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
AutoNDA by SimpleDocs
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 covered services 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 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
Manner of Service Delivery and Provision. In establishing and maintaining the PCP network, the CCN shall consider the following:
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

Related to Manner of Service Delivery and Provision

  • Subcontracting for the Provision of Services (a) The parties acknowledge that, subject to the provisions of LHSIA, 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.

  • 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.

  • STATE’S ABILITY TO MODIFY SCOPE OF MASTER CONTRACT Subject to mutual agreement between the parties, Enterprise Services reserves the right to modify the goods and/or services included in this Master Contract; Provided, however, that any such modification shall be effective only upon thirty (30) days advance written notice; and Provided further, that any such modification must be within the scope of this Master Contract.

  • 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.

  • 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, 2021, the Fund’s performance (Class A shares) was in the 1st quartile, 3rd quartile and 3rd quartile, respectively, 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 outperformed its benchmark in the one-year period, has performed equal to its benchmark in the three-year period and has underperformed its benchmark in the five-year period ended December 31, 2021. 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 (1st quartile being the most favorable and 4th quartile being the least favorable). With respect to management fees paid to other investment advisors by similar funds, the Board noted that the contractual fee rates paid by the Fund, which include a 0.097% fee paid to DIMA under the Fund’s administrative services agreement, were lower than the median (1st quartile) of the applicable Broadridge peer group (based on Broadridge data provided as of December 31, 2021). The Board noted that the Fund’s Class A shares total (net) operating expenses (excluding 12b-1 fees) were expected to be lower than the median (2nd quartile) of the applicable Broadridge expense universe (based on Broadridge data provided as of December 31, 2021, and analyzing Broadridge expense universe Class A (net) expenses less any applicable 12b-1 fees) (“Broadridge Universe Expenses”). The Board also reviewed data comparing each other operational share class’s total (net) operating expenses to the applicable Broadridge Universe Expenses. The Board noted that the expense limitations agreed to by XXXX were expected to help the Fund’s total (net) operating expenses remain competitive. The Board considered the Fund’s management fee rate as compared to fees charged by XXXX to comparable DWS U.S. registered funds (“DWS Funds”), noting that XXXX indicated that it does not provide services to any other comparable DWS Funds. The information requested by the Board as part of its review of fees and expenses also included information about institutional accounts (including any sub-advised funds and accounts) and funds offered primarily to European investors (“DWS Europe Funds”) managed by DWS Group. The Board noted that XXXX indicated that DWS Group does not manage any institutional accounts or DWS Europe Funds comparable to the Fund. On the basis of the information provided, the Board concluded that management fees were reasonable and appropriate in light of the nature, quality and extent of services provided by DIMA.

  • 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.

  • TERMS OF PROVISION OF SERVICES 2.1. The Contractor performs work for the Customer at his own risk and personally. At the same time, the Contractor has the right, with the consent of the Customer, to involve other persons (subcontractors) in the performance of work, remaining responsible to the Customer for the result of their work. Involvement of other persons (subcontractors) in the performance of works must be carried out in full accordance with the terms of this Agreement.

  • Protection of Service and Property Each Party will exercise the same degree of care to prevent harm or damage to the other Party and any third parties, its employees, agents or End User Customers, or their property as it employs to protect its own employees, agents, End User Customers and property, , but in no case less than a commercially reasonable degree of care.

  • Originality of Services Except as to standard generic details, Consultant agrees that all technologies, formulae, procedures, processes, methods, writings, ideas, dialogue, compositions, recordings, teleplays and video productions prepared for, written for, or submitted to the District and/or used in connection with this Agreement, shall be wholly original to Consultant and shall not be copied in whole or in part from any other source, except that submitted to Consultant by District as a basis for such services.

Time is Money Join Law Insider Premium to draft better contracts faster.