Common use of General Laws and Regulations Clause in Contracts

General Laws and Regulations. 1. The PH-MCO must comply with Titles VI and VII of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, 42 U.S.C. Section 2000d et seq. and 2000e et seq.; Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 701 et seq.; the Age Discrimination Act of 1975, 42 U.S.C. 6101 et seq.; the Americans with Xxxxxxxxxxxx Xxx, 00 X.X.X. 00000 et seq.; 45 CFR Parts 160, 162, and 164 (HIPAA Regulations); the Pennsylvania Human Relations Act of 1955, 71 P.S. 941 et seq.; and Article XXI of the Insurance Company Law of 1921, as amended, 40 P.S. 991.2102 et seq. 2. The PH-MCO must comply with the Commonwealth's Contract Compliance Regulations that are set forth at 16 Pa. Code 49.101 and on file with the PH-MCO. 3. Except for the definition of Effective Date in Section 1, the PH-MCO must comply with the Standard Grant Terms and Conditions found in Exhibit D of this Agreement, Standard Grant Terms and Conditions for Services. 4. The PH-MCO must comply with all applicable laws, regulations, and policies of the Pennsylvania Department of Health and the Pennsylvania Insurance Department. The PH-MCO must comply with applicable Federal and State laws that pertain to Member rights and protections. The PH-MCO must ensure that its staff take those rights and protections into account when furnishing services to Members. Also, the PH-MCO must require its Providers to take those rights and protections into account when furnishing services to Members. 5. In addition, the PH-MCO and its subcontractors must respect the conscience rights of individual Providers and Provider organizations, as long as said conscience rights are made known to the PH-MCO in advance, and comply with the current Pennsylvania laws prohibiting discrimination on the basis of the refusal or willingness to participate in certain abortion and sterilization-related activities as outlined in 43 P.S. 955.2 and 18 Pa. C.S. 3213(d). If the PH-MCO elects not to provide, reimburse for, or provide coverage of, a counseling or referral service because of an objection on moral or religious grounds, the PH-MCO must furnish information about the services not covered in accordance with the provisions of 42 CFR 438.102(b) ▪ To the Department ▪ With its Proposal in response to the RFP ▪ Whenever it adopts the policy during the term of the Agreement. The PH-MCO must provide this information to potential Members before and during Enrollment. This information must be provided to Members within thirty (30) days after adopting the policy with respect to any particular service. 6. The PH-MCO must maintain the highest standards of integrity in the performance of this Agreement and must take no action in violation of state or federal laws, regulations, or other requirements that govern contracting with the Commonwealth. The requirements regarding PH-MCO Integrity Provisions, are contained in Exhibit D of this Agreement, Standard Grant Terms and Conditions for Services. 7. Nothing in this Agreement shall be construed to permit or require the Department to pay for any services or items which are not or have ceased to be compensable under the laws, rules and regulations governing the MA Program at the time such services are provided. 8. The PH-MCO must comply with all applicable Federal regulations, including those regulations that prohibit affiliations with individuals debarred by Federal Agencies as described in 42 CFR Part 438, Section 438.610. Additionally, PH-MCOs must comply with 42 CFR 438, Sections 438.726 and 438.730 describing conditions under which CMS may deny payments for new enrollees.

