Common use of LIQUIDATED MONEY DAMAGES Clause in Contracts

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, HHSC 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 HHSC's financial loss and damage resulting from HMO's non-performance. 18.4.2 If HHSC imposes money damages, HHSC 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. 18.4.3 Failure to file or filing incomplete or inaccurate annual, semi-annual or quarterly reports may result in money damages of not more than $11,000.00 for every month from the month the report is due until submitted in the form and format required by HHSC. These money damages apply separately to each report. 18.4.4 Failure to produce or provide records and information requested by HHSC, an entity acting on behalf of HHSC, or an agency authorized by statute or law to require production of records at the time and place the records were required or requested may result in money damages of not more than $5,000.00 per day for each day the records are not produced as required by the requesting entity or agency if the requesting entity or agency is conducting an investigation or audit relating to fraud or abuse, and not more than $1,000.00 per day for each day records are not produced if the requesting entity or agency is conducting routine audits or monitoring activities. 18.4.5 Failure to file or filing incomplete or inaccurate encounter data may result in money damages of not more than $25,000 for each month HMO fails to submit encounter data in the form and format required by HHSC. HHSC will use the encounter data validation methodology established by HHSC to determine the number of encounter data and the number of months for which damages will be assessed. 18.4.6 Failing or refusing to cooperate with HHSC, an entity acting on behalf of HHSC, or an agency authorized by statute or law to require the cooperation of HMO in carrying out an administrative, investigative, or prosecutorial function of the Medicaid program may result in money damages of not more than $8,000.00 per day for each day HMO fails to cooperate. 18.4.7 Failure to enter into a required or mandatory contract or failure to contract for or arrange to have all services required under this contract provided may result in money damages of not more than $1,000.00 per day that HMO either fails to negotiate in good faith to enter into the required contract or fails to arrange to have required services delivered. 18.4.8 Failure to meet the benchmark for benchmarked services under this contract may result in money damages of not more than $25,000 for each month that HMO fails to meet the established benchmark. 18.4.9 HHSC may also impose money damages for a default under Section 16.3.9, Failure to Make Payments to Network Providers and subcontractors, of this contract. These money damages are in addition to the interest HMO is required to pay to providers under the provisions of Sections 4.10.4 and 7.2.7.10 of this contract. 18.4.9.1 If HHSC determines that HMO has failed to pay a provider for a claim or claims for which the provider should have been paid, HHSC may impose money damages of $2 per day for each day the claim is not paid from the date the claim should have been paid (calculated as 30 days from the date a clean claim was received by HMO) until the claim is paid by HMO. 18.4.9.2 If HHSC determines that HMO has failed to pay a capitation amount to a provider who has contracted with HMO to provide services on a capitated basis, HHSC may impose money damages of $10 per day, per Member for whom the capitation is not paid, from the date on which the payment was due until the capitation amount is paid.

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, HHSC TDH may require HMO to pay sums as specified 1999 Renewal Contract Tarrant Service Area 146 August 9, 1999 147 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 HHSCTDH's financial loss and damage resulting from HMO's non-performance. 18.4.2 If HHSC TDH imposes money damages, HHSC TDH 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. 18.4.3 Failure to file or filing incomplete or inaccurate annual, semi-annual or quarterly reports may result in money damages of not more than $11,000.00 for every month from the month the report is due until submitted in the form and format required by HHSCTDH. These money damages apply separately to each report. 18.4.4 Failure to produce or provide records and information requested by HHSCTDH, an entity acting on behalf of HHSCTDH, or an agency authorized by statute or law to require production of records at the time and place the records were required or requested may result in money damages of not more than $5,000.00 per day for each day the records are not produced as required by the requesting entity or agency if the requesting entity or agency is conducting an investigation or audit relating to fraud or abuse, and not more than $1,000.00 per day for each day records are not produced if the requesting entity or agency is conducting routine audits or monitoring activities. 18.4.5 Failure to file or filing incomplete or inaccurate encounter data may result in money damages of not more than $25,000 for each month HMO fails to submit encounter data in the form and format required by HHSCTDH. HHSC TDH will use the encounter data validation methodology established by HHSC TDH to determine the number of encounter data and the number of months for which damages will be assessed. 