Contracting with ODM-Enrolled Providers Sample Clauses

Contracting with ODM-Enrolled Providers i. To reduce provider burden and promote consistency across the Ohio managed care program, ODM has retained the administrative responsibilities for provider enrollment and for credentialing and re-credentialing. ODM’s provider network management (PNM) system is the State’s system of record for Medicaid provider data. ii. In accordance with 42 CFR 438.608 and this Agreement, the MCOP must contract only with providers that are enrolled with ODM and are active providers in ODM's provider network management system. iii. Prior to contracting with a provider or listing the provider as a network provider, the MCOP must validate that the provider is active in ODM's provider network management system and, for eligible to render the specific waiver service, when applicable, using the PMF or ODA-certified provider file. If a provider is not active in ODM's provider network management system, the MCOP must direct the provider to ODM's portal to submit an application for screening and enrollment prior to contracting. iv. The MCOP must conduct a daily reconciliation of the MCOP's provider network and ODM's provider network management system using PNM system data (the provider master file (PMF) and all supplemental files generated by ODM systems) to ensure that network providers and staff affiliations remain active in ODM's provider network management system. v. Except for waiver providers, in accordance with 42 CFR 438.602, an MCOP may execute a temporary 120 calendar day network provider agreement pending the outcome of the ODM screening, enrollment, and revalidation process. If a provider is not enrolling with ODM because they are operating under an out-of-network contract, or when the provider applicant does not identify with a provider type that is available on the web application, the MCOP must complete the form specified by ODM (ODM 10282) and submit the form to ODM for screening and enrollment. The application can be found at: xxxxx://xxxxxxxx.xxxx.xxx/stakeholders-and-partners/legal-and-contracts/forms/forms. The MCOP must immediately terminate the provider and notify affected members upon notification from ODM that the provider cannot be enrolled. In this instance, no advance contract termination notice to the provider is required. vi. The MCOP may only pay a provider who is enrolled with ODM unless the provider is rendering services with a temporary 120 calendar day agreement, a single-case agreement, or for emergency services in accordance with 42 CFR 438.114...
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Related to Contracting with ODM-Enrolled Providers

  • Agreements with Subcontractors Business Associate shall enter into a Business Associate Agreement with any Subcontractor to whom it provides PHI received from Covered Entity or created or received by Business Associate on behalf of Covered Entity in which the Subcontractor agrees to the same restrictions and conditions that apply through this Agreement to Business Associate with respect to such PHI. Business Associate must enter into this Business Associate Agreement before any use by or disclosure of PHI to such agent. The written agreement must identify Covered Entity as a direct and intended third party beneficiary with the right to enforce any breach of the agreement concerning the use or disclosure of PHI. Business Associate shall provide a copy of the Business Associate Agreement it enters into with a subcontractor to Covered Entity upon request. Business associate may not make any disclosure of PHI to any Subcontractor without prior written consent of Covered Entity.

  • Agreements with Other Service Providers Each Fund hereby appoints FSSC as the Fund’s agent to enter into agreements with financial intermediaries that are not registered as broker/dealers under the 1934 Act (each an “Unregistered Intermediary”) to provide Services to their customers that are Shareholders of the Fund. Each Fund agrees to pay Service Fees at an annual rate as set forth in Schedule 1 to this Agreement of up to 0.25% of the average net assets held in Fund accounts for which an Unregistered Intermediary has agreed to provide Services. Any such accounts shall not be treated as FSSC Accounts for purposes of this Agreement.

  • Contracts With Service Providers 13 Section 1.

  • Agreements with Employees and Subcontractors Grantee shall have written, binding agreements with its employees and subcontractors that include provisions sufficient to give effect to and enable Grantee’s compliance with Grantee’s obligations under this Article VI, Intellectual Property.

  • Excluded Providers 4.1 Definition of Excluded Providers

  • Contracts with Subcontractors a. Grantee may enter into contracts with subcontractors unless restricted or otherwise prohibited in the Contract. b. Grantees are prohibited from subcontracting with for-profit organizations under this Contract. c. Prior to entering into a subcontract agreement equaling or exceeding $100,000, Grantee will obtain written approval from the System Agency. d. Grantee will obtain written approval from System Agency before modifying any subcontract agreement to cause the agreement to exceed $100,000. e. Grantee will establish written policies and procedures for competitive procurement and monitoring of subcontracts and will develop a subcontracting monitoring plan. f. monitor subcontractors for both financial and programmatic performance and will maintain pertinent records. g. submit quarterly monitoring reports to the System Agency in a format determined by the System Agency. h. ensure that subcontracts are fully aware of the requirements placed upon them by state/federal statutes, rules, and regulations and by the provisions of this Contract. i. ensure all subcontracts, must be in writing and include the following: 1. Name and address of all parties and the subcontractor’s Vendor Identification Number (VIN) or Employee Identification Number (EIN); 2. Detailed description of the services to be provided; 3. Measurable method and rate of payment and total not-to-exceed amount of the contract; 4. Clearly defined and executable termination clause; and 5. Beginning and ending dates that coincide with the dates of the Contract. j. ensure and be responsible for the performance of the subcontractor(s). k. not contract with a subcontractor, at any tier, that is debarred, suspended, or excluded from or ineligible for participation in federal assistance programs or if the subcontractor would be otherwise ineligible to abide by the terms of this Contract.

  • Follow-On Contracting No person, firm, or subsidiary who has been awarded a Consulting Services agreement may submit a bid for, nor be awarded an agreement for, the providing of services, procuring goods or supplies, or any other related action that is required, suggested, or otherwise deemed appropriate in the end product of this Agreement.

  • Third Party Contractors Tenant shall obtain and deliver to Landlord, Third Party Contractor’s certificates of insurance and applicable endorsements at least seven (7) business days prior to the commencement of work in or about the Premises by any vendor or any other third-party contractor (collectively, a “Third Party Contractor”). All such insurance shall (a) name Landlord as an additional insured under such party’s liability policies as required by Section 10.3.1 above and this Section 10.6, (b) provide a waiver of subrogation in favor of Landlord under such Third Party Contractor’s commercial general liability insurance, (c) be primary and any insurance carried by Landlord shall be excess and non-contributing, and (d) comply with Landlord’s minimum insurance requirements.

  • Where a Contracting Party expropriates the assets of a company which is incorporated or constituted under the law in force in any part of its own territory, and in which investors of the other Contracting Party own shares, it shall ensure that the provisions of this Article are applied so as to guarantee prompt, adequate and effective compensation in respect of their investment to such investors of the other Contracting Party who are owners of those shares.

  • Coordination, Oversight and Monitoring of Service Providers As set forth in the Administrative Services Agreement between the Fund and CRMC, CRMC shall coordinate, monitor and oversee the activities performed by the Service Providers with which AFS contracts. AFS shall monitor Service Providers’ provision of services including the delivery of Customer account statements and all Fund-related material, including summary prospectuses and/or prospectuses, shareholder reports, and proxies.

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