Medicare Bad Debts Sample Clauses

Medicare Bad Debts. Sellers shall be entitled to receive Medicare bad debt reimbursement associated with services furnished prior to the Effective Time (“Sellers’ Bad Debts”). Sellers shall have the right, in their reasonable discretion, to require that Buyer, at Sellers’ sole cost, submit a claim for reimbursement to CMS for a Sellers’ Bad Debt on Buyer’s cost report(s) for the period in which Sellers’ Bad Debt becomes uncollectible by Sellers. If Sellers request that Buyer submit one or more Sellers’ Bad Debt claims to CMS, as contemplated by this Section 9.5, Sellers shall provide to Buyer a list of Sellers’ Bad Debts to be claimed with a certification reasonably acceptable to Buyer and Sellers. Buyer shall remit to Sellers the full amount of reimbursement received by Buyer for Sellers’ Bad Debts within 30 days of the tentative settlement of any cost report in which Sellers’ Bad Debts have been claimed pursuant to this Section 9.5. The parties shall reconcile the prior payment made based on the tentative settlement pursuant to the immediately preceding sentence, with the final amount set forth in the final settlement of the cost report(s), by the making of a cash payment so as to cause the net aggregate amount paid by Buyer to Sellers with respect to any given Sellers’ Bad Debt to be equal to the amount set forth on the final settlement. Any additional payment due to Sellers by Buyer as a result of the cost report audit of Sellers’ Bad Debts claims submitted by Buyer and/or any final settlement shall be remitted to Sellers within 30 days of Buyer’s receipt of the Notice of Program Reimbursement (NPR) for the cost report in question. Any payment due to Buyer from Sellers with respect to Sellers’ Bad Debts as a result of a report audit and/or final settlement shall be remitted to Buyer after 30 days of written notice regarding the final settlement from Buyer.
Sample 1
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Medicare Bad Debts. Sellers shall be entitled to receive Medicare bad debt reimbursement associated with services furnished prior to the Effective Time (“Sellers’ Bad Debts”) upon receipt of the Notice of Program Reimbursement covering the Cost Report period in which the bad debt is claimed and to the extent for which it is allowed. Sellers shall have the right, in their sole discretion, to require that Buyers submit a claim for reimbursement to the CMS for a Sellers’ Bad Debt on Buyers’ cost report(s) for the period in which Sellers’ Bad Debt becomes uncollectible by Sellers; provided, however, that the Buyers shall not be required to submit any such claim to the extent that the Buyers reasonably determine that such claim is not a supportable, valid and permissible claim under applicable Medicare regulations and payment policies. If and to the extent that Buyers receive payment for Sellers’ Bad Debts, Buyers shall remit such receipts to Sellers’ Parent within ten (10) Business Days of receipt. The Buyers shall have the right to offset any such payments by any reduction in Buyers’ Medicare reimbursement attributable to the collection of amounts claimed as Sellers’ Bad Debts on prior Cost Reports.
Sample 1
Medicare Bad Debts. The IRO shall select the six (6) HealthSouth IRFs with the highest amount of bad debt payments claimed on cost reports ending during the Corporate Integrity Agreement HealthSouth Corporation preceding calendar year. The IRO shall utilize RAT-STATS to select and review 15 Medicare bad debts for each facility (a total of 90 bad debts). The IRO shall determine whether reasonable efforts were made to collect the debt and whether the amount of the debt was accurately included in the amount claimed for bad debts on the cost report.
Sample 1
Medicare Bad Debts. With respect to any service provided at the Hospitals as to which Purchaser takes assignment of Seller’s provider number, Seller shall be entitled to receive Medicare bad debt reimbursement associated with services furnished prior to the Effective Time.
Sample 1

Related to Medicare Bad Debts

  • Health Care Benefits (a) Each regular full-time employee may elect coverage for himself and his eligible dependents* under one of the following health insurance plans:

  • Health Care Compliance Neither the Company nor any Affiliate has, prior to the Effective Time and in any material respect, violated any of the health care continuation requirements of COBRA, the requirements of FMLA, the requirements of the Health Insurance Portability and Accountability Act of 1996, the requirements of the Women's Health and Cancer Rights Act of 1998, the requirements of the Newborns' and Mothers' Health Protection Act of 1996, or any amendment to each such act, or any similar provisions of state law applicable to its Employees.

  • Health Care Coverage The Company shall continue to provide Executive with medical, dental, vision and mental health care coverage at or equivalent to the level of coverage that the Executive had at the time of the termination of employment (including coverage for the Executive’s dependents to the extent such dependents were covered immediately prior to such termination of employment) for the remainder of the Term of Employment, provided, however that in the event such coverage may no longer be extended to Executive following termination of Executive’s employment either by the terms of the Company’s health care plans or under then applicable law, the Company shall instead reimburse Executive for the amount equivalent to the Company’s cost of substantially equivalent health care coverage to Executive under ERISA Section 601 and thereafter and Section 4980B of the Internal Revenue Code (i.e., COBRA coverage) for a period not to exceed the lesser of (A) 18 months after the termination of Executive’s employment or (B) the remainder of the Term of Employment, and provided further that (1) any such health care coverage or reimbursement for health care coverage shall cease at such time that Executive becomes eligible for health care coverage through another employer and (2) any such reimbursement shall be made no later than the last day of the calendar year following the end of the calendar year with respect to which such coverage or reimbursement is provided. The Company shall have no further obligations to the Executive as a result of termination of employment described in this Section 8(a) except as set forth in Section 12.

