Contract with CMS for Special Needs Plan Sample Clauses

Contract with CMS for Special Needs Plan. ‌ The MCO agrees to participate in Medicare Advantage as a Dual Eligible Special Needs Plan (SNP), in compliance with 42 CFR 422.107(c)(3), as the same entity holding both the SNP contract and this Contract.
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Contract with CMS for Special Needs Plan. The MCO agrees to participate in Medicare Advantage as a Dual Eligible Special Needs Plan (SNP). The MCO shall notify the STATE, consistent with section 3.6.14, of any material changes in its contract with CMS as a Special Needs Plan, including but not limited to, termination of the contract by either party. The MCO shall inform the STATE regarding significant changes in its Medicare Program or the administration of Medicare Programs, in order to facilitate operating MSHO in as fully integrated a manner as possible. The MCO will notify the STATE of changes, including but not limited to terminations of SNP plans, changes in type of SNPs approved or applied for, denial of a SNP application, failure to meet the CMS Low Income Subsidy (LIS) requirements, Part D issues that may materially affect the SNP, or a decision to conduct a Federal investigative audit that may lead to termination of the SNP, within thirty (30) days of such actions. For any SNP that may enroll Dual Eligible persons, the MCO also agrees to inform the STATE of any requests to CMS for Service Area changes in its SNP Service Area(s) within Minnesota, and of final approval, denial or withdrawal of such requests to CMS within fifteen (15) days of submission of such requests to CMS or within fifteen
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Contract with CMS for Special Needs Plan. The MCO shall notify the STATE of any material changes in its contract with CMS as a Special Needs Plan, including but not limited to, termination of the contract by either party. The MCO shall inform the STATE regarding significant changes in its Medicare Program or the administration of Medicare Programs, in order to facilitate operating MSHO in as fully integrated a manner as possible. The MCO will notify the STATE of changes, including but not limited to terminations of SNP plans, changes in type of SNPs approved or applied for, denial of a SNP application, failure to meet the CMS Low Income Subsidy (LIS) requirements, Part D issues that may materially affect the SNP, or a decision to conduct a Federal investigative audit that may lead to termination of the SNP, within thirty (30) days of such actions. For any SNP that may enroll Dual Eligibles, the MCO also agrees to inform the STATE of any requests to CMS for Service Area changes in its SNP Service Area(s) within Minnesota, and of final approval, denial or withdrawal of such requests to CMS within fifteen (15) days of submission of such requests to CMS or within fifteen
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Contract with CMS for Special Needs Plan. The MCO shall notify the STATE of any material changes in its contract with CMS as a Special Needs Plan, including but not limited to, termination of the contract by either party.
Sample 1Sample 2See All (4)
Contract with CMS for Special Needs Plan. ‌ The MCO agrees to participate in Medicare Advantage, for its integrated SNP only, as a Dual Eligible Special Needs Plan (D-SNP), in compliance with 42 CFR 422.107(c)(3) , as the same entity holding both the D-SNP contract and this Contract. MCO understands that this designation as a Highly Integrated D-SNP (HIDE SNP) includes that its integrated SNP enrollment will be Exclusively Aligned, and agrees to align administrative systems including beneficiary communication materials, enrollment, communications, grievances and appeals processes, and quality improvement, to improve efficiency and beneficiary experience. [42 CFR §§422.2, 422.107]
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Contract with CMS for Special Needs Plan. The MCO agrees to participate in Medicare Advantage as a Dual Eligible Special Needs Plan (SNP). The MCO shall notify the STATE, consistent with section 3.6.14, of any material changes in its contract with CMS as a Special Needs Plan, including but not limited to, termination of the contract by either party. The MCO shall inform the STATE regarding significant changes in its Medicare Program or the administration of Medicare Programs, in order to facilitate operating MSHO in as fully integrated a manner as possible. The MCO will notify the STATE of changes, including but not limited to terminations of SNP plans, changes in type of SNPs approved or applied for, denial of a SNP application, failure to meet the CMS Low Income Subsidy (LIS) requirements, Part D issues that may materially affect the SNP, or a decision to conduct a Federal investigative audit that may lead to termination of the SNP, within thirty (30) days of such actions. For any SNP that may enroll Dual Eligible persons, the MCO also agrees to inform the STATE of any requests to CMS for Service Area changes in its SNP Service Area(s) within Minnesota, and of final approval, denial or withdrawal of such requests to CMS within fifteen (15) days of submission of such requests to CMS or within fifteen (15) days of receipt of notice from CMS, whichever is applicable. Additional Benefits and Premiums. The SNP MCO will notify the STATE of proposed changes with the understanding that the STATE will not share this information. The process of notification is as follows: Prior to the submission of the initial annual Medicare Advantage bids to CMS, the MCO/SNP will consult with the STATE about any changes in proposed Plan Benefit Packages (PBPs), including proposed changes in current benefits or additional premiums the SNP is expecting to request to have approved through the bid; and Notify the STATE of the status of final changes to benefits or premium levels, on or before September 1st of each Contract Year.
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Related to Contract with CMS for Special Needs Plan

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  • Selection of Subcontractors, Procurement of Materials and Leasing of Equipment The contractor shall not discriminate on the grounds of race, color, religion, sex, national origin, age or disability in the selection and retention of subcontractors, including procurement of materials and leases of equipment. The contractor shall take all necessary and reasonable steps to ensure nondiscrimination in the administration of this contract.

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  • Solicitations for Subcontracts, Including Procurement of Materials and Equipment In all solicitation, either by competitive bidding or negotiation, made by the Contractor for work to be performed under a subcontract, including procurement of materials or leases of equipment, each potential Subcontractor or supplier shall be notified by the Contractor of the Contractor’s obligations under this Agreement and the Regulations relative to non-discrimination on the grounds of race, color, or national origin.

  • Public Contracts for Services [Not applicable to agreements relating to the offer, issuance, or sale of securities, investment advisory services or fund management services, sponsored projects, intergovernmental agreements, or information technology services or products and services] Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with a worker without authorization who will perform work under this Agreement and will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E-Verify Program or the Department program established pursuant to C.R.S. §8-17.5-102(5)(c). Contractor shall not knowingly employ or contract with a worker without authorization to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with a worker without authorization to perform work under this Agreement. Contractor (a) shall not use E-Verify Program or Department program procedures to undertake pre-employment screening of job applicants while this Agreement is being performed, (b) shall notify the subcontractor and County within three days if Contractor has actual knowledge that a subcontractor is employing or contracting with a worker without authorization for work under this Agreement, (c) shall terminate the subcontract if a subcontractor does not stop employing or contracting with the worker without authorization within three days of receiving the notice, and (d) shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contractor participates in the Department program, Contractor shall deliver to County a written, notarized affirmation, affirming that Contractor has examined the legal work status of such employee, and shall comply with all of the other requirements of the Department program. If Contractor fails to comply with any requirement of this provision or C.R.S. §8-17.5-102 et seq., County may terminate this Agreement for breach and, if so terminated, Contractor shall be liable for damages.

  • Procurement of Recovered Materials (1) In the performance of this contract, the Contractor shall make maximum use of products containing recovered materials that are EPA-designated items unless the product cannot be acquired

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