal; terminations or deficiencies of the contract; notices of intent to deny; and any novation agreements. Plans must submit any CMS warning letters or corrective action plans within 10 business days of receipt to the HHSC point-of- contact identified in Section 9.06. (f) The MA Dual SNP is required to notify HHSC in the event the Plan receives less than a 3.0 star Medicare rating on either its Part C or Part D scores. The Plan must provide an outline of the steps proposed or implemented to improve the low score. (g) The MA Dual SNP must participate in meetings with HHSC, telephonic or in person, relating to the health care provided under this Agreement and their compliance with this Agreement's terms, and to timely provide any necessary information and data upon HHSC's request. (h) The MA Dual SNP, upon request from HHSC, must provide all documents it provides to and receives from CMS, within 30 days of the HHSC request, unless an extension is granted by HHSC.

  • Sharing If any Lender shall, by exercising any right of setoff or counterclaim or otherwise, obtain payment in respect of any principal of or interest on any of its Loans or other obligations hereunder resulting in such Lender receiving payment of a proportion of the aggregate amount of its Loans and accrued interest thereon or other such obligations greater than its pro rata share thereof as provided herein, then the Lender receiving such greater proportion shall (i) notify the Administrative Agent of such fact, and (ii) purchase (for cash at face value) participations in the Loans and such other obligations of the other Lenders, or make such other adjustments as shall be equitable, so that the benefit of all such payments shall be shared by the Lenders ratably in accordance with the aggregate amount of principal of and accrued interest on their respective Loans and other amounts owing them, provided that: (i) if any such participations are purchased and all or any portion of the payment giving rise thereto is recovered, such participations shall be rescinded and the purchase price restored to the extent of such recovery, without interest; and (ii) the provisions of this paragraph shall not be construed to apply to (x) any payment made by the Borrower pursuant to and in accordance with the express terms of this Credit Agreement or (y) any payment obtained by a Lender as consideration for the assignment of or sale of a participation in any of its Loans to any assignee or participant, other than to the Borrower or any subsidiary thereof (as to which the provisions of this paragraph shall apply). The Borrower consents to the foregoing and agrees, to the extent it may effectively do so under applicable law, that any Lender acquiring a participation pursuant to the foregoing arrangements may exercise against the Borrower rights of setoff and counterclaim with respect to such participation as fully as if such Lender were a direct creditor of the Borrower in the amount of such participation.

  • Data Storage Where required by applicable law, Student Data shall be stored within the United States. Upon request of the LEA, Provider will provide a list of the locations where Student Data is stored.

  • JOB SHARING North Bay; Perth-Huron; Peterborough, Victoria & Haliburton; Sarnia- Lambton Taking into consideration the fact that the Employer wishes to retain well- qualified staff who are unable or prefer not to provide a full-time commitment and the job-sharing can enable this to happen, the parties agree to the following provisions: (a) Job-sharing requests with regard to full-time positions shall be considered on an individual basis, and the Employer shall reserve the right to determine the appropriateness of such arrangements, including the number of job-shared positions after discussions with the Union at the Labour Management Committee. (b) Any incumbent full-time Nurse wishing to share their position may do so without having their half (½) of the position posted. The other half (½) of the job-sharing position will be posted, and selection will be in accordance with the Collective Agreement. (c) Save and except as provided for herein, all job-sharers shall be treated as part-time employees and shall receive percentage in lieu of benefits. (d) If one (1) of the job-sharers leaves the arrangement, their position will be posted. If there is no successful applicant to the position, the shared position must revert to a full-time position. The remaining Nurse will have the option of continuing the full-time position or reverting to a part-time position for which they are qualified. If they do not continue full-time, the position must be posted in accordance with the Collective Agreement. (e) Posted schedules for the job-sharers shall be based on the schedules that would apply to a full-time Nurse holding that position. Such schedule shall conform to the scheduling provisions for full- time. (f) Total hours worked by the two job-sharers shall be equal to one full- time position. The division of these hours over the schedule shall be determined by mutual agreement between the two Nurses and the immediate Supervisor. This does not exclude the Nurses from opportunities for extra available work. (g) Each job-sharer may exchange shifts with their partner, as well as with other Nurses in accordance with the Collective Agreement, provided such exchange creates no additional labour cost to the Employer and meets continuity requirements. (h) It is expected that both job-sharers will cover each other’s absences including incidental illnesses and vacation. If, because of unavoidable circumstances, one cannot cover the other, the Supervisor must be notified to book coverage. Job-sharers are not required to cover for their partners in the case or prolonged or extended absences but may be offered the opportunity to do so. (i) Job-sharers will not be required to work in total more paid holidays than would one full-time Nurse, unless mutually agreed otherwise. Job-sharers will have the right to determine which partner works the scheduled holidays. (j) Either party may discontinue the arrangement with one month’s written notice and the employees shall revert to their former status without posting if such positions are still available. 14.14 Christmas/New Year’s Xxxxxxxxxxxx, Xxxxxxxx & Haliburton

  • Scholarly Sharing On an ad hoc basis, the Authorized Users may transmit to a third party, in hard copy or electronically, minimal, insubstantial amounts or a portion of the Licensed Materials for personal use or scholarly, educational, or scientific research or professional use in the nature of collaboration, comment, or scholarly exchange of ideas but in no case for resale or commercial purposes or in a manner that would substitute for direct access to the Licensed Materials via services offered by the Distributor and/or the Publisher.