18.4.6 Failing or refusing to cooperate with HHSCTDH, an entity acting on behalf of HHSCTDH, or an agency authorized by statute or law to require the cooperation of HMO in carrying out an administrative, investigative, or prosecutorial function of the Medicaid program may result in money damages of not more than $8,000.00 per day for each day HMO fails to cooperate. 18.4.7 Failure to enter into a required or mandatory contract or failure to contract for or arrange to have all services required under this contract provided may result 1999 Renewal Contract Tarrant Service Area 147 August 9, 1999 148 in money damages of not more than $1,000.00 per day that HMO either fails to negotiate in good faith to enter into the required contract or fails to arrange to have required services delivered. 18.4.8 Failure to meet the benchmark for benchmarked services under this contract may result in money damages of not more than $25,000 for each month that HMO fails to meet the established benchmark. 18.4.9 HHSC TDH may also impose money damages for a default under Section Article 16.3.9, Failure to Make Payments to Network Providers and subcontractors, of this contract. These money damages are in addition to the interest HMO is required to pay to providers under the provisions of Sections Articles 4.10.4 and 7.2.7.10 of this contract. 18.4.9.1 If HHSC TDH determines that HMO has failed to pay a provider for a claim or claims for which the provider should have been paid, HHSC TDH may impose money damages of $2 per day for each day the claim is not paid from the date the claim should have been paid (calculated as 30 days from the date a clean claim was received by HMO) until the claim is paid by HMO. 18.4.9.2 If HHSC TDH determines that HMO has failed to pay a capitation amount to a provider who has contracted with HMO to provide services on a capitated basis, HHSC TDH may impose money damages of $10 per day, per Member for whom the capitation is not paid, from the date on which the payment was due until the capitation amount is paid.

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, HHSC 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 HHSCTDH's financial loss and damage resulting from HMO's non-performance. 18.4.2 If HHSC TDH imposes money damages, HHSC TDH 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. 18.4.3 Failure to file or filing incomplete or inaccurate annual, semi-annual or quarterly reports may result in money damages of not more than $11,000.00 for every month from the month the report is due until submitted in the form and format required by HHSCTDH. These money damages apply separately to each report. 18.4.4 Failure to produce or provide records and information requested by HHSCTDH, an entity acting on behalf of HHSCTDH, or an agency authorized by statute or law to require production of records at the time and place the records were required or requested may result in money damages of not more than $5,000.00 per day for each day the records are not produced as required by the requesting entity or agency if the requesting entity or agency is conducting an investigation or audit relating to fraud or abuse, and not more than $1,000.00 per day for each day records are not produced if the requesting entity or agency is conducting routine audits or monitoring activities. 18.4.5 Failure to file or filing incomplete or inaccurate encounter data may result in money damages of not more than $25,000 for each month HMO fails to submit encounter data in the form and format required by HHSCTDH. HHSC TDH will use the encounter data validation methodology established by HHSC TDH to determine the number of encounter data and the number of months for which damages will be assessed.. 1999 Renewal Contract Bexar Service Area August 9, 1999 18.4.6 Failing or refusing to cooperate with HHSCTDH, an entity acting on behalf of HHSCTDH, or an agency authorized by statute or law to require the cooperation of HMO in carrying out an administrative, investigative, or prosecutorial function of the Medicaid program may result in money damages of not more than $8,000.00 per day for each day HMO fails to cooperate. 18.4.7 Failure to enter into a required or mandatory contract or failure to contract for or arrange to have all services required under this contract provided may result in money damages of not more than $1,000.00 per day that HMO either fails to negotiate in good faith to enter into the required contract or fails to arrange to have required services delivered. 18.4.8 Failure to meet the benchmark for benchmarked services under this contract may result in money damages of not more than $25,000 for each month that HMO fails to meet the established benchmark. 18.4.9 HHSC TDH may also impose money damages for a default under Section Article 16.3.9, Failure to Make Payments to Network Providers and subcontractors, of this contract. These money damages are in addition to the interest HMO is required to pay to providers under the provisions of Sections Articles 4.10.4 and 7.2.7.10 of this contract. 18.4.9.1 If HHSC TDH determines that HMO has failed to pay a provider for a claim or claims for which the provider should have been paid, HHSC TDH may impose money damages of $2 per day for each day the claim is not paid from the date the claim should have been paid (calculated as 30 days from the date a clean claim was received by HMO) until the claim is paid by HMO. 18.4.9.2 If HHSC TDH determines that HMO has failed to pay a capitation amount to a provider who has contracted with HMO to provide services on a capitated basis, HHSC TDH may impose money damages of $10 per day, per Member for whom the capitation is not paid, from the date on which the payment was due until the capitation amount is paid.

