Member Appeals. A Member receiving notice of an alleged breach and 26 proposed liquidated damages shall have five (5) days from the date that the Member receives the notice 27 to request an appeal hearing before the Enforcement Committee. If a Member fails to request a hearing 28 within such 5‐day appeal period, the Member’s right of appeal shall expire, the Member shall be 29 deemed to have breached this Agreement in accordance with the Manager’s determination, and the 30 Member shall be obligated to pay the related liquidated damages. If a Member timely requests an 31 appeal hearing, the Manager shall consult with the Enforcement Committee and schedule an 1 Enforcement Committee meeting for that purpose. The Enforcement Committee shall make reasonable 2 efforts to schedule the meeting at a time and place such that the Member requesting the appeal is able 3 to attend, and shall provide the Member with at least thirty (30) days advance written notice of the time 4 and place of the meeting. At such meeting, the Enforcement Committee shall provide the Manager with 5 an opportunity to present evidence of the apparent breach, and shall provide the Member in apparent 6 breach with a reasonable opportunity to rebut such evidence. Per Section 9, above, the catch and 7 delivery data produced by the Manager shall be presumed accurate, and, absent manifest error, each 8 Member's obligations under this Agreement and all related documents may be enforced to their fullest 11 amount provided for such breach under this Agreement.
Member Appeals. A Member receiving notice of an alleged breach and proposed liquidated damages shall have five (5) days from the date that the Member receives the notice to request an appeal hearing before the Enforcement Committee. If a Member fails to request a hearing within such 5‐day appeal period, the Member’s right of appeal shall expire, the Member shall be deemed to have breached this Agreement in accordance with the Manager’s determination, and the Member shall be obligated to pay the related liquidated damages. If a Member timely requests an appeal hearing, the Manager shall consult with the Enforcement Committee and schedule an Enforcement Committee meeting for that purpose. The Enforcement Committee shall make reasonable efforts to schedule the meeting at a time and place such that the Member requesting the appeal is able to attend, and shall provide the Member with at least thirty (30) days advance written notice of the time and place of the meeting. At such meeting, the Enforcement Committee shall provide the Manager with an opportunity to present evidence of the apparent breach, and shall provide the Member in apparent breach with a reasonable opportunity to rebut such evidence. Per Section 9, above, the catch and delivery data produced by the Manager shall be presumed accurate, and, absent manifest error, each Member's obligations under this Agreement and all related documents may be enforced to their fullest extent on the basis of such data. If the Enforcement Committee determines that a Member breached this Agreement, the Sector shall have the right to collect from such Member the liquidated damages amount provided for such breach under this Agreement.
Member Appeals. Contractor must resolve one hundred percent (100%) of member appeals within thirty (30) calendar days of receipt of the appeal. For each quarter in which in which Contractor fails to provide and communicate a timely resolution on one hundred percent (100%) of member appeals, Contractor shall pay liquidated damages in the amount of two thousand, two hundred dollars ($2,200). The Contractor must also provide a timely and satisfactory response to documentation required to facilitate member appeals in accordance with the FSSA Fair Hearing process. In addition, the Contractor shall provide a representative to participate in the FSSA fair hearing process to represent the State. For each instance in which the Contractor fails to either (i) provide a timely response to documentation required for the member appeal within the time frames set forth by FSSA, or (ii) upon adequate notice, represent the State at the FSSA fair hearing, Contractor shall pay liquidated damages in the amount of one thousand, fifty dollars ($1,050).
Member Appeals. County must provide written notification to providers on member grievance procedures as outlined in this Contract.
I. PAYMENTS FOR DIAGNOSIS OF WHETHER AN EMERGENCY CONDITION EXISTS Pay for appropriate diagnostic tests or evaluations utilized to determine if an emergency exists. Payment for emergency services continues until the patient is stabilized and can be safely discharged or transferred. J. MEMORANDA OF UNDERSTANDING (MOU) FOR EMERGENCY SERVICES AND POST-STABILIZATOIN SERVICES Negotiate in good faith MOUs with emergency care providers to ensure prompt and appropriate delivery of and payment for emergency services. Such MOUs shall provide for:
1. The process for determining whether an emergency exists.
2. The requirements and procedures for contacting the County before the provision of urgent or routine care.
3. Agreements, if any, between the County and the provider regarding indemnification, hold harmless, or any other deviation from malpractice or other legal liability which would attach to the County or provider in the absence of such an agreement.
4. Payments for appropriate diagnostic tests or evaluations to determine if an emergency exists.
5. Assurance of timely and appropriate provision of and payment for emergency services. Unless a Contract or MOU specifies otherwise, the County is liable to the extent that the fee-for-service system would have been liable for the emergency situation. The Department reserves the right to resolve disputes between the County, hospitals and urgent care centers regarding emergency situations based on fee-for-service criteria.
Member Appeals. A Member receiving notice of an alleged breach and
Member Appeals. A Member receiving notice of an alleged breach and 7 proposed liquidated damages shall have five (5) days from the date that the Member receives the notice 8 to request an appeal hearing before the Enforcement Committee. If a Member fails to request a hearing 9 within such 5‐day appeal period, the Member’s right of appeal shall expire, the Member shall be deemed 10 to have breached this Agreement in accordance with the Manager’s determination, and the Member shall 11 be obligated to pay the related liquidated damages. If a Member timely requests an appeal hearing, the 12 Manager shall consult with the Enforcement Committee and schedule an Enforcement Committee 13 meeting for that purpose. The Enforcement Committee shall make reasonable efforts to schedule the 14 meeting at a time and place such that the Member requesting the appeal is able to attend, and shall 15 provide the Member with at least thirty (30) days advance written notice of the time and place of the
Member Appeals. All Member appeals shall be resolved in accordance with the provisions of the applicable Membership Agreement or EOC.
