Manner of Service Delivery and Provision Sample Clauses

Manner of Service Delivery and Provision. In establishing and maintaining the service delivery network, the Contractor must consider the following: • The anticipated Medicaid enrollment. • The expected utilization of services, taking into consideration the characteristics and health care needs of specific Medicaid populations represented by the Contractor • The number of network providers who are not accepting new Medicaid patients • The geographic location of providers and Medicaid members; considering distance travel time, means of transportation ordinarily used by Medicaid members, and whether the location provides physical access for Medicaid members with disabilities. The Contractor shall provide female members with direct access to a women’s health specialist within the network for covered care necessary to provide women’s routine and preventive health care services. This is in addition to the members designated source of primary care if that source is not a women’s health specialist. The Contractor shall provide a second opinion from a qualified health care professional.
Sample 1
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Manner of Service Delivery and Provision. In establishing and maintaining the service delivery network, the Contractor must consider the following: • The anticipated enrollment; • The expected utilization of services, taking into consideration the characteristics and health care needs of specific populations represented by the Contractor; • The number of network providers who are not accepting new SCHIP patients; and • The geographic location of providers and members; considering distance travel time, means of transportation ordinarily used by this population, and whether the location provides physical access for members with disabilities. When determined appropriate, the Contractor shall provide a second opinion from a qualified health care professional within the network or arrange for the member to obtain one outside the network at no cost to the member. If the network is unable to provide necessary services covered under the contract to a particular member, the Contractor shall adequately and timely cover these services out of network for the member for as long as the Contractor is unable to provide them.
Sample 1
Manner of Service Delivery and Provision. In establishing and maintaining the PCP network, the CCN shall consider the following: a. The maximum Medicaid/CHIP enrollment capacity; b. The expected utilization of services, taking into consideration the characteristics and health care needs of specific Medicaid/CHIP populations enrolled in the CCN; c. The number of network providers who are not accepting new Medicaid/CHIP patients; and d. The geographic location of providers and Medicaid/CHIP members; considering distance travel time, and means of transportation ordinarily used by Medicaid/CHIP members. e. All providers shall be in compliance with American with Disabilities Act (ADA) requirements and provide physical access for Medicaid/CHIP members with disabilities. The CCN shall allow female members direct access to a women’s health specialist within the network for covered care necessary to provide women’s routine and preventive health care services. This is in addition to the members designated source of primary care if that source is not a women’s health specialist.
Sample 1
Manner of Service Delivery and Provision. In establishing and maintaining the service delivery network, the CCN must consider the following: • The anticipated Medicaid enrollment; • The expected utilization of services, taking into consideration the characteristics and health care needs of specific Medicaid/CHIP populations enrolled in the CCN; • The number of network providers who are not accepting new Medicaid/CHIP patients; • The geographic location of providers and Medicaid/CHIP members; considering distance and travel time, and means of transportation ordinarily used by Medicaid/CHIP members; and • All providers shall be in compliance with Americans with Disabilities ACT (ADA) requirements and provide and provide physical access for Medicaid/CHIP members with disabilities. The CCN shall provide female members with direct access to a women’s health specialist within the network for core benefits and services necessary to provide women’s routine and preventive health care services. This is in addition to the members designated source of primary care if that source is not a women’s health specialist. The CCN shall provide a second opinion from a qualified health care professional within the CCN or arrange for the member to obtain one outside the CCN at no cost to the member. If the CCN’s network providers are unable to provide necessary services, specified under the Provider Agreement, to a particular member, the CCN shall adequately and timely cover these services out-of-network for the member. The Provider Agreement will require any out-of-network providers to coordinate with the CCN with respect to payment to ensure that there is no cost to the member. Same as if the services were furnished within the CCN.
Sample 1
Manner of Service Delivery and Provision. In establishing and maintaining the service delivery network, the Contractor must consider the following:  The anticipated Medicaid enrollment.  The expected utilization of services, taking into consideration the characteristics and health care needs of specific Medicaid populations represented in the geographical service area being considered by the Contractor.  The number of network Providers who are not accepting new Medicaid patients.  The geographic location of Providers and Medicaid MCO Members, considering distance travel time, means of transportation ordinarily used by Medicaid MCO Members, and whether the location provides physical access for Medicaid MCO Members with disabilities. The Contractor shall provide female Medicaid MCO Members with direct access to a women’s health specialist within the network for Covered Services necessary to provide women’s routine and preventive health care services. This is in addition to the Medicaid MCO Member’s designated source of primary care if that source is not a women’s health specialist. The Contractor shall provide a second opinion from a qualified Health Care Professional within the network or arrange for the Medicaid MCO Member to obtain one outside the network at no cost to the Medicaid MCO Member. If the network is unable to provide necessary Covered Services to a particular Medicaid MCO Member, the Contractor shall adequately and timely cover these services out of network for the Medicaid MCO Member for as long as the Contractor is unable to provide them. The Contract will require any out-of-network Providers to coordinate with the Contractor with respect to payment to ensure that any cost to the Medicaid MCO Member is no greater than it would be if the services were furnished within the network.
Sample 1

