For Drug Medi Sample Clauses

For Drug Medi. Cal, late claims submitted with a written request within a reasonable timeframe before the one-year regulation cut off, if it is due to circumstances beyond the control of the Contractor and with evidences of good causes acceptable for federal/state reimbursement, may be approved by the Director for claim submission.
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For Drug Medi. Cal services, the County shall determine the final compensation to the Contractor based on the final audited Cost Report specified in Exhibit D, Section IV and Section XXIX, at the actual rate or contract rate, whichever is lower. In all situations the rate shall not exceed the State Maximum Allowance (SMA). G. If Medi-Cal applies, County shall make payments to Contractor for services claimed by Contractor prior to billing for Federal Financial Participation (FFP) reimbursement. In the event any claim is denied/rejected by the Federal and/or State government, Contractor shall take all actions necessary to obtain such approval. If any denied claim by Federal and/or State government is not finally approved for payment reimbursement, Contractor’s next payment from County shall be reduced by the amount of denied/rejected claims by Medi-Cal and Medicare. Contractor disallowances are the Contractor’s fiscal and program responsibility, per Section L below. H. County shall authorize payment within twenty-five (25) (for Drug Medi-Cal claim) or forty-five (45) days (for non Drug Medi-Cal claim) of the receipt of Contractor’s appropriate claim, required reports, and any further documentation requested by the County for purposes of this Agreement. I. In the event that the Contractor fails to comply with any provision of this Agreement, County may withhold payment otherwise due Contractor pursuant to this Agreement or any other agreement between Contractor and County until such noncompliance has been corrected. J. If applicable, County shall make a diligent effort to process and submit xxxxxxxx to the Federal and/or State government in a timely manner. Should the Federal and/or State government deny payment to the County due to late billing, County will demand repayment from Contractor, for any such paid claim that is not submitted within the timelines as specified in the above paragraph C, irrespective if such services were claimed in the original or resubmitted claim, or such claims were withheld by County due to Contractor’s noncompliance with any provision of this Agreement. K. County will demand repayment from Contractor for compensation made to the Contractor, in the event that any goods and/or services related to such compensation are subsequently determined disallowable, regardless of reason. L. Should the County, State and/or Federal government, and their authorized representatives, determine that Contractor’s actual expenses for goods and/or services provided...
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