Common use of Liability for Payment Clause in Contracts

Liability for Payment. Contractor agrees that members are not held liable for the following: • Contractor’s debts, in the event of Contractor’s insolvency, • Services provided to the member, for which the State does not pay Contractor, or the State, or Contractor, does not pay the individual or the health care provider that furnishes the services under a contractual, referral, or other arrangement, or • Payments for covered services furnished under a contract, referral, or other arrangement to the extent that those payments are in excess of the amount that the Member would owe if Contractor provided the services directly. Pursuant to Section 1932(b)(6) of the Act, and to 42 C.F.R. § 438.106(a), in the event that the Contractor becomes insolvent, the Contractor will not hold Medicaid enrollees liable for the Contractor’s debts. In accordance with 42 C.F.R. § 438.116(a), the Contractor will provide assurances satisfactory to the State that its provision against the risk of insolvency is adequate to ensure that Medicaid enrollees will not be liable for the Contractor’s debt if the Contractor becomes insolvent. Should any part of the scope of work under this Agreement relate to a State program that is no longer authorized by law (e.g., which has been vacated by a court of law, or for which CMS has withdrawn federal authority, or which is the subject of a legislative repeal), Contractor must do no work on that part after the effective date of the loss of program authority. EOHHS must adjust capitation rates to remove costs that are specific to any program or activity that is no longer authorized by law. If Contractor works on a program or activity no longer authorized by law after the date the legal authority for the work ends, Contractor will not be paid for that work. If the state paid the Contractor in advance to work on a no-longer-authorized program or activity and under the terms of this contract the work was to be performed after the date the legal authority ended, the payment for that work should be returned to EOHHS. However, if Contractor worked on a program or activity prior to the date legal authority ended for that program or activity, and EOHHS included the cost of performing that work in its payments to Contractor, Contractor may keep the payment for that work even if the payment was made after the date the program or activity lost legal authority. 3.5 GUARANTEES, WARRANTIES, AND CERTIFICATIONS‌ A. Contractor Certification of Truthfulness

Liability for Payment. Contractor agrees that members are not held liable for the following: • Contractor’s debts, in the event of Contractor’s insolvency, • Services provided to the member, for which the State does not pay Contractor, or the State, or Contractor, does not pay the individual or the health care provider that furnishes the services under a contractual, referral, or other arrangement, or • Payments for covered services furnished under a contract, referral, or other arrangement to the extent that those payments are in excess of the amount that the Member would owe if Contractor provided the services directly. Pursuant to Section 1932(b)(6) of the Act, and to 42 C.F.R. § 438.106(a), in the event that the Contractor becomes insolvent, the Contractor will not hold Medicaid enrollees liable for the Contractor’s debts. In accordance with 42 C.F.R. § 438.116(a), the Contractor will provide assurances satisfactory to the State that its provision against the risk of insolvency is adequate to ensure that Medicaid enrollees will not be liable for the Contractor’s debt if the Contractor becomes insolvent. Should any part of the scope of work under this Agreement relate to a State program that is no longer authorized by law (e.g., which has been vacated by a court of law, or for which CMS has withdrawn federal authority, or which is the subject of a legislative repeal), Contractor must do no work on that part after the effective date of the loss of program authority. EOHHS must adjust capitation rates to remove costs that are specific to any program or activity that is no longer authorized by law. If Contractor works on a program or activity no longer authorized by law after the date the legal authority for the work ends, Contractor will not be paid for that work. If the state paid the Contractor in advance to work on a no-longer-authorized program or activity and under the terms of this contract the work was to be performed after the date the legal authority ended, the payment for that work should be returned to EOHHS. However, if Contractor worked on a program or activity prior to the date legal authority ended for that program or activity, and EOHHS included the cost of performing that work in its payments to Contractor, Contractor may keep the payment for that work even if the payment was made after the date the program or activity lost legal authority. 3.5 GUARANTEES, WARRANTIES, AND CERTIFICATIONS‌ A. Contractor Certification of Truthfulness