Related to Manner of Service Delivery and Provision

  • Subcontracting for the Provision of Services (a) The parties acknowledge that, subject to the provisions of the Enabling Legislation, the HSP may subcontract the provision of some or all of the Services. For the purposes of this Agreement, actions taken or not taken by the subcontractor, and Services provided by the subcontractor, will be deemed actions taken or not taken by the HSP, and Services provided by the HSP. (b) When entering into a subcontract the HSP agrees that the terms of the subcontract will enable the HSP to meet its obligations under this Agreement. Without limiting the foregoing, the HSP will include a provision that permits the Funder or its authorized representatives, to audit the subcontractor in respect of the subcontract if the Funder or its authorized representatives determines that such an audit would be necessary to confirm that the HSP has complied with the terms of this Agreement. (c) Nothing contained in this Agreement or a subcontract will create a contractual relationship between any subcontractor or its directors, officers, employees, agents, partners, affiliates or volunteers and the Funder. (d) When entering into a subcontract, the HSP agrees that the terms of the subcontract will enable the HSP to meet its obligations under the FLSA.

  • Performance of Service; Limitation of Liability A. PFS shall exercise reasonable care in the performance of its duties under this Agreement. PFS shall not be liable for any error of judgment or mistake of law or for any loss suffered by the Trust in connection with matters to which this Agreement relates, including losses resulting from mechanical breakdowns or the failure of communication or power supplies beyond PFS's control, except a loss arising out of or relating to PFS's refusal or failure to comply with the terms of this Agreement or from bad faith, negligence, or willful misconduct on its part in the performance of its duties under this Agreement. Notwithstanding any other provision of this Agreement, if PFS has exercised reasonable care in the performance of its duties under this Agreement, the Trust shall indemnify and hold harmless PFS from and against any and all claims, demands, losses, expenses, and liabilities (whether with or without basis in fact or law) of any and every nature (including reasonable attorneys' fees) which PFS may sustain or incur or which may be asserted against PFS by any person arising out of any action taken or omitted to be taken by it in performing the services hereunder, except for any and all claims, demands, losses, expenses, and liabilities arising out of or relating to PFS's refusal or failure to comply with the terms of this Agreement or from bad faith, negligence or from willful misconduct on its part in performance of its duties under this Agreement, (i) in accordance with the foregoing standards, or (ii) in reliance upon any written or oral instruction provided to PFS by any duly authorized officer of the Trust, such duly authorized officer to be included in a list of authorized officers furnished to PFS and as amended from time to time in writing by resolution of the Board of Trustees of the Trust. PFS shall indemnify and hold the Trust harmless from and against any and all claims, demands, losses, expenses, and liabilities (whether with or without basis in fact or law) of any and every nature (including reasonable attorneys' fees) which the Trust may sustain or incur or which may be asserted against the Trust by any person arising out of any action taken or omitted to be taken by PFS as a result of PFS's refusal or failure to comply with the terms of this Agreement, its bad faith, negligence, or willful misconduct. In the event of a mechanical breakdown or failure of communication or power supplies beyond its control, PFS shall take all reasonable steps to minimize service interruptions for any period that such interruption continues beyond PFS's control. PFS will make every reasonable effort to restore any lost or damaged data and correct any errors resulting from such a breakdown at the expense of PFS. PFS agrees that it shall, at all times, have reasonable contingency plans with appropriate parties, making reasonable provision for emergency use of electrical data processing equipment to the extent appropriate equipment is available. Representatives of the Trust shall be entitled to inspect PFS's premises and operating capabilities at any time during regular business hours of PFS, upon reasonable notice to PFS. B. In order that the indemnification provisions contained in this section shall apply, it is understood that if in any case the indemnitor may be asked to indemnify or hold the indemnitee harmless, the indemnitor shall be fully and promptly advised of all pertinent facts concerning the situation in question, and it is further understood that the indemnitee will use all reasonable care to notify the indemnitor promptly concerning any situation which presents or appears likely to present the probability of a claim for indemnification. The indemnitor shall have the option to defend the indemnitee against any claim which may be the subject of this indemnification. In the event that the indemnitor so elects, it will so notify the indemnitee and thereupon the indemnitor shall take over complete defense of the claim, and the indemnitee shall in such situation initiate no further legal or other expenses for which it shall seek indemnification under this section. The indemnitee shall in no case confess any claim or make any compromise in any case in which the indemnitor will be asked to indemnify the indemnitee except with the indemnitor's prior written consent. C. PFS is hereby expressly put on notice of the limitation of shareholder, Trustee, officer, employee or agent liability as set forth in the Declaration of Trust of the Trust and agrees that obligations assumed by the Trust pursuant to this Agreement shall be limited in all cases to the Trust and its assets, and if the liability relates to one or more Funds, the obligations hereunder shall be limited to the respective assets of such Fund. PFS further agrees that it shall not seek satisfaction of any such obligation from any shareholder of a Fund, nor from any Trustee, officer, employee or agent of the Trust.