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, HHSC 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 HHSCTDH's financial loss and damage resulting from HMO's non-performance. 18.4.2 If HHSC TDH imposes money damages, HHSC TDH 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. 18.4.3 Failure to file or filing incomplete or inaccurate annual, semi-annual or 1999 Renewal Contract Harrxx Xxxvice Area 147 August 9, 1999 148 quarterly reports may result in money damages of not more than $11,000.00 for every month from the month the report is due until submitted in the form and format required by HHSCTDH. These money damages apply separately to each report. 18.4.4 Failure to produce or provide records and information requested by HHSCTDH, an entity acting on behalf of HHSCTDH, or an agency authorized by statute or law to require production of records at the time and place the records were required or requested may result in money damages of not more than $5,000.00 per day for each day the records are not produced as required by the requesting entity or agency if the requesting entity or agency is conducting an investigation or audit relating to fraud or abuse, and not more than $1,000.00 per day for each day records are not produced if the requesting entity or agency is conducting routine audits or monitoring activities. 18.4.5 Failure to file or filing incomplete or inaccurate encounter data may result in money damages of not more than $25,000 for each month HMO fails to submit encounter data in the form and format required by HHSCTDH. HHSC TDH will use the encounter data validation methodology established by HHSC TDH to determine the number of encounter data and the number of months for which damages will be assessed. 18.4.6 Failing or refusing to cooperate with HHSCTDH, an entity acting on behalf of HHSCTDH, or an agency authorized by statute or law to require the cooperation of HMO in carrying out an administrative, investigative, or prosecutorial function of the Medicaid program may result in money damages of not more than $8,000.00 per day for each day HMO fails to cooperate. 18.4.7 Failure to enter into a required or mandatory contract or failure to contract for or arrange to have all services required under this contract provided may result in money damages of not more than $1,000.00 per day that HMO either fails to negotiate in good faith to enter into the required contract or fails to arrange to have required services delivered. 18.4.8 Failure to meet the benchmark for benchmarked services under this contract may result in money damages of not more than $25,000 for each month that HMO fails to meet the established benchmark. 18.4.9 HHSC TDH may also impose money damages for a default under Section Article 16.3.9, Failure to Make Payments to Network Providers and subcontractors, of this contract. These money damages are in addition to the interest HMO is required to pay to providers under the provisions of Sections Articles 4.10.4 and 7.2.7.10 of this contract.. 1999 Renewal Contract Harrxx Xxxvice Area 148 August 9, 1999 149 18.4.9.1 If HHSC TDH determines that HMO has failed to pay a provider for a claim or claims for which the provider should have been paid, HHSC TDH may impose money damages of $2 per day for each day the claim is not paid from the date the claim should have been paid (calculated as 30 days from the date a clean claim was received by HMO) until the claim is paid by HMO. 18.4.9.2 If HHSC TDH determines that HMO has failed to pay a capitation amount to a provider who has contracted with HMO to provide services on a capitated basis, HHSC TDH may impose money damages of $10 per day, per Member for whom the capitation is not paid, from the date on which the payment was due until the capitation amount is paid.

