FEDERAL HEALTHCARE COMPLIANCE PROGRAM Sample Clauses

FEDERAL HEALTHCARE COMPLIANCE PROGRAM. A. In entering into this agreement, Consultant acknowledges the County’s Program for Compliance with Federal Healthcare Programs (“Compliance Program”) and agrees to comply, and to require its employees who are considered “Covered Individuals” to comply, with all policies and procedures of the Compliance Program including, without limitation, ADDENDUM 1, Attachment 3, Code of Conduct Certification, attached and incorporated herein. Should the aforementioned Code of Conduct be amended during the term of this agreement, Consultant shall comply with the Code of Conduct as amended and as provided to Consultant by County. “Covered Individuals” are defined as employees of the Consultant with responsibilities pertaining to the ordering, provision, documentation, coding, or billing of services payable by a Federal Healthcare program for which County seeks reimbursement from a Federal Healthcare program. B. Consultant agrees to provide copies of the Code of Conduct to all Covered Individuals who are its employees and to obtain signed certifications from each individual certifying that they have received, read, and understand the Code of Conduct- Consultant and agree to abide by the requirements of the Compliance Program. C. Consultant agrees that all of its employees who are Covered Individuals, both current and all newly-hired, will be required to attend, upon hire and annually thereafter, the complete compliance training program provided by County, or Consultant’s program with prior approval of County’s Compliance Officer, or designee, as required by the County’s Compliance Program. Consultant shall provide copies of signed Code of Conduct-Consultant to County within 24-hours of request by County. D. Consultant shall not, pursuant to 42 C.F.R. section 438.214(d), employ or contract with providers or other individuals and entities who are, or at any time, have been excluded from participation in federal health care programs (as defined in section 1128B(f) of the Social Security Act) under either section 1128, 1128A, or 1156 of the Social Security Act, including and without limitation, Medicare or Medi-Cal. E. Consultant hereby attests that Consultant and all Consultant’s employees and subcontractors, as well as any person with an ownership or control interest, and agents or managing employees are not, nor at any time have been, excluded from any federally funded healthcare program, including Medicare or Medi-Cal provider participation. F. Pursuant to 42 CFR sectio...
Sample 1
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FEDERAL HEALTHCARE COMPLIANCE PROGRAM. (a) In entering into this Agreement, CONTRACTOR acknowledges BEHAVIORAL HEALTH’s Program for Compliance with Federal Healthcare Programs (Compliance Program) and agrees to comply, and to require its employees who are considered “Covered Individuals” to comply with all policies and procedures of the Compliance Program including, without limitation, Xxxxxx County Department of Health and Human Services’ Code of Conduct (“Code of Conduct”), attached hereto as Exhibit D and incorporated herein by reference. “Covered Individuals” are defined as employees of CONTRACTOR with responsibilities pertaining to the ordering, provision, documentation, coding, or billing of services payable by a Federal Healthcare program for which BEHAVIORAL HEALTH seeks reimbursement from the Federal Healthcare programs. (b) CONTRACTOR agrees to provide copies of the Code of Conduct to all Covered Individuals who are its employees and to obtain (subject to review by BEHAVIORAL HEALTH and/or Office of Inspector General [OIG]) a signed certification from the Compliance Officer certifying that covered individual have received, read, and understand the Code of Conduct and agree to abide by the requirements of the Compliance Program. CONTRACTOR will submit the signed certifications to BEHAVIORAL HEALTH’s Compliance Officer within thirty (30) days after the effective date of this Agreement for all employees. (c) As required by the BEHAVIORAL HEALTH’s Program for Compliance with Federal Healthcare Programs, CONTRACTOR acknowledges Xxxxxx County Department of Health and Human Services Code of Conduct. (d) CONTRACTOR shall not enter into an agreement with any contractor who is, or at any time has been, excluded from participation in any federally funded healthcare program, including, without limitation, Medi-Care or Medi-Cal.
Sample 1
FEDERAL HEALTHCARE COMPLIANCE PROGRAM. A. In entering into this agreement, Contractor acknowledges the County’s Program for Compliance with Federal Healthcare Programs (Compliance Program) and agrees to comply, and to require its employees who are considered “Covered Individuals” to comply with all policies and procedures of the Compliance Program including, without limitation, County’s Code of Conduct, attached and incorporated herein as EXHIBIT
Sample 1
FEDERAL HEALTHCARE COMPLIANCE PROGRAM. In entering into this agreement, Provider acknowledges and agrees to comply with the County’s Program for Compliance with Federal Healthcare Programs and the County’s Contractor Code of Conduct (Code of Conduct), attached and incorporated herein as EXHIBIT NO. 4. Should the aforementioned Code of Conduct be amended during the term of this agreement, Provider shall comply with the Code of Conduct as amended and provided to Provider by County.
Sample 1

Related to FEDERAL HEALTHCARE COMPLIANCE PROGRAM

  • Compliance Program The Company has established and administers a compliance program applicable to the Company, to assist the Company and the directors, officers and employees of the Company in complying with applicable regulatory guidelines (including, without limitation, those administered by the FDA, the EMA, and any other foreign, federal, state or local governmental or regulatory authority performing functions similar to those performed by the FDA or EMA); except where such noncompliance would not reasonably be expected to have a Material Adverse Effect.

  • Clinical Management for Behavioral Health Services (CMBHS) System 1. request access to CMBHS via the CMBHS Helpline at (000) 000-0000. 2. use the CMBHS time frames specified by System Agency. 3. use System Agency-specified functionality of the CMBHS in its entirety. 4. submit all bills and reports to System Agency through the CMBHS, unless otherwise instructed.

  • COVERED HEALTHCARE SERVICES This section describes covered healthcare services. This plan covers services only if they meet all of the following requirements: • Listed as a covered healthcare service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered healthcare service under this plan. • Medically necessary, consistent with our medical policies and related guidelines at the time the services are provided. • Not listed in Exclusions Section. • Received while a member is enrolled in the plan. • Consistent with applicable state or federal law. We review medical necessity in accordance with our medical policies and related guidelines. Our medical policies can be found on our website. Our medical policies are written to help administer benefits for the purpose of claims payment. They are made available to you for informational purposes and are subject to change. Medical policies are not meant to be used as a guide for your medical treatment. Your medical treatment remains a decision made by you with your physician. If you have questions about our medical policies, please call Customer Service. When a new service or drug becomes available, when possible, we will review it within six (6) months of one of the events described below to determine whether the new service or drug will be covered: • the assignment of an American Medical Association (AMA) Current Procedural Terminology (CPT) code in the annual CPT publication; • final Food and Drug Administration (FDA) approval; • the assignment of processing codes other than CPT codes or approval by governing or regulatory bodies other than the FDA; • submission to us of a claim meeting the criteria above; and • generally, the first date an FDA approved prescription drug is available in pharmacies (for prescription drug coverage only). During the review period, new services and drugs are not covered. For all covered healthcare services, please see the Summary of Medical Benefits and the Summary of Pharmacy Benefits to determine the amount that you pay and any benefit limits.

  • Health Promotion and Health Education Both parties to this Agreement recognize the value and importance of health promotion and health education programs. Such programs can assist employees and their dependents to maintain and enhance their health, and to make appropriate use of the health care system. To work toward these goals:

  • Extended Health Care Plan ‌ The Employer shall pay the monthly premium for regular employees entitled to coverage under a mutually acceptable extended health care plan.

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