{"component": "clause", "props": {"groups": [{"snippet_links": [{"key": "general-requirement", "type": "clause", "offset": [0, 19]}, {"key": "in-this-contract", "type": "clause", "offset": [52, 68]}, {"key": "pursuant-to", "type": "definition", "offset": [69, 80]}], "snippet": "General Requirement All directed payments set forth in this Contract pursuant to 42 CFR 438.6(c)(1)(i)-", "samples": [{"hash": "kwM8TQoEjg3", "uri": "/contracts/kwM8TQoEjg3#directed-payments", "label": "Standard Contract", "score": 34.2105369568, "published": true}, {"hash": "jzctKCjcS9G", "uri": "/contracts/jzctKCjcS9G#directed-payments", "label": "Standard Contract", "score": 34.2105369568, "published": true}, {"hash": "g0j81jkXYx5", "uri": "/contracts/g0j81jkXYx5#directed-payments", "label": "Standard Contract", "score": 34.2105369568, "published": true}], "size": 26, "hash": "c892d1e58b469f1bfd01c2cdf998c9f8", "id": 1}, {"snippet_links": [{"key": "a-party", "type": "clause", "offset": [3, 10]}, {"key": "this-purchase-agreement", "type": "clause", "offset": [48, 71]}, {"key": "other-party", "type": "definition", "offset": [85, 96]}, {"key": "five-days", "type": "definition", "offset": [97, 106]}, {"key": "a-bank", "type": "clause", "offset": [139, 145]}, {"key": "account-number", "type": "definition", "offset": [150, 164]}, {"key": "payment-to", "type": "clause", "offset": [193, 203]}, {"key": "payment-by-wire-transfer", "type": "clause", "offset": [243, 267]}, {"key": "immediately-available-funds", "type": "definition", "offset": [272, 299]}, {"key": "designated-account", "type": "definition", "offset": [308, 326]}], "snippet": "If a party which is entitled to a payment under this Purchase Agreement provides the other party five days' advance written designation of a bank and account number into which the payee wishes payment to be made, then the payor will make such payment by wire transfer (in immediately available funds) to the designated account of the payee.", "samples": 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"clause", "offset": [367, 386]}, {"key": "payment-to-the-contractor", "type": "clause", "offset": [396, 421]}, {"key": "letter-of-direction", "type": "definition", "offset": [432, 451]}, {"key": "of-the-contractor", "type": "clause", "offset": [531, 548]}, {"key": "subject-to", "type": "definition", "offset": [550, 560]}, {"key": "approval-by", "type": "clause", "offset": [568, 579]}, {"key": "unless-otherwise-specified", "type": "clause", "offset": [584, 610]}, {"key": "risk-arrangements", "type": "clause", "offset": [649, 666]}, {"key": "the-non", "type": "clause", "offset": [749, 756]}, {"key": "comply-with-the", "type": "clause", "offset": [849, 864]}, {"key": "payment-limits", "type": "definition", "offset": [871, 885]}, {"key": "provider-services", "type": "clause", "offset": [1025, 1042]}, {"key": "provider-handbook", "type": "clause", "offset": [1072, 1089]}, {"key": "contract-providers", "type": "clause", "offset": [1097, 1115]}, {"key": "the-contractor-may", "type": "clause", "offset": [1117, 1135]}, {"key": "distribute-the", "type": "clause", "offset": [1136, 1150]}, {"key": "electronic-copy", "type": "definition", "offset": [1266, 1281]}, {"key": "to-request", "type": "clause", "offset": [1290, 1300]}, {"key": "hard-copy", "type": "definition", "offset": [1303, 1312]}, {"key": "no-charge", "type": "definition", "offset": [1316, 1325]}, {"key": "table-of-contents", "type": "definition", "offset": [1422, 1439]}, {"key": "turquoise-care", "type": "definition", "offset": [1456, 1470]}, {"key": "assessment-information", "type": "definition", "offset": [1518, 1540]}, {"key": "covered-services", "type": "definition", "offset": [1598, 1614]}, {"key": "description-of-the", "type": "clause", "offset": [1616, 1634]}, {"key": "care-coordinators", "type": "clause", "offset": [1643, 1660]}, {"key": "cultural-competency", "type": "definition", "offset": [1662, 1681]}, {"key": "cultural-humility", "type": "clause", "offset": [1686, 1703]}, {"key": "interpretation-and", 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[2200, 