Common use of Conditions Endangering Performance Clause in Contracts

Conditions Endangering Performance. At its option, the Department may provide the MCO with written notice of conditions endangering Contract performance. Conditions that endanger performance include, but are not limited to, the following: • Failing to substantially provide Medically Necessary covered items and services that are required (under law or under the MCO’s Contract with the Department) to be provided to an enrollee covered under the Contract; • Imposing premiums, copays, or charges enrollees in excess of the premiums, copays, or charges permitted under the Medicaid program; • Engaging in any practice that discriminates on the basis of health status or need for health care services; • Misrepresenting or falsifying information furnished to the Department, an enrollee, a potential enrollee, or health care provider; • Failing to comply with the physician incentive requirements under section 1903(m)(2)(A)(x) of the Social Security Act; or • Distributing directly or through any agent or independent contractor marketing materials that contain false or misleading information. At any time the MCO is found to perform any of the above activities the Department must notify the CMS Regional Office. Unless otherwise specified in the written notice of condition(s) that endanger performance, the Department may allow the MCO a minimum of ten working days to remedy the condition(s) contained in the notice. If after such notice of conditions that endanger performance the MCO fails to remedy the conditions contained in the notice, within ten working days or the time period specified in the notice, the Department may pursue other remedies under this Contract or any intermediate remedies outlined in 42 CFR 438.702.

Conditions Endangering Performance. At its option, the Department may provide the MCO with written notice of conditions endangering Contract contract performance. Conditions that endanger performance include, but are not limited to, the following: •  Failing to substantially provide Medically Necessary covered items and services that are required (under law or under the MCO’s Contract contract with the Department) to be provided to an enrollee covered under the Contract; •  Imposing premiums, copays, or charges enrollees in excess of the premiums, copays, or charges permitted under the Medicaid program; •  Engaging in any practice that discriminates on the basis of health status or need for health care services; •  Misrepresenting or falsifying information furnished to the Department, an enrollee, a potential enrollee, or health care provider; •  Failing to comply with the physician incentive requirements under section 1903(m)(2)(A)(x) of the Social Security Act; or •  Distributing directly or through any agent or independent contractor marketing materials that contain false or misleading information. At any time the MCO is found to perform any of the above activities the Department must notify the CMS Regional Office. Unless otherwise specified in the written notice of condition(s) that endanger performance, the Department may allow the MCO a minimum of ten working days to remedy the condition(s) contained in the notice. If after such notice of conditions that endanger performance the MCO fails to remedy the conditions contained in the notice, within ten working days or the time period specified in the notice, the Department may pursue other remedies under this Contract or any intermediate remedies outlined in 42 CFR 438.702.

Conditions Endangering Performance. At its option, the Department may provide the MCO with written notice of conditions endangering Contract contract performance. Conditions that endanger performance include, but are not limited to, the following: • Failing to substantially provide Medically Necessary covered items and services that are required (under law or under the MCO’s Contract contract with the Department) to be provided to an enrollee covered under the Contract; • Imposing premiums, copays, or charges enrollees in excess of the premiums, copays, or charges permitted under the Medicaid program; • Engaging in any practice that discriminates on the basis of health status or need for health care services; • Misrepresenting or falsifying information furnished to the Department, an enrollee, a potential enrollee, or health care provider; • Failing to comply with the physician incentive requirements under section 1903(m)(2)(A)(x) of the Social Security Act; or • Distributing directly or through any agent or independent contractor marketing materials that contain false or misleading information. At any time the MCO is found to perform any of the above activities the Department must notify the CMS Regional Office. Unless otherwise specified in the written notice of condition(s) that endanger performance, the Department may allow the MCO a minimum of ten working days to remedy the condition(s) contained in the notice. If after such notice of conditions that endanger performance the MCO fails to remedy the conditions contained in the notice, within ten working days or the time period specified in the notice, the Department may pursue other remedies under this Contract or any intermediate remedies outlined in 42 CFR 438.702.

