Fraud, Waste and Abuse Prevention. 1. Contractor will provide fraud, waste and abuse prevention and detection systems to identify aberrant claims and billing practices. Where it appears that fraud has been perpetrated on the State employee plan Contractor agrees to share results of investigations conducted by it with the State, including the Office of the Attorney General. In such event, Contractor will cooperate with Comptroller and the Office of the Attorney General in connection with investigations of suspected fraud waste and abuse.
Fraud, Waste and Abuse Prevention. $5,000 per Calendar Day that the Department determines the PHP is not in compliance
Fraud, Waste and Abuse Prevention. Provider shall cooperate fully with Health Plan’s policies and procedures designed to protect program integrity and prevent and detect potential or suspected fraud, abuse and waste in the administration and delivery of services under the State Contracts. Provider shall assist the State Programs and any other State or federal agency charged with the duty of preventing, identifying, investigating, sanctioning or prosecuting suspected fraud, abuse or waste in state and federal health care programs.
Fraud, Waste and Abuse Prevention. Provider shall cooperate fully with United’s policies and procedures designed to protect program integrity and prevent and detect potential or suspected fraud, abuse and waste in the administration and delivery of services under the State Contracts. Provider shall assist the State Programs and any other State or federal agency charged with the duty of preventing, identifying, investigating, sanctioning or prosecuting suspected fraud, abuse or waste in state and federal health care programs.
Fraud, Waste and Abuse Prevention. Provider shall cooperate fully with Subcontractor’s and Health Plan’s policies and procedures designed to protect program integrity and prevent and detect potential or suspected fraud, abuse and waste in the administration and delivery of services under the State Contract and shall cooperate and assist the State Program and any other State or federal agency charged with the duty of preventing, identifying, investigating, sanctioning or prosecuting suspected fraud, abuse or waste in state and/or federal health care programs. In accordance with Health Plan’s policies and the Deficit Reduction Act of 2005 (DRA), if Provider receives annual Medicaid payments of at least five million dollars ($5,000,000) (cumulative, from all sources), Provider shall have written policies for its employees, contractors or agents that: (a) provide detailed information about the federal False Claims Act (established under sections 3729 through 3733 of title 31, United States Code); (b) cite administrative remedies for false claims and statements (established under chapter 38 of title 31, United States Code) and whistleblower protections under federal and state laws; (c) reference state laws pertaining to civil or criminal penalties for false claims and statements; and (d) with respect to the role of such laws in preventing and detecting fraud, waste, and abuse in federal health care programs (as defined in section 1128B(f)), include as part of such written policies, detailed provisions regarding Provider’s policies and procedures for detecting and preventing fraud, waste, and abuse. Provider agrees to train its staff on the aforesaid policies and procedures.
Fraud, Waste and Abuse Prevention. Provider shall promptly report any suspected fraud and abuse by to March Vision Care. Provider shall also cooperate fully with March Vision Care’s policies and procedures designed to protect program integrity and prevent and detect potential or suspected fraud, waste, and abuse in the administration and delivery of services and shall cooperate and assist March Vision Care, a plan, and any agency charged with the duty of preventing, identifying, investigating, sanctioning or prosecuting suspected fraud, waste, and abuse in state and/or federal health care program
Fraud, Waste and Abuse Prevention