2215]}, {"key": "how-to-report", "type": "clause", "offset": [2251, 2264]}, {"key": "suspected-fraud", "type": "definition", "offset": [2265, 2280]}, {"key": "other-providers", "type": "definition", "offset": [2313, 2328]}, {"key": "major-subcontractors", "type": "clause", "offset": [2330, 2350]}, {"key": "background-checks", "type": "clause", "offset": [2395, 2412]}, {"key": "suspected-abuse", "type": "clause", "offset": [2455, 2470]}, {"key": "of-members", "type": "clause", "offset": [2498, 2508]}, {"key": "prior-authorization", "type": "definition", "offset": [2510, 2529]}, {"key": "requirements-and-procedures", "type": "clause", "offset": [2574, 2601]}, {"key": "reporting-and-records", "type": "clause", "offset": [2631, 2652]}, {"key": "claims-submission", "type": "definition", "offset": [2654, 2671]}, {"key": "and-standards", "type": "clause", "offset": [2682, 2695]}, {"key": "all-information", "type": "clause", "offset": [2724, 2739]}, {"key": "necessary-for", "type": "definition", "offset": [2740, 2753]}, {"key": "clean-claims", "type": "clause", "offset": [2754, 2766]}, {"key": "payment-policies", "type": "clause", "offset": [2768, 2784]}, {"key": "credentialing-and-recredentialing-requirements", "type": "clause", "offset": [2786, 2832]}, {"key": "hipaa-requirements", "type": "definition", "offset": [2854, 2872]}, {"key": "the-provider-must", "type": "clause", "offset": [2884, 2901]}, {"key": "member-rights-and-responsibilities", "type": "clause", "offset": [2910, 2944]}, {"key": "telephone-number", "type": "definition", "offset": [2950, 2966]}, {"key": "a-separate", "type": "definition", "offset": [3003, 3013]}, {"key": "services-and", "type": "clause", "offset": [3072, 3084]}, {"key": "exempt-members", "type": "clause", "offset": [3089, 3103]}, {"key": "as-needed", "type": "clause", "offset": [3148, 3157]}, {"key": "changes-to-the", "type": "definition", "offset": [3187, 3201]}], "snippet": "The CONTRACTOR shall comply with Directed Payments established by HCA and approved by CMS. All assurances specified in 42 C.F.R. \u00a7 438.6(c)(2)(ii)-(iii) applicable to the type of Directed Payment, as defined in 42 C.F.R. \u00a7 438.6(c)(1)(i)-(iii), and made by HCA part of the approval process for Directed Payments are restated and reaffirmed. HCA shall communicate the requirements of the Directed Payment to the CONTRACTOR through a Letter of Direction. The Directed Payments listed in Attachment 10: Directed Payments are required of the CONTRACTOR, subject to annual approval by CMS unless otherwise specified. The CONTRACTOR shall comply with non-risk arrangements established by HCA and approved by CMS. HCA shall communicate the requirements of the non-risk arrangement to the CONTRACTOR through a Letter of Direction. The non-risk arrangements comply with the upper payment limits specified in 42 C.F.R. \u00a7 447.362. The non-risk arrangements listed in Attachment 11: Non-Risk Arrangements are required of the CONTRACTOR. Provider Services The CONTRACTOR shall issue a provider handbook to all Contract Providers. The CONTRACTOR may distribute the Provider handbook electronically (e.g., via its website) as long as Providers are notified about how to obtain the electronic copy and how to request a hard copy at no charge to the Provider. At a minimum, the Provider handbook shall include the following information: A table of contents; Description of Turquoise Care, including eligibility, enrollment, and Member assessment information; Information about CISC Members and the CISC CONTRACTOR; Covered Services; Description of the role of care coordinators; Cultural competency and cultural humility; How the Provider can access language interpretation and specialized communication services; Description of the SDCB and the Agency-Based Community Benefit; Emergency Services responsibilities; Information on Member Grievance and Appeal rights and processes, including Fair Hearings; Policies and procedures of the provider complaint system; Medically Necessary Service standards and clinical practice guidelines; PCP responsibilities; Member lock in standards