Conditions Endangering Performance. At its option, the Department may provide the MCO with written notice of conditions endangering Contract performance. Conditions that endanger performance include, but are not limited to, the following: •  Failing to substantially provide Medically Necessary covered items and services that are required (under law or under the MCO’s Contract with the Department) to be provided to an enrollee covered under the Contract; •  Imposing premiums, copays, or charges enrollees in excess of the premiums, copays, or charges permitted under the Medicaid program; •  Engaging in any practice that discriminates on the basis of health status or need for health care services; •  Misrepresenting or falsifying information furnished to the Department, an enrollee, a potential enrollee, or health care provider; •  Failing to comply with the physician incentive requirements under section 1903(m)(2)(A)(x) of the Social Security Act; or •  Distributing directly or through any agent or independent contractor marketing materials that contain false or misleading information. At any time the MCO is found to perform any of the above activities the Department must notify the CMS Regional Office. Unless otherwise specified in the written notice of condition(s) that endanger performance, the Department may allow the MCO a minimum of ten working (10) business days to remedy the condition(s) contained in the notice. If after such notice of conditions that endanger performance the MCO fails to remedy the conditions contained in the notice, within ten working (10) business days or the time period specified in the notice, the Department may pursue other remedies under this Contract or any intermediate remedies outlined in 42 CFR 438.702.

Conditions Endangering Performance. At its option, the Department may provide the MCO with written notice of conditions endangering Contract performance. Conditions that endanger performance include, but are not limited to, the following: •  Failing to substantially provide Medically Necessary covered items and services that are required (under law or under the MCO’s Contract with the Department) to be provided to an enrollee covered under the Contract; •  Imposing premiums, copays, or charges enrollees in excess of the premiums, copays, or charges permitted under the Medicaid program; •  Engaging in any practice that discriminates on the basis of health status or need for health care services; •  Misrepresenting or falsifying information furnished to the Department, an enrollee, a potential enrollee, or health care provider; •  Failing to comply with the physician incentive requirements under section 1903(m)(2)(A)(x) of the Social Security Act; or •  Distributing directly or through any agent or independent contractor marketing materials that contain false or misleading information. At any time the MCO is found to perform any of the above activities the Department must notify the CMS Regional Office. Unless otherwise specified in the written notice of condition(s) that endanger performance, the Department may allow the MCO a minimum of ten working days to remedy the condition(s) contained in the notice. If after such notice of conditions that endanger performance the MCO fails to remedy the conditions contained in the notice, within ten working days or the time period specified in the notice, the Department may pursue other remedies under this Contract or any intermediate remedies outlined in 42 CFR 438.702.

Conditions Endangering Performance. At its option, the Department may provide the MCO with written notice of conditions endangering Contract performance. Conditions that endanger performance include, but are not limited to, the following: • Failing to substantially provide Medically Necessary covered items and services that are required (under law or under the MCO’s Contract with the Department) to be provided to an enrollee covered under the Contract; • Imposing premiums, copays, or charges enrollees in excess of the premiums, copays, or charges permitted under the Medicaid program; • Engaging in any practice that discriminates on the basis of health status or need for health care services; • Misrepresenting or falsifying information furnished to the Department, an enrollee, a potential enrollee, or health care provider; • Failing to comply with the physician incentive requirements under section 1903(m)(2)(A)(x) of the Social Security Act; or • Distributing directly or through any agent or independent contractor marketing materials that contain false or misleading information. At any time the MCO is found to perform any of the above activities the Department must notify the CMS Regional Office. Unless otherwise specified in the written notice of condition(s) that endanger performance, the Department may allow the MCO a minimum of ten working (10) business days to remedy the condition(s) contained in the notice. If after such notice of conditions that endanger performance the MCO fails to remedy the conditions contained in the notice, within ten working (10) business days or the time period specified in the notice, the Department may pursue other remedies under this Contract or any intermediate remedies outlined in 42 CFR 438.702.