Home Health Homebound Waiver Benefit Enhancement Sample Clauses

Home Health Homebound Waiver Benefit Enhancement. ‌ A. Appendix N shall apply to the Agreement for any Performance Year for which the ACO has selected the Home Health Homebound Waiver Benefit Enhancement as described in Section 8.01 and for which the ACO has submitted an Implementation Plan under Section 10.01.B for the Home Health Homebound Waiver Benefit Enhancement and CMS has not rejected the ACO’s selection pursuant to Section 8.02 or Section 10.01.E. B. The ACO shall require that, in order to be eligible to submit claims for services furnished to REACH Beneficiaries pursuant to the Home Health Homebound Waiver Benefit Enhancement, the individual or entity must be: 1. A home health agency that is a Participant Provider or Preferred Provider; and 2. Designated on the Participant Provider List or Preferred Provider List submitted in accordance with Article IV as participating in the Home Health Homebound Waiver Benefit Enhancement; and 3. Approved by CMS according to the criteria described in this Section 10.06.B and Appendix N of the Agreement. C. If CMS notifies the ACO that a home health agency that is a Participant Provider or Preferred Provider has not been approved for participation in the Home Health Homebound Waiver Benefit Enhancement under this Section 10.06, but the home health agency is otherwise eligible to be a Participant Provider or Preferred Provider, the ACO may either remove the home health agency from the Participant Provider or Preferred Provider List, or amend the relevant list to reflect that the home health agency will not participate in the Home Health Homebound Waiver Benefit Enhancement. The ACO shall amend the relevant list no later than 30 Days after the date of the notice from CMS. D. The ACO shall ensure the Participant Providers and Preferred Providers do not substitute home health services for inpatient services when inpatient services are more clinically appropriate. E. The ACO shall ensure that Participant Providers and Preferred Providers only furnish Medically Necessary home health services and do not use home health services to prevent or deter a Beneficiary from seeking or receiving inpatient care when such care is Medically Necessary.
Sample 1Sample 2Sample 3See All (7)
AutoNDA by SimpleDocs
Home Health Homebound Waiver Benefit Enhancement. A. Appendix N shall apply to the Agreement for any Performance Year for which the DCE has selected the Home Health Homebound Waiver Benefit Enhancement as described in Section 8.01 and for which the DCE has submitted an Implementation Plan under Section 10.01.B for the Home Health Homebound Waiver Benefit Enhancement and CMS has not rejected the DCE's selection pursuant to Section 8.02 or Section 10.01.E. B. The DCE shall require that, in order to be eligible to submit claims for services furnished to DC Beneficiaries pursuant to the Home Health Homebound Waiver Benefit Enhancement, the individual or entity must be: 1. A home health agency that is a DC Participant Provider or Preferred Provider; and 2. Designated on the DC Participant Provider List or Preferred Provider List submitted in accordance with Article IV as participating in the Home Health Homebound Waiver Benefit Enhancement; and 3. Approved by CMS according to the criteria described in this Section
Sample 1

Related to Home Health Homebound Waiver Benefit Enhancement

  • Compensation; Employment Agreements; Etc Enter into or amend or renew any employment, consulting, severance or similar agreements or arrangements with any director, officer or employee of Metropolitan or its Subsidiaries, or grant any salary or wage increase or increase any employee benefit (including incentive or bonus payments), except (i) for normal individual increases in compensation to employees in the ordinary course of business consistent with past practice, (ii) for other changes that are required by applicable law, and (iii) to satisfy Previously Disclosed contractual obligations existing as of the date hereof.

  • Dental Care Plan The Welfare Plan will include a Dental Care Plan which will reimburse members for expenses incurred in respect of the coverages summarized in Appendix "1". The Plan will not duplicate benefits provided now or which may be provided in the future by any government program.

  • Incentive, Savings and Retirement Plans During the Employment Period, the Executive shall be entitled to participate in all incentive, savings and retirement plans, practices, policies and programs applicable generally to other peer executives of the Company and its affiliated companies, but in no event shall such plans, practices, policies and programs provide the Executive with incentive opportunities (measured with respect to both regular and special incentive opportunities, to the extent, if any, that such distinction is applicable), savings opportunities and retirement benefit opportunities, in each case, less favorable, in the aggregate, than the most favorable of those provided by the Company and its affiliated companies for the Executive under such plans, practices, policies and programs as in effect at any time during the 120-day period immediately preceding the Effective Date or if more favorable to the Executive, those provided generally at any time after the Effective Date to other peer executives of the Company and its affiliated companies.

  • Supplemental Retirement Plan During the Contract Period, if the Executive was entitled to benefits under any supplemental retirement plan prior to the Change in Control, the Executive shall be entitled to continued benefits under such plan after the Change in Control and such plan may not be modified to reduce or eliminate such benefits during the Contract Period.

  • Additional Benefits/Card Enhancements The Credit Union may from time to time offer additional services to your account, such as travel accident insurance, at no additional cost to you. You understand that the Credit Union is not obligated to offer such services and may withdraw or change them at any time.