and requirements; The CONTRACTOR\u2019s Fraud and Abuse policies and procedures, including how to report suspected Fraud and/or Abuse; Coordination with other Providers, Major Subcontractors, or HCA contractors; Requirements regarding background checks; Information on identifying and reporting suspected Abuse, neglect, and exploitation of Members; Prior authorization, referral, and other Utilization Management requirements and procedures; Protocol for Encounter Data reporting and records; Claims submission protocols and standards, including instructions and all information necessary for Clean Claims; Payment policies; Credentialing and recredentialing requirements; Confidentiality and HIPAA requirements with which the Provider must comply; Member rights and responsibilities; The telephone number for the Provider services line; and A separate section and/or addendum that specifically address the ABP services and ABP Exempt Members. The CONTRACTOR shall disseminate bulletins as needed to incorporate any necessary changes to the provider handbook.", "samples": [{"hash": "1nxPPXC9Jlw", "uri": "/contracts/1nxPPXC9Jlw#directed-payments", "label": "Medicaid Managed Care Services Agreement", "score": 32.8045463562, "published": true}, {"hash": "bgTASXFayAm", "uri": "/contracts/bgTASXFayAm#directed-payments", "label": "Medicaid Managed Care Services Agreement", "score": 32.7388496399, "published": true}, {"hash": "gyRK0n50O0u", "uri": "/contracts/gyRK0n50O0u#directed-payments", "label": "Medicaid Managed Care Services Agreement", "score": 32.5636558533, "published": true}], "size": 4, "hash": "ab3fe5bba3c66d1b3c1f235c442a787b", "id": 3}, {"snippet_links": [{"key": "effective-dates", "type": "definition", "offset": [4, 19]}, {"key": "cms-approval", "type": "clause", "offset": [63, 75]}, {"key": "subject-to", "type": "definition", "offset": [80, 90]}, {"key": "annual-renewal", "type": "definition", "offset": [91, 105]}, {"key": "end-date", "type": "clause", "offset": [168, 176]}, {"key": "in-place", "type": "definition", "offset": [199, 207]}, {"key": "contract-term", "type": "clause", "offset": [232, 245]}, {"key": "termination-of-the-contract", "type": "clause", "offset": [309, 336]}], "snippet": "The effective dates of the directed payments are contingent on CMS approval and subject to annual renewal unless otherwise noted. Directed payments without a specified end date are anticipated to be in place for the duration of the contract term and will be removed from this Attachment if ended prior to the termination of the contract term.", "samples": [{"hash": "8MqBiuw8htC", "uri": "/contracts/8MqBiuw8htC#directed-payments", "label": "Medicaid Managed Care Services Agreement", "score": 33.3862405249, "published": true}, {"hash": "ktIuEIS7rg2", "uri": "/contracts/ktIuEIS7rg2#directed-payments", "label": "Medicaid Managed Care Services Agreement", "score": 33.0035629272, "published": true}, {"hash": "8ZuyIVFRkN", "uri": "/contracts/8ZuyIVFRkN#directed-payments", "label": "Medicaid Managed Care Services Agreement", "score": 32.9705085754, "published": true}], "size": 4, "hash": "9dfcc28bcbc3a9fda2f0fd302d59fb71", "id": 4}, {"snippet_links": [{"key": "other-payments", "type": "clause", "offset": [6, 20]}], "snippet": "5 (B) Other Payments ........................................................ 5", "samples": [{"hash": "kBedXXsUXA7", "uri": "/contracts/kBedXXsUXA7#directed-payments", "label": "Share Purchase Agreement (Ferro Corp)", "score": 18.0, "published": true}, {"hash": "2SBPxZpzKoU", "uri": "/contracts/2SBPxZpzKoU#directed-payments", "label": "Purchase Agreement (Ferro Corp)", "score": 18.0, "published": true}], "size": 2, "hash": "fb015468b9e937fc0e60f67365771aa0", "id": 5}, {"snippet_links": [{"key": "by-the-department", "type": "clause", "offset": [12, 29]}, {"key": "health-plan", "type": "definition", "offset": [31, 42]}, {"key": "payments-to", "type": "definition", "offset": [93, 104]}, {"key": "frequency-and-amount", "type": "clause", "offset": [133, 153]}, {"key": "where-permitted", "type": "clause", "offset": [237, 252]}], "snippet": "If