LICENSES, ACCREDITATIONS, CREDENTIALING AND QUALIFICATIONS a. The CONTRACTOR shall maintain all licenses, certifications, accreditations and registrations required for its facilities and staff providing services under the Contract as are required by Controlling Authority. Within ten (10) days after the CONTRACTOR receives notice of any sanction by any applicable licensing board, certification or registration agency, or accrediting body which affect the ability of CONTRACTOR to xxxx the LME/PIHP for services, the Contractor shall forward a copy of the notice to the LME/PIHP.
b. The CONTRACTOR shall not xxxx the LME/PIHP:
i. For any services provided by CONTRACTOR during any period of revocation or suspension of required licensure or accreditation of the CONTRACTOR’s facility;
ii. For any services provided by a member of the CONTRACTOR’s staff during any period of revocation or suspension of the staff member’s required certification, licensure, or credentialing.
c. The CONTRACTOR certifies that at the time of execution of this Contract, that neither CONTRACTOR, nor any of its staff or employees, is excluded from participation in Federal Health Care Programs under section 1128 of the Social Security Act and/or 42 CFR Part 1001. Within five (5) business days of notification of exclusion of CONTRACTOR or any of its staff or employees by the U.S. Office of Inspector General, CMS or any other State Medicaid program, CONTRACTOR shall notify the LME/PIHP of the exclusion and its plan for compliance.
d. CONTRACTOR, upon written request by the LME/PIHP, shall provide the LME/PIHP with proof of CONTRACTOR accreditation and copies of accreditation reports as part of the credentialing process.
e. The LME/PIHP will conduct an assessment of the CONTRACTOR’s qualifications to remain in the LME/PIHP’s network at a minimum of once every three (3) years.
LICENSES, ACCREDITATIONS, CREDENTIALING AND QUALIFICATIONS a. Provider shall maintain all licenses, certifications, accreditations and registrations required for its facilities and staff providing services under the Contract as are required by Controlling Authority and that are sufficient to meet Alliance’s network participation requirements pursuant to Alliance’s Credentialing and Re-credentialing Policy (the Credentialing and Re-credentialing Policy is subject to amendment based upon Department review and approval, while awaiting approval of its Policy by the Department). Within five (5) days of receipt by Provider of notice of any sanction by any applicable licensing board, certification or registration agency, or accrediting body that affects the ability of Provider to bill Alliance for services, the Provider shall notify Alliance in writing.
b. Provider must notify Alliance of any changes in the status of any information relating to Provider’s professional credentials.
c. Provider must be enrolled as a Medicaid provider and active in NC Tracks and satisfy the requirements of 42 C.F.R. §455.410, and is subject to termination of this Contract if such enrollment is not maintained.
d. Provider certifies that at the time of execution of this Contract, that neither Provider, nor any of its staff or employees, or principals is excluded from participation, suspended or debarred by any applicable governmental authority from conducting any business or activities contemplated by this Contract whether under current legal name, DBA or any additional name or former name, including the current or former name of a division, department, program or subsidiary. Within five
LICENSES, ACCREDITATIONS, CREDENTIALING AND QUALIFICATIONS. A. The Contractor shall maintain all licenses, certifications, accreditations, credentialing and registrations required for its facilities and staff providing services under the Contract, as are required by the Controlling Authority. Should Contractor receive notice of a sanction by any applicable licensing board, certification or registration agency, or accrediting body or other authority which affects the ability of Contractor to bill the BH I/DD Tailored Plan for services, the Contractor shall forward a copy of the notice to the BH I/DD Tailored Plan as outlined in the Provider Manual.
B. The Contractor shall not bill the BH I/DD Tailored Plan:
i. For any services provided by Contractor during any period of revocation or suspension of required credentialing, licensure or accreditation of the Contractor’s facility;
ii. For any services provided by Contractor’s staff during any period of revocation or suspension of the staff’s required certification, licensure, or credentialing.
C. The Contractor certifies that, at the time of execution of this Contract, neither Contractor nor any of its staff or employees are excluded from participation in Federal Health Care Programs under section 1128 of the Social Security Act, 42 C.F.R. § 455.410, and/or 42 CFR Part 1001. Should Contractor receive a notification of exclusion of Contractor or any of its staff or employees by the U.S. Office of Inspector General, CMS or any other State Medicaid program, Contractor shall notify the BH I/DD Tailored Plan of the exclusion and its plan for compliance as outlined in the Provider Manual.
D. Contractor, upon written request by the BH I/DD Tailored Plan, shall provide proof of Contractor accreditation and copies of accreditation reports as part of the credentialing process.