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, HHSC 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 HHSCTDH's financial loss and damage resulting from HMO's non-performance. 18.4.2 If HHSC TDH imposes money damages, HHSC TDH 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. 18.4.3 Failure to file or filing incomplete or inaccurate annual, semi-annual or quarterly reports may result in money damages of not more than $11,000.00 for every month from the month the report is due until submitted in the form and format required by HHSCTDH. These money damages apply separately to each report. 18.4.4 Failure to produce or provide records and information requested by HHSCTDH, an entity acting on behalf of HHSCTDH, or an agency authorized by statute or law to require production of records at the time and place the records were required or requested may result in money damages of not more than $5,000.00 per day for each day the records are not produced as required by the requesting entity or agency if the requesting entity or agency is conducting an investigation or audit relating to fraud or abuse, and not more than $1,000.00 per day for each day records are not produced if the requesting entity or agency is conducting routine audits or monitoring activities. 18.4.5 Failure to file or filing incomplete or inaccurate encounter data may result in money damages of not more than $25,000 for each month HMO fails to submit encounter data in the form and format required by HHSCTDH. HHSC TDH will use the encounter data validation methodology established by HHSC TDH to determine the number of encounter data and the number of months for which damages will be assessed. 18.4.6 Failing or refusing to cooperate with HHSCTDH, an entity acting on behalf of HHSCTDH, or an agency authorized by statute or law to require the cooperation of HMO in carrying out an administrative, investigative, or prosecutorial function of the Medicaid program may result in money damages of not more than $8,000.00 per day for each day HMO fails to cooperate. 18.4.7 Failure to enter into a required or mandatory contract or failure to contract for or arrange to have all services required under this contract provided may result in money damages of not more than $1,000.00 per day that HMO either fails to negotiate in good faith to enter into the required contract or fails to arrange to have required services delivered. 18.4.8 Failure to meet the benchmark for benchmarked services under this contract may result in money damages of not more than $25,000 for each month that HMO fails to meet the established benchmark. 18.4.9 HHSC TDH may also impose money damages for a default under Section Article 16.3.9, Failure to Make Payments to Network Providers and subcontractors, of this contract. These money damages are in addition to the interest HMO is required to pay to providers under the provisions of Sections Articles 4.10.4 and 7.2.7.10 7.2.8.10 of this contract. 18.4.9.1 If HHSC TDH determines that HMO has failed to pay a provider for a claim or claims for which the provider should have been paid, HHSC TDH may impose money damages of $2 per day for each day the claim is not paid from the date the claim should have been paid (calculated as 30 days from the date a clean claim was received by HMO) until the claim is paid by HMO. 18.4.9.2 If HHSC TDH determines that HMO has failed to pay a capitation amount to a provider who has contracted with HMO to provide services on a capitated basis, HHSC TDH may impose money damages of $10 per day, per Member for whom the capitation is not paid, from the date on which the payment was due until the capitation amount is paid.

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, HHSC 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 HHSCTDH's financial loss and damage resulting from HMO's non-performance. 18.4.2 If HHSC TDH imposes money damages, HHSC TDH 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. 18.4.3 Failure to file or filing incomplete or inaccurate annual, semi-annual or quarterly reports may result in money damages of not more than $11,000.00 for every month from the month the report is due until submitted in the form and format required by HHSCTDH. These money damages apply separately to each report. 18.4.4 Failure to produce or provide records and information requested by HHSCTDH, an entity acting on behalf of HHSCTDH, or an agency authorized by statute or law to require production of records at the time and place the records were required or requested may result in money damages of not more than $5,000.00 per day for each day the records are not produced as required by the requesting entity or agency if the 1999 Renewal Contract Xxxxxx Service Area August 9, 1999 137 requesting entity or agency is conducting an investigation or audit relating to fraud or abuse, and not more than $1,000.00 per day for each day records are not produced if the requesting entity or agency is conducting routine audits or monitoring activities. 18.4.5 Failure to file or filing incomplete or inaccurate encounter data may result in money damages of not more than $25,000 for each month HMO fails to submit encounter data in the form and format required by HHSCTDH. HHSC TDH will use the encounter data validation methodology established by HHSC TDH to determine the number of encounter data and the number of months for which damages will be assessed. 18.4.6 Failing or refusing to cooperate with HHSCTDH, an entity acting on behalf of HHSCTDH, or an agency authorized by statute or law to require the cooperation of HMO in carrying out an administrative, investigative, or prosecutorial function of the Medicaid program may result in money damages of not more than $8,000.00 per day for each day HMO fails to cooperate. 