General Laws and Regulations. ‌ 1. The PH-MCO must comply with Titles VI and VII of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, 42 U.S.C. Section 2000d et seq. and 2000e et seq.; Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 701 et seq.; the Age Discrimination Act of 1975, 42 U.S.C. 6101 et seq.; the Americans with Xxxxxxxxxxxx Xxx, 00 X.X.X. 00000 et seq.; 45 CFR Parts 160, 162, and 164 (HIPAA Regulations); the Pennsylvania Human Relations Act of 1955, 71 P.S. 941 et seq.; and Article XXI of the Insurance Company Law of 1921, as amended, 40 P.S. 991.2102 et seq. 2. The PH-MCO must comply with the Commonwealth's Contract Compliance Regulations that are set forth at 16 Pa. Code 49.101 and on file with the PH-MCO. 3. Except for the definition of Effective Date in Section 1, the PH-MCO must comply with the Standard Grant Terms and Conditions found in Exhibit D of this Agreement, Standard Grant Terms and Conditions for Services. Additionally, the PH-MCO must comply with Exhibit E, DHS Addendum to Standard Contract Terms and Conditions of this Agreement and Exhibit E(1) Other Federal Requirements of this Agreement. 4. The PH-MCO must comply with all applicable laws, regulations, and policies of the Pennsylvania Department of Health and the Pennsylvania Insurance Department. The PH-MCO must comply with applicable Federal and State laws that pertain to Member rights and protections. The PH-MCO must ensure that its staff take those rights and protections into account when furnishing services to Members. Also, the PH-MCO must require its Providers to take those rights and protections into account when furnishing services to Members. 5. In addition, the PH-MCO and its subcontractors must respect the conscience rights of individual Providers and Provider organizations, as long as said conscience rights are made known to the PH-MCO in advance, and comply with the current Pennsylvania laws prohibiting discrimination on the basis of the refusal or willingness to participate in certain abortion and sterilization-related activities as outlined in 43 P.S. 955.2 and 18 Pa. C.S. 3213(d). If the PH-MCO elects not to provide, reimburse for, or provide coverage of, a counseling or referral service because of an objection on moral or religious grounds, the PH-MCO must furnish information about the services not covered in accordance with the provisions of 42 CFR 438.102(b) ▪ To the Department ▪ With its Proposal in response to the RFP ▪ Whenever it adopts the policy during the term of the Agreement. The PH-MCO must provide this information to potential Members before and during Enrollment. This information must be provided to Members within thirty (30) days after adopting the policy with respect to any particular service. 6. The PH-MCO must maintain the highest standards of integrity in the performance of this Agreement and must take no action in violation of state or federal laws, regulations, or other requirements that govern contracting with the Commonwealth. The requirements regarding PH-MCO Integrity Provisions, are contained in Exhibit D of this Agreement, Standard Grant Terms and Conditions for Services. 7. Nothing in this Agreement shall be construed to permit or require the Department to pay for any services or items which are not or have ceased to be compensable under the laws, rules and regulations governing the MA Program at the time such services are provided. 8. The PH-MCO must comply with all applicable Federal regulations, including those regulations that prohibit affiliations with individuals debarred by Federal Agencies as described in 42 CFR Part 438, Section 438.610. Additionally, PH-MCOs must comply with 42 CFR 438, Sections 438.726 and 438.730 describing conditions under which CMS may deny payments for new enrollees.

General Laws and Regulations. 1. The PH-MCO must comply with Titles VI and VII of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, 42 U.S.C. Section 2000d et seq. and 2000e et seq.; Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 701 et seq.; the Age Discrimination Act of 1975, 42 U.S.C. 6101 et seq.; the Americans with Xxxxxxxxxxxx Xxx, 00 X.X.X. 00000 et seq.; 45 CFR Parts 160, 162, and 164 (HIPAA Regulations); the Pennsylvania Human Relations Act of 1955, 71 P.S. 941 et seq.; and Article XXI of the Insurance Company Law of 1921, as amended, 40 P.S. 991.2102 et seq. 2. The PH-MCO must comply with the Commonwealth's Contract Compliance Regulations that are set forth at 16 Pa. Code 49.101 and on file with the PH-MCO. 3. Except for the definition of Effective Date in Section 1, the PH-MCO must comply with the Standard Grant Contract Terms and Conditions found in Exhibit D of this Agreement, Standard Grant Contract Terms and Conditions for Services. The use of the terms Contract and Contractor in Exhibit D, Standard Contract Terms and Conditions for Services, refers to this Agreement and the PH-MCO. 4. The PH-MCO must comply with all applicable laws, regulations, and policies of the Pennsylvania Department of Health and the Pennsylvania Insurance Department. The PH-MCO must comply with applicable Federal and State laws that pertain to Member rights and protections. The PH-MCO must ensure that its staff take those rights and protections into account when furnishing services to Members. Also, the PH-MCO must require its Providers to take those rights and protections into account when furnishing services to Members. 5. In addition, the PH-MCO and its subcontractors must respect the conscience rights of individual Providers and Provider organizations, as long as said conscience rights are made known to the PH-MCO in advance, and comply with the current Pennsylvania laws prohibiting discrimination on the basis of the refusal or willingness to participate in certain abortion and sterilization-related activities as outlined in 43 P.S. 955.2 and 18 Pa. C.S. 3213(d). If the PH-MCO elects not to provide, reimburse for, or provide coverage of, a counseling or referral service because of an objection on moral or religious grounds, the PH-MCO must furnish information about the services not covered in accordance with the provisions of 42 CFR 438.102(b) ▪ To the Department ▪ With its Proposal in response to the RFP ▪ Whenever it adopts the policy during the term of the Agreement. The PH-MCO must provide this information to potential Members before and during Enrollment. This information must be provided to Members within thirty (30) days after adopting the policy with respect to any particular service. 6. The PH-MCO must maintain the highest standards of integrity in the performance of this Agreement and must take no action in violation of state or federal laws, regulations, or other requirements that govern contracting with the Commonwealth. The requirements regarding PH-MCO Integrity Provisions, are contained in Exhibit D of this Agreement, Standard Grant Contract Terms and Conditions for Services. 7. Nothing in this Agreement shall be construed to permit or require the Department to pay for any services or items which are not or have ceased to be compensable under the laws, rules and regulations governing the MA Program at the time such services are provided. 8. The PH-MCO must comply with all applicable Federal regulations, including those regulations that prohibit affiliations with individuals debarred by Federal Agencies as described in 42 CFR Part 438, Section 438.610. Additionally, PH-MCOs must comply with 42 CFR 438, Sections 438.726 and 438.730 describing conditions under which CMS may deny payments for new enrollees.