  • Health Care Laws The Company and each of its subsidiaries is, and at all times has been, in compliance in all material respects with all applicable Health Care Laws, and has not engaged in activities which are, as applicable, cause for false claims liability, civil penalties, or mandatory or permissive exclusion from Medicare, Medicaid, or any other state health care program or federal health care program. For purposes of this Agreement, “Health Care Laws” means: (i) the Federal Food, Drug, and Cosmetic Act, (ii) all applicable federal, state, local and foreign health care related fraud and abuse Laws, including, without limitation, the U.S. Anti-Kickback Statute (42 U.S.C. Section 1320a-7b(b)), the U.S. Physician Payment Sunshine Act (42 U.S.C. Section 1320a-7h), the U.S. Civil False Claims Act (31 U.S.C. Section 3729 et seq.), the criminal False Claims Law (42 U.S.C. Section 1320a-7b(a)), all criminal Laws relating to health care fraud and abuse, including but not limited to 18 U.S.C. Sections 286 and 287, and the health care fraud criminal provisions under the U.S. Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) (42 U.S.C. Section 1320d et seq.) as amended by the Health Information Technology for Economic and Clinical Health Act (42 U.S.C. Section 17921 et seq.), the exclusion laws (42 U.S.C. Section 1320a-7), the civil monetary penalties law (42 U.S.C. Section 1320a-7a), (iii) Medicare (Title XVIII of the Social Security Act); (iv) Medicaid (Title XIX of the Social Security Act), (v) the Controlled Substances Act (21 U.S.C. Sections 801 et seq.), (vi) Healthcare Product Laws, including but not limited to HIPAA, relating to data privacy and the protection of personal information, including personal health information, and (vii) any and all other applicable health care laws and regulations. Neither the Company nor any of its subsidiaries has received written notice of any claim, action, suit, proceeding, hearing, enforcement, audit, investigation, arbitration or other action from any court, arbitrator, other Governmental Authority or third party alleging that any product, operation or activity of the Company or a subsidiary is in material violation of any Health Care Laws, and, to the Company’s knowledge, no such claim, action, suit, proceeding, hearing, enforcement, audit, investigation, arbitration or other action is threatened. Neither the Company nor any of its subsidiaries are a party to or have any ongoing reporting obligations pursuant to any corporate integrity agreements, deferred prosecution agreements, monitoring agreements, consent decrees, settlement orders, plans of correction or similar agreements with or imposed by any Regulatory Agency or other Governmental Authority. Neither the Company, any of its subsidiaries, any of their respective directors, officers, nor, to the Company’s knowledge, any of their respective employees or agents has been excluded, suspended or debarred from participation in any U.S. federal health care program or human clinical research or, to the knowledge of the Company, is subject to an inquiry, investigation, proceeding, or other similar action by any Governmental Authority that would reasonably be expected to result in debarment, suspension, or exclusion.

  • Payors EXHIBIT 2.28 sets forth a true, complete and correct list of the names and addresses of each payor of Company's services which accounted for more than 10% of revenues of Company in the preceding fiscal year. Company has good relations with all such payors and other material payors of Company and none of such payors has notified Company that it intends to discontinue its relationship with Company or to deny any claims submitted to such payor for payment.

  • Insurance Contracts To the extent that any Welfare Plan is funded through the purchase of an insurance contract or is subject to any stop loss contract, the Parties shall cooperate and use their commercially reasonable efforts to replicate such insurance contracts for SpinCo or Parent as applicable (except to the extent that changes are required under applicable Law or filings by the respective insurers) and to maintain any pricing discounts or other preferential terms for both Parent and SpinCo for a reasonable term. Neither Party shall be liable for failure to obtain such insurance contracts, pricing discounts, or other preferential terms for the other Party. Each Party shall be responsible for any additional premiums, charges, or administrative fees that such Party may incur pursuant to this Section 7.06.

  • Health Care Matters Without limiting the generality of any representation or warranty made in Article 7 or any covenant made in Articles 8 or 9, each Borrower represents and warrants on a joint and several basis to and covenants with the Administrative Agent and each Lender, and shall be deemed to represent, warrant and covenant on each day on which any advance or accommodation in respect of any Loan is requested or made or any Liabilities shall be outstanding under this Agreement (or any Affiliate Term Loan Liabilities shall be outstanding under the Term Loan Agreement), that:

  • Medi Cal PII is information directly obtained in the course of performing an administrative function on behalf of Medi-Cal, such as determining Medi-Cal eligibility or conducting IHSS operations, that can be used alone, or in conjunction with any other information, to identify a specific individual. PII includes any information that can be used to search for or identify individuals, or can be used to access their files, such as name, social security number, date of birth, driver’s license number or identification number. PII may be electronic or paper. AGREEMENTS

  • HIPAA To the extent (if any) that DXC discloses “Protected Health Information” or “PHI” as defined in the HIPAA Privacy and Security Rules (45 CFR, Part 160-164) issued pursuant to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) to Supplier or Supplier accesses, maintains, uses, or discloses PHI in connection with the performance of Services or functions under this Agreement, Supplier will: (a) not use or further disclose PHI other than as permitted or required by this Agreement or as required by law; (b) use appropriate safeguards to prevent use or disclosure of PHI other than as provided for by this Agreement, including implementing requirements of the HIPAA Security Rule with regard to electronic PHI; (c) report to DXC any use or disclosure of PHI not provided for under this Agreement of which Supplier becomes aware, including breaches of unsecured protected health information as required by 45 CFR §164.410, (d) in accordance with 45 CFR §164.502(e)(1)(ii), ensure that any subcontractors or agents of Supplier that create, receive, maintain, or transmit PHI created, received, maintained or transmitted by Supplier on DXC’s behalf, agree to the same restrictions and conditions that apply to Supplier with respect of such PHI; (e) make available PHI in a Designated Record Set (if any is maintained by Supplier) in accordance with 45 CFR section 164.524;

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