required by the Department, Health Plan shall make additional, utilization-based directed payments to qualifying Providers in the frequency and amount directed by Department where Health Plan is reimbursed for such by Department, and where permitted in 42 CFR \u00a7 438.6(c)(1)(iii)(B).", "samples": [{"hash": "cmg35fvr21w", "uri": "/contracts/cmg35fvr21w#directed-payments", "label": "Participating Provider Agreement", "score": 25.7392196655, "published": true}], "size": 2, "hash": "638c326158c120b0b74ab67e6746bba2", "id": 6}, {"snippet_links": [{"key": "medical-group", "type": "definition", "offset": [19, 32]}, {"key": "in-accordance-with", "type": "definition", "offset": [50, 68]}, {"key": "the-contractor-shall", "type": "clause", "offset": [97, 117]}, {"key": "to-pay", "type": "clause", "offset": [130, 136]}, {"key": "specified-amount", "type": "definition", "offset": [144, 160]}, {"key": "actuarially-sound", "type": "definition", "offset": [202, 219]}, {"key": "per-month", "type": "clause", "offset": [231, 240]}, {"key": "payment-to-the-contractor", "type": "clause", "offset": [252, 277]}, {"key": "member-months", "type": "definition", "offset": [305, 318]}, {"key": "form-a", "type": "definition", "offset": [343, 349]}, {"key": "directed-payment", "type": "definition", "offset": [360, 376]}, {"key": "health-plans", "type": "definition", "offset": [423, 435]}, {"key": "the-department", "type": "clause", "offset": [452, 466]}, {"key": "at-the-end-of", "type": "clause", "offset": [468, 481]}, {"key": "directed-to", "type": "definition", "offset": [518, 529]}, {"key": "pay-to", "type": "definition", "offset": [530, 536]}, {"key": "similar-to", "type": "definition", "offset": [606, 616]}, {"key": "average-commercial-rate", "type": "definition", "offset": [617, 640]}], "snippet": "University of Utah Medical Group Providers (UUMG) In accordance with 42 CFR \u00a7 438.6(c)(2)(i)(B), the Contractor shall be required to pay UUMG a specified amount each month. An identified portion of the actuarially sound per member per month Capitation Payment to the Contractor for UUMG multiplied by the member months for the paid month will form a pool. The directed payment pool will be aggregated with amounts from all Health Plans contracted with the Department. At the end of each month, the Contractor shall be directed to pay to the UUMG an amount which is anticipated to result in UUMG being paid similar to average commercial rate (ACR) levels.", "samples": [{"hash": "88xOWnPwqFq", "uri": "/contracts/88xOWnPwqFq#directed-payments", "label": "Contract", "score": 31.6137905121, "published": true}], "size": 1, "hash": "5f57d4a1892a6d96cfea44d759b193b5", "id": 7}, {"snippet_links": [{"key": "other-payments", "type": "clause", "offset": [6, 20]}], "snippet": "5 (B) Other Payments. . . . . . . . . . . . . . . .5", "samples": [{"hash": "6jCfwDVRUcT", "uri": "/contracts/6jCfwDVRUcT#directed-payments", "label": "Share Purchase Agreement (PCD Inc)", "score": 18.0, "published": true}], "size": 1, "hash": "f65fa87f9045dda158f2aef9b14e2f54", "id": 8}, {"snippet_links": [{"key": "closing-adjustment", "type": "definition", "offset": [11, 29]}, {"key": "deliveries-at-the-closing", "type": "clause", "offset": [108, 133]}], "snippet": "10 f. Post-Closing Adjustment..................... 11 g. The Closing................................. 12 h. Deliveries at the Closing................... 12 i. Allocation.................................. 12 j. Proration................................... 