FQHCs and RHCs Sample Clauses

FQHCs and RHCs. The MCO will submit a quarterly data report of FQHC or RHC copayments for service dates on or after January 1, 2015 in accordance with section 3.7(C) below. In the event that a FQHC/RHC contacts the MCO or the STATE regarding payments made to the FQHC/RHC prior to January 1, 2015, but not included in any submitted report, the MCO shall review, and if appropriate, must submit the missing data. Within eight (8) business days of receipt of this report, the STATE shall provide the MCO a return file that contains incorrect data lines that cannot be read by the system and loaded. The MCO must review the data lines and correct appropriately. Corrected data lines must be resubmitted within thirty (30) days, and shall be reported separately as a corrected file. The MCO shall not resubmit data already submitted and accepted.
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FQHCs and RHCs. The MCO shall provide to the STATE a quarterly report for the first quarter of Contract Year 2010, due no later than thirty (30) days following the end of the quarter. The report must identify MCO payments made to FQHCs and RHCs for all programs covered under this Contract. As of April 1st of Contract Year, reports shall be submitted monthly, with the first monthly report due no later than May 31, 2010. (1) The STATE will provide to the MCO no later than the third business day of each month a list of all Providers currently qualified to be designated FQHCs or RHCs. If a new list is not provided, the MCO shall use the prior monthly listing. Any new FQHC/RHC Providers identified after the third of the month will be added to the following monthly MCO report. (2) Pursuant to the State’s specifications in the document entitled “FQHC/RHC Payment Data Report,” MCO reports will be submitted no later than the last day of the following month. (3) Within eight (8) business days of receipt of this report, the STATE shall provide the MCO a return file that contains incorrect data lines that cannot be read by the system and loaded. The MCO must review the data lines and correct appropriately. Corrected data lines must be re-submitted with the next monthly report, and shall be reported separately as a corrected file. The MCO shall not re-submit data already submitted and accepted. (4) In the event that a FQHC/RHC contacts the MCO regarding payments made to the FQHC/RHC during the previous month, but not included in the submitted report, the MCO shall review, and if appropriate, must submit the missing data on the following monthly report.
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FQHCs and RHCs. The MCO will submit a quarterly data report of FQHC or RHC copayments for service dates on or after January 1, 2015 in accordance with section 3.8(C) below. In the event that a FQHC/RHC contacts the MCO or the STATE regarding payments made to the FQHC/RHC prior to January 1, 2015, but not included in any submitted report, the MCO shall review, and if appropriate, must submit the missing data. Within eight (8) business days of receipt of this report, the STATE shall provide the MCO a return file that contains incorrect data lines that cannot be read by the system and loaded. The MCO must review the data lines and correct appropriately. Corrected data lines must be resubmitted within thirty (30) days, and shall be reported separately as a corrected file. The MCO shall not resubmit data already submitted and accepted. Payment for ad hoc Reporting. The STATE may require reimbursement at standard rates for ad hoc reports requested of the STATE. For the purposes of this section, “standard rates” means those listed in the STATE policy “DHS Policies and Procedures for Handling Protected Information: 2.60 Data Requests and Copy Costs” available at xxxx://xxx.xxx.xxxxx.xx.xx/id_017855. Reporting on MSHO Stakeholder Group. For the MCO’s local or regional stakeholder group (as required in section 7.4.4) the MCO will submit to the STATE twice per Contract Year, on or before June 15th and December 15th, documentation in the form of stakeholder meeting agendas and meeting minutes that demonstrate the MCO response to significant concerns raised by stakeholder group participants. The STATE shall provide the MCO with an electronic listing of all enrolled MHCP Providers and their NPI or UMPI numbers on a monthly basis. The MCO must update the Provider identification numbers by submitting, for Providers who are new to the MCO and do not already have a STATE Provider number (UMPI) or NPI, current complete demographic information about the Provider, on a form approved by the STATE. The MCO shall not require Providers to enroll as an MHCP FFS Provider. If a Provider will only be serving MCO Enrollees, the MCO shall follow the process established by the STATE for MCO-only Providers. Payment Review Information. The MCO shall identify aggregate payment information for specific Provider categories and assess the information as to how it compares to FFS payment information. As part of the assessment the MCO will also be expected to provide an explanation of the basis for how the Prov...
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FQHCs and RHCs. In the event that a FQHC/RHC contacts the MCO or the STATE regarding payments made to the FQHC/RHC prior to January 1, 2015, but not included in any submitted report, the MCO shall review, and if appropriate, must submit the missing data. (1) Within eight (8) business days of receipt of this report, the STATE shall provide the MCO a return file that contains incorrect data lines that cannot be read by the system and loaded. The MCO must review the data lines and correct appropriately. Corrected data lines must be resubmitted within thirty (30) days, and shall be reported separately as a corrected file. The MCO shall not resubmit data already submitted and accepted.
Sample 1

