LIQUIDATED MONEY DAMAGES. 18.4.1 The measure of damages in the event that HMO fails to perform its obligations under this contract may be difficult or impossible to calculate or quantify. Therefore, should HMO fail to perform in accordance with the terms and conditions of this contract, TDH may require HMO to pay sums as specified below as liquidated damages. The liquidated damages set out in this Article are not intended to be in the nature of a penalty but are intended to be reasonable estimates of TDH's financial loss and damage resulting from HMO's non-performance.
LIQUIDATED MONEY DAMAGES. 139 18.5 APPOINTMENT OF TEMPORARY MANAGEMENT.............................. 141 18.6 TDH-INITIATED DISENROLLMENT OF A MEMBER OR MEMBERS WITHOUT CAUSE.................................................... 142 18.7 RECOMMENDATION TO HCFA THAT SANCTIONS BE TAKEN AGAINST HMO...................................................... 142 18.8 CIVIL MONETARY PENALTIES......................................... 142 18.9 FORFEITURE OF ALL OR PART OF THE TDI PERFORMANCE BOND............ 143 18.10 REVIEW OF REMEDY OR REMEDIES TO BE IMPOSED....................... 143 ARTICLE XIX TERM........................................................ 143 1999 Renewal Contract Xxxxxx Service Area August 9, 1999 vi APPENDIX A Standards For Quality Improvement Programs APPENDIX B HUB Progress Assessment Reports APPENDIX C Value-added Services APPENDIX D Required Critical Elements APPENDIX E Transplant Facilities APPENDIX F Trauma Facilities APPENDIX G Hemophilia Treatment Centers And Programs APPENDIX I Managed Care Financial-Statistical Report APPENDIX J Utilization Management Report - Physical Health APPENDIX K Preventive Health Performance Objectives APPENDIX L Cost Principles For Administrative Expenses APPENDIX M Arbitration/Litigation Report 1999 1999 Renewal Contract Xxxxxx Service Area August 9, 1999 vii CONTRACT FOR SERVICES Between THE TEXAS DEPARTMENT OF HEALTH And HMO This contract is entered into between the Texas Department of Health (TDH) and PCA Health Plans of Texas, Inc. (HMO). The purpose of this contract is to set forth the terms and conditions for HMO's participation as a managed care organization in the TDH STAR Program (STAR or STAR Program). Under the terms of this contract HMO will provide comprehensive health care services to qualified and Medicaid-eligible recipients through a managed care delivery system. This is a risk-based contract. HMO was selected to provide services under this contract under Health and Safety Code, Title 2, ss. 12.011 and ss.12.021, and Texas Government Code ss.533.001 et seq. HMO's selection for this contract was based upon HMO's Application submitted in response to TDH's Request for Application (RFA) in the service area. Representations and responses contained in HMO's Application are incorporated into and are enforceable provisions of this contract, except where changed by this contract.
LIQUIDATED MONEY DAMAGES. 167 18.5 APPOINTMENT OF TEMPORARY MANAGEMENT.................................................................... 169 18.6 HHSC-INITIATED DISENROLLMENT OF A MEMBER OR MEMBERS WITHOUT CAUSE ..................................... 170
LIQUIDATED MONEY DAMAGES. 18.4.1 The measure of damages in the event that HMO fails to perform its obligations under this contract may be difficult or impossible to calculate or quantify. Therefore, should HMO fail to perform in accordance with the terms and conditions of this contract, TDHS may require HMO to pay sums as specified below as liquidated damages. The liquidated damages set out in this Article are not intended to be in the nature of a penalty but are intended to be reasonable estimates of TDHS' financial loss and damage resulting from HMO's non-performance. TDHS/HMO CONTRACT August 11, 1999 114 121 18.4.2 TDHS imposes money damages, TDHS may collect those damages by reducing the amount of any monthly premium payments otherwise due to HMO by the amount of the damages. Money damages that are withheld from monthly premium payments are forfeited and will not be subsequently paid to HMO upon compliance or cure of default unless a determination is made after appeal that the damages should not have been imposed.