General Laws and Regulations. ‌ 1. The PH-MCO must comply with Titles VI and VII of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, 42 U.S.C. Section §§2000d et seq. and 2000e et seq.; Title IX of the Education Amenxxxxxx xx 0000, 00 X.X.X. §§0000 xx seq.; Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section §§701 et seq.; the Age Discrimination Act of 1975, 42 U.S.C. §§6101 et seq.; the Americans with Xxxxxxxxxxxx XxxDisabilities Act, 00 X.X.X. 00000 42 U.S.C. §§12101 et seq.; 45 CFR Parts 160, 162, the Health Insurance Portability and 164 Accountability Act of 1996 (HIPAA Regulations); the Pennsylvania Human Relations Act of 1955, 71 P.S. §§941 et seq.; and Article XXI of the Insurance Company Law of 1921, as amended, 40 P.S. §§991.2102 et seq.; and Drug and Alcohol Use and Dependency Coverage Act 106 of 1989, 40 P.S. §§908-1 et seq. 2. The PH-MCO must comply with the Commonwealth's Contract Compliance Regulations that are set forth at 16 Pa. Code 49.101 and on file with the PH-MCO. 3. Except for the definition of Effective Date in Section 1, the The PH-MCO must comply with the Standard Grant Terms and Conditions found in Exhibit D of this Agreement, Standard Grant Terms and Conditions for Services. Additionally, the PH-MCO must comply with Exhibit E, DHS Addendum to Standard Contract Terms and Conditions of this Agreement and Exhibit E(1) Other Federal Requirements of this Agreement. 4. The PH-MCO must comply with all applicable laws, regulations, and policies of the Pennsylvania Department of Health DOH and the Pennsylvania Insurance DepartmentPID. The PH-MCO must comply with applicable Federal and State laws that pertain to Member rights and protections. The PH-MCO must ensure require that its staff take those rights and protections into account when furnishing services to Members. Also, the PH-MCO must require its Providers to take those rights and protections into account when furnishing services to Members. 5. In addition, the The PH-MCO and its subcontractors must respect the conscience rights of individual Providers and Provider organizationsProviders, as long as said conscience rights are made known to the PH-MCO in advance, and comply with the current Pennsylvania laws prohibiting discrimination on the basis of the refusal or willingness to participate in certain abortion and sterilization-related activities provide health care services on moral or religious grounds as outlined in 40 P.S. §901.2121 and §991.2171; 43 P.S. 955.2 P.S.§955.2 and 18 Pa. C.S. §3213(d). If the PH-MCO elects not to provide, reimburse for, or provide coverage of, a counseling or referral service because of an objection on moral or religious grounds, the PH-MCO must furnish information about the services not covered in accordance with the provisions of 42 CFR §438.102(b) ▪ To the Department ▪ With its Proposal in response to the RFP ▪ Whenever it adopts the policy during the term of the Agreement. The PH-MCO must provide this information to potential Members before and during Enrollment. This information must be provided to Members within thirty (30) days after adopting the policy with respect to any particular service. 6. The PH-MCO must maintain the highest standards of integrity in the performance of this Agreement and must take no action in violation of state or federal laws, regulations, or other requirements that govern contracting with the Commonwealth. The requirements regarding PH-MCO Integrity Provisions, are contained in Exhibit D of this Agreement, Standard Grant Terms and Conditions for Services. 7. Nothing in this Agreement shall be construed to permit or require the Department to pay for any services or items which are not or have ceased to be compensable under the laws, rules and regulations governing the MA Program at the time such services are provided. 8. The PH-MCO must comply with all applicable Federal regulations, including those regulations that prohibit affiliations with individuals debarred by Federal Agencies as described in 42 CFR Part 438, Section 438.610. Additionally, PH-MCOs must comply with 42 CFR 438, Sections C.F.R. §§438.726 and 438.730 describing conditions under which CMS may deny payments for new enrollees.