Related to FQHCs and RHCs

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  • SUBCONTRACTORS AND SUPPLIERS The Commissioner reserves the right to reject any proposed Subcontractor or supplier for bona fide business reasons, including, but not limited to: the company failed to solicit New York State certified minority- and women-owned business enterprises as required in prior OGS Contracts; the fact that such Subcontractor or supplier is on the New York State Department of Labor’s list of companies with which New York State cannot do business; the Commissioner’s determination that the company is not qualified or is not responsible; or the fact that the company has previously provided unsatisfactory work or services.

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  • Contractor’s Employees and Subcontractors (a) Contractor shall only disclose PII to Contractor’s employees and subcontractors who need to know the PII in order to provide the Services and the disclosure of PII shall be limited to the extent necessary to provide such Services. Contractor shall ensure that all such employees and subcontractors comply with the terms of this DPA. (b) Contractor must ensure that each subcontractor performing functions pursuant to the Service Agreement where the subcontractor will receive or have access to PII is contractually bound by a written agreement that includes confidentiality and data security obligations equivalent to, consistent with, and no less protective than, those found in this DPA. (c) Contractor shall examine the data security and privacy measures of its subcontractors prior to utilizing the subcontractor. If at any point a subcontractor fails to materially comply with the requirements of this DPA, Contractor shall: notify the EA and remove such subcontractor’s access to PII; and, as applicable, retrieve all PII received or stored by such subcontractor and/or ensure that PII has been securely deleted and destroyed in accordance with this DPA. In the event there is an incident in which the subcontractor compromises PII, Contractor shall follow the Data Breach reporting requirements set forth herein. (d) Contractor shall take full responsibility for the acts and omissions of its employees and subcontractors. (e) Contractor must not disclose PII to any other party unless such disclosure is required by statute, court order or subpoena, and the Contractor makes a reasonable effort to notify the EA of the court order or subpoena in advance of compliance but in any case, provides notice to the EA no later than the time the PII is disclosed, unless such disclosure to the EA is expressly prohibited by the statute, court order or subpoena.

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  • Contractor’s Employees Contractor may, in its discretion and at its own expense, employ such assistants as Contractor deems necessary to perform the Services. If any specific employee is designated in Schedule 1 to perform the Services, Contractor may only replace such designated employee with SMUD’s prior written approval, and with a replacement satisfactory to SMUD. SMUD may not control, direct, or supervise Contractor or Contractor’s Representatives in the performance of the Services. Contractor agrees to assume full responsibility for the payment and deduction of all state and federal taxes and benefits from Contractor’s Representatives, including but not limited to any applicable payroll and income taxes, unemployment insurance, disability insurance, retirement, workers’ compensation, pension, or other social security benefits for all persons or entities employed or retained by Contractor in the performance of the Services under this Agreement, and if applicable for all self-employment and other taxes incurred by Contractor in the performance of the Services.

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