Medicare Requirements. If it is ultimately determined that this Agreement is a subcontract for services, the value of which is ten thousand dollars ($10,000) or more during a twelve (12) month period within the meaning of Section 952 of the Omnibus Reconciliation Act of 1980 (Pub. L. 96-499), and 42 C.F.R, Part 420, then, until the expiration of four (4) years after the furnishing of services, the parties shall make available, upon written request, to the Secretary of Health and Human Services or to the Comptroller General of the United States, or any of their duly authorized representatives, this Agreement, and the books, documents and records of the parties that are necessary to evaluate the nature and extent of such costs.
Medicare Requirements. This Exhibit A sets forth terms and conditions required by Company’s contract with CMS. In the event of a conflict between the terms and conditions set forth in this Exhibit A and the terms of the Agreement, this Exhibit A shall control.
Medicare Requirements. In addition to the other provisions set forth in this Agreement, the following requirements specifically apply to any Members that are enrolled by Plan under a Medicare Contract between Plan and CMS.
Medicare Requirements. All retirees, regardless of location, are obliged to participate in Medicare Part B when first eligible, with fees to be paid by the retired unit member, to offset the cost to the District of providing the benefits under this paragraph. Furthermore, all SDPL retirees are obligated to assign their Medicare benefits to their health plan provider. Failure to participate in Medicare Part B or to assign benefits shall constitute forfeiture of all benefits under this Article.
Medicare Requirements. 7.5.1 Affiliated Provider shall permit the Comptroller General of the United States, the Department of Health and Human Services and their duly authorized representatives access to Affiliated Provider’s books, documents, and records relating to each service rendered under this Agreement for a period of five (5) years after such service is rendered, if the provisions of Section 952 of the Omnibus Reconciliation Act of 1980 (P.O. 96449) and 42. C.F.R. Part 420, Subpart D are deemed to apply to the services provided under this Agreement. Authority for similar access will be included in any subcontract for the provision of services under this Agreement between Affiliated Provider and any organization related to it, where the cost or value of such subcontract is $10,000.00 or more in a twelve (12) month period.
Medicare Requirements. To the extent that Pharmacy is providing Covered Services for which a Plan Sponsor receives payment pursuant to Medicare Part D or Medicare Advantage programs, Pharmacy agrees that such Covered Services shall be provided consistent and in compliance with the terms of the Medicare Part D plan sponsor or Medicare Advantage organization’s contract with CMS. Without limitation of the foregoing: (a) Pharmacy agrees to abide by United States state and federal privacy and security requirements, including the confidentiality and security provisions stated in the regulations for the Part D program at 42 C.F.R. § 423.136;
Medicare Requirements. Where applicable, Exhibit D to this Agreement sets forth additional terms and conditions, applicable to Covered Services provided to persons enrolled in Medicare managed care products, including Exhibit D-1. This includes products offered pursuant to a Payor’s Medicare Advantage contract and cost contracts (Collectively “Medicare Contracts”) with the Centers for Medicare and Medicaid Services (CMS) of the United States Department of Health and Human Services (HHS), including but not limited to coordinated care plans (both HMO and PPO Plans) (collectively “Medicare Plans”).
Medicare Requirements. (1) Seller acknowledges to the best of its knowledge, information and belief, there are no past or pending investigations, legal actions, or matters subject to arbitration involving Seller or any of its employees, contractors, governing body / board of director members, or major
