Data Submission Requirements to the Exchange Sample Clauses

Data Submission Requirements to the Exchange. Contractor shall submit a complete data set, inclusive of all member and provider identified data, claims, and encounter data, on a quarterly basis to the Exchange or the Exchange’s designated recipient to be used by the Exchange as it determines to be necessary. Such submissions will conform to all applicable Federal and State personal health information and related privacy laws, rules and regulations, and shall comply with the terms and conditions set forth in the Agreement by and between Contractor and the Exchange. Contractor will bear the full cost of data collection, extraction and submission; provided, however, that except as expressly set forth in this Attachment or the Agreement, Contractor will not be required to pay for any expenses related to the analysis of that data in order to comply with the terms of this Agreement. When data is submitted to a vendor for the Exchange, that vendor will be a Business Associate of the Contractor and shall protect the information provided to the extent required under applicable laws, rules and regulations.
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Data Submission Requirements to the Exchange. Contractor shall submit a complete data set, inclusive of all member and provider identified data, claims, encounter and pharmacy data, on a quarterly basis to the Exchange or the Exchange’s designated recipient to be used by the Exchange as it determines to be necessary. Such submissions will conform to all applicable Federal and State personal health information and related privacy laws, rules and regulations, and shall comply with the terms and conditions set forth in the Agreement by and between Contractor and the Exchange. Contractor will bear the full cost of data collection, extraction and submission; provided, however, that except as expressly set forth in this Attachment or the Agreement, Contractor will not be required to pay for any expenses related to the analysis of that data in order to comply with the terms of this Agreement. Contractor is not required to provide the Exchange with Individually Identifiable Health Information as to any Enrollee unless authorized by law. When conformance with data submission requirements necessitates disclosure of Individually Identifiable Health Information not authorized by law, such information shall be submitted by Contractor to a third-party vendor selected by the Exchange and who enters into an agreement with the Contractor to do data analysis and provide reports and analyses to the Exchange. Such vendor must be a Business Associate of the Contractor who shall protect the information provided as required by applicable laws, rules and regulations. Any Personally Identifiable Health Information disclosed to the third party vendor shall be de-identified in any subsequent analysis provided to the Exchange. If the use of such a vendor is necessary, the details of the arrangement shall be set forth in a data use and reporting agreement mutually agreeable to the Exchange and the Contractor. When data is submitted to a vendor for the Exchange, that vendor will be a Business Associate of the Contractor and shall protect the information provided to the extent required under applicable laws, rules and regulations. The Exchange has provided the data file formats contained in Appendix 1 to this Attachment 7 as its initial expectation of Contractors’ provision of data to support oversight requirements, including actuarial review, clinical quality improvement, network management and fraud and waste reduction, delivery system reform goals, consumer information and research. Additional data and expanded file formats may ...
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Data Submission Requirements to the Exchange. Contractor shall provide to the Exchange information regarding Contractor’s membership through the Exchange in a consistent manner to that which Contractor currently provides to its major purchasers. Contractor and the Exchange shall work together in good faith to further define mutually agreeable information and formats for Contractor to provide to the Exchange, in all cases to remain generally consistent with the information shared by Contractor with its major purchasers.
Sample 1Sample 2
Data Submission Requirements to the Exchange. Contractor shall submit a complete data set, inclusive of all claims, encounter and pharmacy data, on a quarterly basis to the Exchange or the Exchange’s designated recipient. Such submissions will conform to all applicable State and Federal personal health information and related privacy laws, rules and regulations, and shall comply with the terms and conditions set forth in the Agreement by and between Contractor and the Exchange. Contractor will bear the full cost of data collection, extraction and submission; provided, however, that except as expressly set forth in this Attachment or the Agreement, Contractor will not be required to pay for any expenses related to the analysis of that data in order to comply with the terms of this Agreement. Contractor shall submit such information at such times and in accordance with the data set standards established by the Exchange, including, the technical specifications set forth in separate attachments to the Administrative Manual • Plan • Member • Member History • Contracted PMGs • Providers (all providers with paid claims, including non-contracted) • Hospitals (all providers with paid claims, including non-contracted) • Professional Claims • Hospital Claims Header • Hospital Claims Detail • Drug Claims Contractor agrees to work with the Exchange to add additional data elements critical to the Exchange’s Enrollees and in order to refine existing quality related assessments. By 2015, Contractor shall be capable of stratifying claims and quality data to the following categories: (i) Race (ii) Ethnicity (iii) Gender
Sample 1
Data Submission Requirements to the Exchange. Contractor shall submit a complete data set, inclusive of all member and provider identified data, claims, encounter and pharmacy data, on a quarterly basis to the Exchange or the Exchange’s designated recipient to be used by the Exchange as it determines to be necessary. Such submissions will conform to all applicable State and Federal personal health information and related privacy laws, rules and regulations, and shall comply with the terms and conditions set forth in the Agreement by and between Contractor and the Exchange. Contractor will bear the full cost of data collection, extraction and submission; provided, however, that except as expressly set forth in this Attachment or the Agreement, Contractor will not be required to pay for any expenses related to the analysis of that data in order to comply with the terms of this Agreement. Data shall be submittedWhen data is submitted to a vendor for the Exchange, that vendor will be is a Business Associate of the Contractor andthat shall protect the information provided to the extent required under applicable laws, rules and regulations. The Exchange has provided the data file formats contained in Appendix 1 to this Attachment 7 as its initial expectation of Contractors’ provision of data to support oversight requirements, including actuarial review, clinical quality improvement, network management and fraud and waste reduction, delivery system reform goals, consumer information and research. Additional data and expanded file formats may be requested in the future in support of the Exchange contributing data to statewide collaborative efforts to advance development of an all payer claims database.
Sample 1

Related to Data Submission Requirements to the Exchange

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