12", "samples": [{"hash": "hxtToS85mtR", "uri": "/contracts/hxtToS85mtR#directed-payments", "label": "Asset Purchase Agreement (Showbiz Pizza Time Inc)", "score": 18.0, "published": true}], "size": 1, "hash": "3da2e1f8d7f513e1349f75b5736187e8", "id": 9}, {"snippet_links": [{"key": "all-payments", "type": "clause", "offset": [0, 12]}, {"key": "obligations-assumed", "type": "clause", "offset": [21, 40]}, {"key": "by-buyer", "type": "clause", "offset": [41, 49]}, {"key": "pursuant-to-this-agreement", "type": "clause", "offset": [50, 76]}, {"key": "of-the-acquisition", "type": "clause", "offset": [98, 116]}, {"key": "from-seller", "type": "clause", "offset": [158, 169]}, {"key": "payments-to-parent", "type": "clause", "offset": [175, 193]}, {"key": "obligations-of-parent", "type": "clause", "offset": [206, 227]}, {"key": "the-case", "type": "definition", "offset": [321, 329]}, {"key": "for-the-benefit-of", "type": "definition", "offset": [338, 356]}, {"key": "at-seller", "type": "definition", "offset": [368, 377]}, {"key": "payment-of-the", "type": "clause", "offset": [401, 415]}, {"key": "outstanding-principal-balance", "type": "definition", "offset": [416, 445]}, {"key": "obligations-of-seller", "type": "clause", "offset": [463, 484]}, {"key": "gross-amount", "type": "definition", "offset": [530, 542]}, {"key": "interest-payable", "type": "clause", "offset": [553, 569]}, {"key": "with-respect-to", "type": "clause", "offset": [570, 585]}, {"key": "the-debt", "type": "clause", "offset": [586, 594]}, {"key": "date-hereof", "type": "clause", "offset": [614, 625]}, {"key": "in-accordance-with", "type": "definition", "offset": [638, 656]}, {"key": "treasury-regulation", "type": "definition", "offset": [671, 690]}, {"key": "carry-on-business", "type": "clause", "offset": [737, 754]}, {"key": "in-the-united-states", "type": "clause", "offset": [755, 775]}, {"key": "permanent-establishment", "type": "clause", "offset": [787, 810]}, {"key": "article-5", "type": "definition", "offset": [839, 848]}, {"key": "convention-between", "type": "clause", "offset": [856, 874]}, {"key": "the-united-states-of-america", "type": "clause", "offset": [893, 921]}, {"key": "the-government-of-australia", "type": "clause", "offset": [926, 953]}, {"key": "avoidance-of-double-taxation", "type": "clause", "offset": [962, 990]}, {"key": "taxes-on-income", "type": "clause", "offset": [1044, 1059]}], "snippet": "All payments and all obligations assumed by Buyer pursuant to this Agreement are in consideration of the acquisition of the Somni Stock and the Eastern Stock from Seller. Any payments to Parent by Buyer or obligations of Parent assumed by Buyer pursuant to this Agreement are being paid to Parent or assumed by Buyer, as the case may be, for the benefit of Seller and at Seller\u2019s direction in partial payment of the outstanding principal balance of existing debt obligations of Seller owed to Parent (the \u201cDebt Obligations\u201d). The gross amount of stated interest payable with respect to the Debt Obligations on the date hereof, calculated in accordance with United States Treasury Regulation 1.1441-3(b)(1) is $3,423,730. Parent does not carry on business in the United States through a \u201cpermanent establishment\u201d as that term is defined in Article 5 of the Convention Between the Government of the United States of America and the Government of Australia for the Avoidance of Double Taxation and the Prevention of Fiscal Evasion With Respect to Taxes on Income, dated August 6, 1982.", "samples": [{"hash": "9a1VOO9rfvt", "uri": "/contracts/9a1VOO9rfvt#directed-payments", "label": "Stock Sale Agreement (Graymark Healthcare, Inc.)", "score": 19.0, "published": true}], "size": 1, "hash": "8bdd8d413fd3d7645549f9a512a90375", "id": 10}], "next_curs": "CloSVGoVc35sYXdpbnNpZGVyY29udHJhY3RzcjYLEhZDbGF1c2VTbmlwcGV0R3JvdXBfdjU2IhpkaXJlY3RlZC1wYXltZW50cyMwMDAwMDAwYQyiAQJlbhgAIAA=", "clause": {"children": [], "title": "Directed Payments", "parents": [["method-of-payment", "METHOD OF PAYMENT"], ["purchase-and-sale", "Purchase and Sale"], ["the-merger", "The Merger"], ["miscellaneous", "Miscellaneous"], ["warranties-and-representations", "Warranties and Representations"]], "size": 52, "id": "directed-payments", "related": [["misdirected-payments", "Misdirected Payments", "Misdirected Payments"], ["permitted-payments", "Permitted Payments", "Permitted Payments"], ["refused-payments", "Refused Payments", "Refused Payments"], ["restricted-payments", "Restricted Payments", "Restricted Payments"], ["returned-payments", "Returned Payments", "Returned Payments"]], "related_snippets": [], "updated": "2025-07-10T04:27:38+00:00"}, "json": true, "cursor": ""}}