18.4.7 Failure to enter into a required or mandatory contract or failure to contract for or arrange to have all services required under this contract provided may result in money damages of not more than $1,000.00 per day that HMO either fails to negotiate in good faith to enter into the required contract or fails to arrange to have required services delivered. 18.4.8 Failure to meet the benchmark for benchmarked services under this contract may result in money damages of not more than $25,000 for each month that HMO fails to meet the established benchmark. 18.4.9 HHSC TDH may also impose money damages for a default under Section Article 16.3.9, Failure to Make Payments to Network Providers and subcontractors, of this contract. These money damages are in addition to the interest HMO is required to pay to providers under the provisions of Sections Articles 4.10.4 and 7.2.7.10 of this contract. 18.4.9.1 If HHSC TDH determines that HMO has failed to pay a provider for a claim or claims for which the provider should have been paid, HHSC TDH may impose money damages of $2 per day for each day the claim is not paid from the date the claim should have been paid (calculated as 30 days from the date a clean claim was received by HMO) until the claim is paid by HMO. 18.4.9.2 If HHSC TDH determines that HMO has failed to pay a capitation amount to a provider who has contracted with HMO to provide services on a capitated basis, HHSC TDH may impose money damages of $10 per day, per Member for whom the capitation is not paid, from the date on which the payment was due until the capitation amount is paid.. 1999 Renewal Contract Xxxxxx Service Area August 9, 1999 138

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, HHSC TDH may require HMO to pay sums as specified below as liquidated 133 Dallas Service Area Contract 140 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 HHSCTDH's financial loss and damage resulting from HMO's non-performance. 18.4.2 If HHSC TDH imposes money damages, HHSC TDH 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. 18.4.3 Failure to file or filing incomplete or inaccurate annual, semi-annual or quarterly reports may result in money damages of not more than $11,000.00 for every month from the month the report is due until submitted in the form and format required by HHSCTDH. These money damages apply separately to each report. 18.4.4 Failure to produce or provide records and information requested by HHSCTDH, an entity acting on behalf of HHSCTDH, or an agency authorized by statute or law to require production of records at the time and place the records were required or requested may result in money damages of not more than $5,000.00 per day for each day the records are not produced as required by the requesting entity or agency if the requesting entity or agency is conducting an investigation or audit relating to fraud or abuse, and not more than $1,000.00 per day for each day records are not produced if the requesting entity or agency is conducting routine audits or monitoring activities. 18.4.5 Failure to file or filing incomplete or inaccurate encounter data may result in money damages of not more than $25,000 for each month HMO fails to submit encounter data in the form and format required by HHSCTDH. HHSC TDH will use the encounter data validation methodology established by HHSC TDH to determine the number of encounter data and the number of months for which damages will be assessed. 18.4.6 Failing or refusing to cooperate with HHSCTDH, an entity acting on behalf of HHSCTDH, or an agency authorized by statute or law to require the cooperation of HMO in carrying out an administrative, investigative, or prosecutorial function of the Medicaid program may result in money damages of not more than $8,000.00 per day for each day HMO fails to cooperate. 18.4.7 Failure to enter into a required or mandatory contract or failure to contract for or arrange to have all services required under this contract provided may result in money damages of not more than $1,000.00 per day that HMO either fails to negotiate in good faith to enter into the required contract or fails to arrange to have required services delivered. . 134 Dallas Service Area Contract 141 18.4.8 Failure to meet the benchmark for benchmarked services under this contract may result in money damages of not more than $25,000 for each month that HMO fails to meet the established benchmark. 18.4.9 HHSC may also impose money damages for a default under Section 16.3.9, Failure to Make Payments to Network Providers and subcontractors, of this contract. These money damages are in addition to the interest HMO is required to pay to providers under the provisions of Sections 4.10.4 and 7.2.7.10 of this contract. 18.4.9.1 If HHSC determines that HMO has failed to pay a provider for a claim or claims for which the provider should have been paid, HHSC may impose money damages of $2 per day for each day the claim is not paid from the date the claim should have been paid (calculated as 30 days from the date a clean claim was received by HMO) until the claim is paid by HMO. 18.4.9.2 If HHSC determines that HMO has failed to pay a capitation amount to a provider who has contracted with HMO to provide services on a capitated basis, HHSC may impose money damages of $10 per day, per Member for whom the capitation is not paid, from the date on which the payment was due until the capitation amount is paid.