E. The BH I/DD Tailored Plan will conduct an assessment of the Contractor’s qualifications to remain in the BH I/DD Tailored Plan’s network at a minimum of once every three (3) years, unless otherwise required by the Department.
LICENSES, ACCREDITATIONS, CREDENTIALING AND QUALIFICATIONS. The LIP shall maintain all licenses, certifications, accreditations and registrations required for its facilities and staff providing services under the Contract as are required by Controlling Authority. “
LICENSES, ACCREDITATIONS, CREDENTIALING AND QUALIFICATIONS a. Provider shall maintain all licenses, certifications, accreditations and registrations required for its facilities and staff providing services under the Contract as are required by Controlling Authority and that are sufficient to meet Alliance’s network participation requirements pursuant to Alliance’s Credentialing and Re-credentialing Policy. Within five (5) days of receipt by Provider of notice of any sanction by any applicable licensing board, certification or registration agency, or accrediting body that affects the ability of Provider to bill Alliance for services, the Provider shall notify Alliance in writing and provide a copy of the notice to Alliance.
b. Provider must notify Alliance of any changes in the status of any information relating to Provider’s professional credentials.
c. Provider must be actively enrolled with the Department as a State-funded Services provider in NC Tracks and is subject to termination of this Contract if such enrollment is not maintained in an active status.
d. Provider certifies that at the time of execution of this Contract, that neither Provider, nor any of its staff or employees, or principals is excluded from participation, suspended or debarred by any applicable governmental authority from conducting any business or activities contemplated by this Contract whether under current legal name, DBA or any additional name or former name, including the current or former name of a division, department, program or subsidiary. Within five (5) business days of notification of exclusion of Provider or any of its principals, staff or employees by the U.S. Office of Inspector General, CMS or any State Medicaid program, Provider shall notify Alliance of the exclusion and its plan for compliance.
e. Provider must complete re-credentialing pursuant to Alliance’s Credentialing Criteria prior to contract renewal, but, in any event, no less than the following time periods:
i. During the Provider Credentialing Transition Period, no less frequently than every five (5) years;
ii. After Provider Credentialing Transition Period, no less frequently than every three (3) years.
iii. Failure to meet re-credentialing standards shall be deemed a material breach of this contract and shall result in the termination of this Contract.
f. Provider shall secure and maintain for themselves and their employees commercial general liability and professional liability insurance coverage for claims arising out of events occurring throughout the term ...
LICENSES, ACCREDITATIONS, CREDENTIALING AND QUALIFICATIONS a. The Contractor shall maintain all licenses, certifications, accreditations and registrations required for its facilities and staff providing services under the Contract as are required by Controlling Authority. Within ten (10) days after the Contractor receives notice of any sanction by any applicable licensing board, certification or registration agency, or accrediting body which affect the ability of Contractor to bill the LME/PIHP for services, the Contractor shall forward a copy of the notice to the LME/PIHP.
b. The Contractor shall not bill the LME/PIHP:
i. For any services provided by Contractor during any period of revocation or suspension of required licensure or accreditation of the Contractor facility;
ii. For any services provided by a member of the Contractor staff during any period of revocation or suspension of the staff member’s required certification, licensure, or credentialing.
c. The Contractor certifies that at the time of execution of this Contract, that neither Contractor, nor any of its staff or employees, is excluded from participation in Federal Health Care Programs under section 1128 of the Social Security Act and/or 42 CFR Part 1001. Within five (5) business days of notification of exclusion of Contractor or any of its staff or employees by the U.S. Office of Inspector General, CMS or any other State Medicaid program, Contractor shall notify the LME/PIHP of the exclusion and its plan for compliance.
d. Contractor, upon written request by the LME/PIHP, shall provide the LME/PIHP with proof of Contractor accreditation and copies of accreditation reports as part of the credentialing process.
e. The LME/PIHP will conduct an assessment of the Contractor qualifications to remain in the LME/PIHP’s network at a minimum of once every three (3) years. This Contract does not create any right to remain in the LME/PIHP provider network.
LICENSES, ACCREDITATIONS, CREDENTIALING AND QUALIFICATIONS a. The LIP shall maintain all licenses, certifications, accreditations and registrations required for its facilities and staff providing services under the Contract as are required by Controlling Authority. “Facilities” means any person at one location whose primary purpose is to provide services for those with mental health, intellectual developmental disability and/or substance abuse needs. N.C.G.S 122C §3 (14). Within ten (10) days after the LIP receives notice of any sanction by any applicable licensing board, certification or registration agency, or accrediting body or other authority which affect the ability of LIP to xxxx the LME/PIHP for services, the LIP shall forward a copy of the notice to the LME/PIHP.