  • Third Party Administrators for Defined Contribution Plans 2.1 The Fund may decide to make available to certain of its customers, a qualified plan program (the “Program”) pursuant to which the customers (“Employers”) may adopt certain plans of deferred compensation (“Plan or Plans”) for the benefit of the individual Plan participant (the “Plan Participant”), such Plan(s) being qualified under Section 401(a) of the Code and administered by TPAs which may be plan administrators as defined in the Employee Retirement Income Security Act of 1974, as amended. 2.2 In accordance with the procedures established in Schedule 2.1 entitled “Third Party Administrator Procedures,” as may be amended by the Transfer Agent and the Fund from time to time (“Schedule 2.1”), the Transfer Agent shall: (a) Treat Shareholder accounts established by the Plans in the name of the Trustees, Plans or TPAs, as the case may be, as omnibus accounts; (b) Maintain omnibus accounts on its records in the name of the TPA or its designee as the Trustee for the benefit of the Plan; and (c) Perform all Services under Section 1 as transfer agent of the Funds and not as a record-keeper for the Plans. 2.3 Transactions identified under Sections 1 and 2 of this Agreement shall be deemed exception services (“Exception Services”) when such transactions: (a) Require the Transfer Agent to use methods and procedures other than those usually employed by the Transfer Agent to perform transfer agency and recordkeeping services; (b) Involve the provision of information to the Transfer Agent after the commencement of the nightly processing cycle of the TA2000 System; or (c) Require more manual intervention by the Transfer Agent, either in the entry of data or in the modification or amendment of reports generated by the TA2000 System, than is normally required.

  • Please see the current Washtenaw Community College catalog for up-to-date program requirements Conditions & Requirements

  • Health Care Savings Plan As provided in this Agreement, eligible ASF Members will participate in the health care savings plan (HCSP) established under Minnesota Statute 352.98, and as administered by the Plan Administrator. The Employer is responsible only for transferring funds, as specified in this agreement, to the Plan Administrator. Subd. 1. All ASF Members who receive severance pay as defined in Section A of this article must participate in the health care savings plan. Subd. 2. All severance pay as defined in Section B of this article shall be transferred to the severed employee's health care savings plan account. At the time of separation, if an ASF Member has an approved exception to participation in the health care savings plan account from the plan administrator, then the ASF Member shall receive this payment in one lump sum payment of cash.

  • SAVINGS/FORCE MAJEURE A force majeure occurrence is an event or effect that cannot be reasonably anticipated or controlled. Force majeure includes, but is not limited to, acts of God, acts of war, acts of public enemies, strikes, fires, explosions, actions of the elements, floods, or other similar causes beyond the control of the Contractor or the Commissioner in the performance of the Contract which non- performance, by exercise of reasonable diligence, cannot be prevented. Contractor shall provide the Commissioner with written notice of any force majeure occurrence as soon as the delay is known. Neither the Contractor nor the Commissioner shall be liable to the other for any delay in or failure of performance under the Contract due to a force majeure occurrence. Any such delay in or failure of performance shall not constitute default or give rise to any liability for damages. The existence of such causes of such delay or failure shall extend the period for performance to such extent as determined by the Contractor and the Commissioner to be necessary to enable complete performance by the Contractor if reasonable diligence is exercised after the cause of delay or failure has been removed. Notwithstanding the above, at the discretion of the Commissioner where the delay or failure will significantly impair the value of the Contract to the State or to Authorized Users, the Commissioner may: a. Accept allocated performance or deliveries from the Contractor. The Contractor, however, hereby agrees to grant preferential treatment to Authorized Users with respect to Product subjected to allocation; and/or b. Purchase from other sources (without recourse to and by the Contractor for the costs and expenses thereof) to replace all or part of the Products which are the subject of the delay, which purchases may be deducted from the Contract quantities without penalty or liability to the State; or c. Terminate the Contract or the portion thereof which is subject to delays, and thereby discharge any unexecuted portion of the Contract or the relative part thereof.

  • Termination of 401(k) Plan At Parent’s written request, delivered no later than fifteen (15) days prior to the Closing, the Company shall terminate the Furmanite Corporation 401(k) Savings and Investment Plan (the “Company 401(k) Plan”) effective immediately prior to the Closing Date and contingent upon the occurrence of the Closing, and upon such termination, shall cease all further contributions to the Company 401(k) Plan for pay periods beginning on and after the Closing Date and, to the extent the Company 401(k) Plan provides for loans to participants, and upon such termination, shall cease making any such additional loans effective immediately prior to the Closing Date. If Parent does not instruct the Company to terminate the Company 401(k) Plan, nothing herein shall be deemed to prevent the Surviving Corporation or Parent from terminating the Company 401(k) Plan following the Closing in accordance with applicable Law. In the event that Parent instructs the Company to terminate the Company 401(k) Plan, (a) prior to the Closing Date and thereafter (as applicable), the Company and Parent shall take any and all action as may be required, including amendments to the Company 401(k) Plan and/or the corresponding 401(k) plan sponsored or maintained by Parent or one of its Subsidiaries (the “Parent 401(k) Plan”) to comply with applicable Law, (b) subject to the receipt of a favorable IRS determination letter with respect to the termination of the Company 401(k) Plan, to permit each employee of the Company and its Subsidiaries who continues to be employed by Parent or its Subsidiaries (including, for the avoidance of doubt the Surviving Corporation and its Subsidiaries) immediately following the Effective Time (each, a “Continuing Employee”) to make rollover contributions of “eligible rollover distributions” (within the meaning of Section 401(a)(31) of the Code, including of loans) in cash or notes (in the case of loans) in an amount equal to the eligible rollover distribution portion of the account balance distributable to such Continuing Employee from the Company 401(k) Plan to the corresponding Parent 401(k) Plan, and (c) upon any termination of the Company 401(k) Plan in accordance with this Section 6.03, the Continuing Employees shall be eligible to participate, effective as of the Effective Time, in the Parent 401(k) Plan.

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!