  • Inspection of Services Subcontractor shall make the Services accessible at all reasonable times for inspection by the Contractor. Subcontractor shall, at the first opportunity, inspect all material and equipment delivered to the job site by others to be used or incorporated in the Subcontractor’s Services and give prompt notice of any defect therein. Subcontractor assumes full responsibility to protect the work done hereunder until final acceptance by the Contractor or any authorized third (3rd) party.

  • Performance of Services in Accordance with Regulatory Requirements; Furnishing of Books and Records In performing the services set forth in this Agreement, the Manager: A. shall conform with the 1940 Act and all rules and regulations thereunder, with all other applicable federal, state and foreign laws and regulations, with any applicable procedures adopted by the Trust’s Board of Trustees, and with the provisions of the Trust’s Registration Statement filed on Form N-1A as supplemented or amended from time to time; B. will make available to the Trust, promptly upon request, any of the Fund’s books and records as are maintained under this Agreement, and will furnish to regulatory authorities having the requisite authority any such books and records and any information or reports in connection with the Manager’s services under this Agreement that may be requested in order to ascertain whether the operations of the Trust are being conducted in a manner consistent with applicable laws and regulations.

  • Service Warranty Provider has carefully examined and analyzed the provisions of this Agreement, including but not limited to all exhibits attached and incorporated into it, and can and will perform, or cause, the Services to be performed in strict accordance with the provisions and requirements of the Agreement. Services will be performed in a timely, professional and workmanlike manner in accordance with all applicable industry and professional standards.

  • Scheduling Provisions The scheduling and premium provisions relating to consecutive weekends off in Article 16 do not apply to employees who accept positions under this provision.

  • Quality of Service Contractor shall perform its services with care, skill, and diligence, in accordance with the applicable professional standards currently recognized by such profession, and shall be responsible for the professional quality, technical accuracy, completeness, and coordination of all reports, designs, drawings, plans, information, specifications, and/or other items and services furnished under this Agreement. Contractor shall, without additional compensation, correct or revise any errors or deficiencies immediately upon discovery in its reports, drawings, specifications, designs, and/or other related items or services.

  • Quality and Extent of Services The Board considered the terms of the Agreement, including the scope of advisory services provided under the Agreement. The Board noted that, under the Agreement, XXXX provides portfolio management services to the Fund and that, pursuant to a separate administrative services agreement, DIMA provides administrative services to the Fund. The Board considered the experience and skills of senior management and investment personnel and the resources made available to such personnel. The Board also considered the risks to XXXX in sponsoring or managing the Fund, including financial, operational and reputational risks, the potential economic impact to XXXX from such risks and XXXX’s approach to addressing such risks. The Board reviewed the Fund’s performance over short-term and long-term periods and compared those returns to various agreed-upon performance measures, including market index(es) and a peer universe compiled using information supplied by Morningstar Direct (“Morningstar”), an independent fund data service. The Board also noted that it has put into place a process of identifying “Funds in Review” (e.g., funds performing poorly relative to a peer universe), and receives additional reporting from XXXX regarding such funds and, where appropriate, XXXX’s plans to address underperformance. The Board believes this process is an effective manner of identifying and addressing underperforming funds. Based on the information provided, the Board noted that, for the one-, three- and five-year periods ended December 31, 2020, the Fund’s performance (Class A shares) was in the 2nd quartile of the applicable Morningstar universe (the 1st quartile being the best performers and the 4th quartile being the worst performers). The Board also observed that the Fund has underperformed its benchmark in the one-, three- and five-year periods ended December 31, 2020. Fees and Expenses. The Board considered the Fund’s investment management fee schedule, operating expenses and total expense ratios, and comparative information provided by Broadridge Financial Solutions, Inc. (“Broadridge”) and the Fee Consultant regarding investment management fee rates paid to other investment advisors by similar funds

  • COMMERCIAL REUSE OF SERVICES The member or user herein agrees not to replicate, duplicate, copy, trade, sell, resell nor exploit for any commercial reason any part, use of, or access to 's sites.

  • Quality of Services (a) The Consultant shall be responsible for the professional quality, technical accuracy, and the coordination of all designs, drawings, specifications, and other services furnished pursuant to this Agreement. (b) To that end, the Consultant shall correct or shall revise, without additional compensation, any errors or omissions in its work product or shall make such revisions as are necessary as the result of the failure of the Consultant to provide an accurate, more efficient, and properly constructable product in its designs, drawings, specifications, or other services. (c) The County's review/approval/acceptance of or payment for the services required by this Agreement shall NOT be construed to operate as a waiver of any rights or of any cause of action arising out of the performance of this Agreement. Additionally, the Consultant shall be and remain liable to the County in accordance with applicable law for all damages to the County caused by the Consultant's negligent performance of any of the services furnished under this Agreement. (d) The rights and remedies of the County provided for under this Agreement are in addition to any other rights and remedies otherwise provided by law.

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