REPORTING AND EVALUATION The Provider agrees to comply with 7 AAC 81.120, Confidentiality and 7 AAC 81.150, Reports, and other applicable state or federal law regarding the submission of information, including the provisions of Section VI of this Agreement. The Provider agrees to submit any reporting information required under this Agreement and to make available information deemed necessary by DHSS to evaluate the efficacy of service delivery or compliance with applicable state or federal statutes or regulations. The Provider agrees to provide state officials and their representatives access to facilities, systems, books and records, for the purpose of monitoring compliance with this Agreement and evaluating services provided under this Agreement. On-site Quality Assurance Reviews may be conducted by DHSS staff to ensure compliance with service protocols. The Provider will ensure that DHSS staff has access to program files for the purposes of follow-up, quality assurance monitoring and fiscal administration of the program.
Substance Abuse Treatment Information Substance abuse treatment information shall be maintained in compliance with 42 C.F.R. Part 2 if the Party or subcontractor(s) are Part 2 covered programs, or if substance abuse treatment information is received from a Part 2 covered program by the Party or subcontractor(s).
TECHNICAL EVALUATION (a) Detailed technical evaluation shall be carried out by Purchase Committee pursuant to conditions in the tender document to determine the substantial responsiveness of each tender. For this clause, the substantially responsive bid is one that conforms to all the eligibility and terms and condition of the tender without any material deviation. The Institute’s determination of bid’s responsiveness is to be based on the contents of the bid itself without recourse to extrinsic evidence. The Institute shall evaluate the technical bids also to determine whether they are complete, whether required sureties have been furnished, whether the documents have been properly signed and whether the bids are in order.
Student Evaluation A. All unit members shall be subject to student evaluations each semester in each course taught.
How to Obtain Prescription Drug Preauthorization To obtain prescription drug preauthorization, the prescribing provider must submit a prescription drug preauthorization request form. These forms are available on our website or by calling the number listed for the “Pharmacist” on the back of your ID card. Prescription drugs that require preauthorization will only be approved when our clinical guidelines are met. These guidelines are based upon clinically appropriate criteria that ensure that the prescription drug is appropriate and cost- effective for the illness, injury or condition for which it has been prescribed. We will send you written notification of the prescription drug preauthorization determination within fourteen (14) calendar days of the receipt of the request. How to Request an Expedited Preauthorization Review You may request an expedited review if the circumstances are an emergency. Due to the urgent nature of an expedited review, your prescribing provider must either call or fax the completed form and indicate the urgent nature of the request. When an expedited preauthorization review is received, we will respond to you with a determination within seventy-two (72) hours or less. If we deny your request for preauthorization, you can submit a medical appeal. See Appeals in Section 5 for information on how to file a medical appeal. Formulary Exception Process When a prescription drug is not on our formulary, you can request that this plan cover the drug as an exception. To request a formulary exception, complete a Coverage Exception form (located on our website), contact our Customer Service Department, or have your prescribing provider submit a request for you. We will respond to you with a determination within seventy- two (72) hours following receipt of the request. For standard exception reviews, if the exception is approved, we will cover the prescription drug for the duration of the prescription, including refills. How to Request an Expedited Formulary Exception Review You may request an expedited review if a delay could significantly increase the risk to your health or your ability to regain maximum function, or you are undergoing a current course of treatment with a drug not on our formulary. Please indicate “urgent” on the Coverage Exception form or inform Customer Service of the urgent nature of your request. We will respond to you with a determination within twenty-four (24) hours following receipt of the request. For expedited exception reviews, if the exception is approved, we will cover the prescription drug for the duration of the exigency. For both standard and expedited exception reviews, if we grant your request for a formulary exception, the amount you pay will be the copayment at the highest formulary tier in your plan. Other applicable benefit requirements, such as step therapy, are not waived by this exception and must be reviewed separately. If we deny your request for a formulary exception, we will notify you with information on how to appeal our decision, including external appeal information.
Monitoring and Evaluation a. The AGENCY shall expeditiously provide to the COUNTY upon request, all data needed for the purpose of monitoring, evaluating and/or auditing the program(s). This data shall include, but not be limited to, clients served, services provided, outcomes achieved, information on materials and services delivered, and any other data required, in the sole discretion of the COUNTY, that may be required to adequately monitor and evaluate the services provided under this Contract. Monitoring shall be performed in accordance with COUNTY’S established Noncompliance Standards, a copy of which is attached hereto and incorporated by reference as Attachment “C”.
Annual Evaluation The Partnership will be evaluated on an annual basis through the use of the Strategic Partnership Annual Evaluation Format as specified in Appendix C of OSHA Instruction CSP 00-00-000, OSHA Strategic Partnership Program for Worker Safety and Health. Xxxxxxxxx & Xxxxxx will be responsible for gathering required participant data to evaluate and track the overall results and success of the Partnership. This data will be shared with OSHA. OSHA will be responsible for writing and submitting the annual evaluation.
Fraud, Xxxxx and Abuse If you have concerns about being billed for services you never received, or that your insurance information has been stolen or used by someone else, you may report potential health care fraud, waste or abuse to our Special Investigations Unit by using our confidential anti-fraud hotline at 0-000-000-0000 or by email at XXX@xxxxxx.xxx. You may also send an anonymous letter to us at: Blue Cross & Blue Shield of Rhode Island Special Investigations Unit 000 Xxxxxxxx Xxxxxx Providence RI, 02903
Final Evaluation IC must submit a final report and a project evaluation to the Arts Commission within thirty (30) days after the completion of the Services. Any and all unexpended funds from IC must be returned to City no later than sixty (60) days after the completion of the Services.
National Treatment on Internal Taxation and Regulation Each Party shall accord national treatment to the goods of the other Parties in accordance with Article III of GATT 1994. To this end, Article III of GATT 1994 shall be incorporated into and shall form part of this Agreement, mutatis mutandis.
