Fraud or Abuse. Vendor may terminate or suspend an affected Service or Service Component and, if the activity materially and adversely affects the entire Participation Agreement, terminate or suspend the entire Participation Agreement, immediately by providing Member with as much advance notice as is reasonably practicable under the circumstances if Member, in the course of breaching the Contract, Participation Agreement:
(i) commits a fraud upon Vendor; (ii) uses the Service to commit a fraud upon another party;
(iii) unlawfully uses the Service; (iv) abuses or misuses Vendor’s network or Service; or
(v) interferes with another customer’s use of Vendor’s network or services.
Fraud or Abuse. When the Enrollee provides fraudulent information on an Enrollment form or the Enrollee willfully misuses or permits another person to misuse the Enrollee’s ID card.
2.3.5.7.4.1. The STAR+PLUS MMP may submit a request that an Enrollee be involuntarily disenrolled if an Enrollee knowingly provides, on the election form, fraudulent information that materially affects the individual’s eligibility to enroll in the STAR+PLUS MMP’s plan; or if the Enrollee intentionally permits others to use their Enrollment card to obtain services under the STAR+PLUS MMP’s plan.
2.3.5.7.4.2. Prior to submission, the STAR+PLUS MMP must have and provide to CMS/HHSC credible evidence substantiating the allegation that the Enrollee knowingly provided fraudulent information or intentionally permitted others to use their card.
2.3.5.7.4.3. The STAR+PLUS MMP must immediately notify the CMT so that the Enrollment broker and the HHS Office of the Inspector General may initiate an investigation of the alleged Fraud and/or Abuse.
2.3.5.7.4.4. The STAR+PLUS MMP must provide notice to the Enrollee prior to submission of the request outlining the intent to request disenrollment with an explanation of the basis of the STAR+PLUS MMP’s decision and information on the Enrollee’s access to Grievance procedures and a Fair Hearing.
Fraud or Abuse. The Provider represents that, as of the effective date of this Contract, it was not under investigation by any authority for fraud or abuse pursuant to federal regulations at 42 CFR Part 455, Subpart A. The Provider shall notify EOHHS within 10 business days of learning that it is under investigation by any authority for fraud or abuse. The Provider shall cooperate with and assist EOHHS and any state or federal agency charged with the duty of identifying, investigating, sanctioning, or prosecuting suspected fraud and abuse.
Fraud or Abuse. When the Enrollee provides fraudulent information on an Enrollment form or the Enrollee willfully misuses or permits another person to misuse the Enrollee’s identification (ID) card.
2.3.2.6.3.1 The Contractor may submit a request that an Enrollee be involuntarily disenrolled if an Enrollee knowingly provides, on the election form, fraudulent information that materially affects the individual's eligibility to enroll in the Contractor; or if the Enrollee intentionally permits others to use their ID card to obtain services under the Contractor.
2.3.2.6.3.2 Prior to submission, the Contractor must have and provide to CMS and the Department credible evidence substantiating the allegation that the Enrollee knowingly provided fraudulent information or intentionally permitted others to use their ID card.
2.3.2.6.3.3 The Contractor must immediately notify the CMT so that the Enrollment broker and the HHS Office of the Inspector General may initiate an investigation of the alleged Fraud and/or Abuse.
2.3.2.6.3.4 The Contractor must provide notice to the individual prior to submission of the request outlining the intent to request disenrollment with an explanation of the basis of the Contractor’s decision and information on the Enrollee’s access to Grievance procedures and a fair hearing.
Fraud or Abuse. ER Tech Pros reserves the right to interrupt or restrict service without notice to you if ER Tech Pros suspects fraudulent or abusive activity. Customer agrees to cooperate with ER Tech Pros in any fraud investigation and to use any fraud prevention measures ER Tech Pros prescribes within reason. Customer shall be solely liable for and shall indemnify ER Tech Pros against, any and all damages resulting from Customer’s fraudulent or abusive usage or activity.
Fraud or Abuse. AT&T may terminate or suspend an affected Service or Service Component and, if the activity materially and adversely affects the entire Agreement, terminate or suspend the entire Agreement, immediately by providing TAMUS with as much advance notice as is reasonably practicable under the circumstances if TAMUS, in the course of breaching the Agreement: (i) commits a fraud upon AT&T; (ii) uses the Service to commit a fraud upon another party; (iii) unlawfully uses the Service; (iv) abuses or misuses AT&T’s network or Service; or (v) interferes with another customer’s use of AT&T’s network or services.
Fraud or Abuse. Seller may terminate or suspend an affected Carrier Service or Service Component either with respect to an individual User of Purchaser or with respect to Purchaser taken as a whole, and, if the activity materially and adversely affects the entire Carrier Agreement, terminate or suspend the entire Carrier Agreement, immediately by providing Purchaser with such advance notice as is reasonably practicable under the circumstances if Purchaser or a User: (i) commits a fraud upon Seller or its suppliers; (ii) uses the Carrier Service to commit a fraud upon another party; (iii) unlawfully uses the Carrier Service; (iv) abuses or misuses Seller or its supplier’s network or Carrier Service; or (v) interferes with another customer’s use of Seller or its supplier’s network or services.
Fraud or Abuse. When the Participant provides fraudulent information on an Enrollment form or the Participant willfully misuses or permits another person to misuse the Participant’s ID card.
Fraud or Abuse. Seller may terminate or suspend an affected Carrier Service or Service Component either with respect to an individual User of Purchaser or with respect to Purchaser taken as a whole, and, if the activity materially and adversely affects the entire Carrier Agreement, terminate or suspend the entire Carrier Agreement, immediately by providing Purchaser with such
Fraud or Abuse. When the Participant provides fraudulent information on an Enrollment form or the Participant willfully misuses or permits another person to misuse the Participant’s ID card.
2.3.3.10.2.1. The FIDA-IDD Plan may submit a request that a Participant be involuntarily disenrolled if a Participant knowingly provides, on the election form, fraudulent information that materially affects the Participant’s eligibility to enroll in the FIDA-IDD Plan; or if the Participant intentionally permits others to use his or her ID card to obtain services under the FIDA-IDD Plan.
2.3.3.10.2.2. Prior to submission, the FIDA-IDD Plan must have and provide to CMS/NYSDOH credible evidence substantiating the allegation that the Participant knowingly
2.3.3.10.2.3. The FIDA-IDD Plan must immediately notify the CMT so that the Enrollment Broker and the HHS Office of the Inspector General may initiate an investigation of the alleged Fraud and/or Abuse.
