MONITORING OF AVAILABLE FUNDS. The Contractor shall monitor the total expenses submitted to HHS, as well as the anticipated expenses of the high risk pool. The Contractor shall work with HHS to develop mitigation strategies should the actual or projected expenses reimbursable under this contract be projected to exceed the amounts established in this contract or modifications to this contract. If HHS determines that the amounts available in this contract for expenses of the high risk pool may be less than the projected amount of Contractor expenses, the Contractor shall recommend adjustments sufficient to eliminate such deficit, and implement such adjustments after approval by the contracting officer. If the contractor has exercised reasonable efforts to eliminate the deficit, HHS will reimburse the Contractor for all claims and administrative expense in excess of the amounts established in the contract or modification to the contract insofar as permitted under Section 1101 of the Affordable Care Act. HHS reserves the right to adjust the aggregate amounts available for payment of expenses in the high risk pool as are necessary to eliminate an aggregate deficit as provided in 1101(g)(2) of the Affordable Care Act and to direct the Contractor to cease taking applications for participation in the program as provided in 1101(g)(4) of the Affordable Care Act.
Appears in 5 contracts
Samples: Contract Agreement, Contract Agreement, Operate a Qualified
MONITORING OF AVAILABLE FUNDS. The Contractor shall monitor the total expenses submitted to HHS, as well as the anticipated expenses of the high risk pool. The Contractor shall work with HHS to develop mitigation strategies should the actual or projected expenses reimbursable under this contract be projected to exceed the amounts established in this contract or modifications to this contract. If HHS determines that the amounts available in this contract for expenses of the high risk pool may be less than the projected amount of Contractor expenses, the Contractor shall recommend adjustments sufficient to eliminate such deficit, and implement such adjustments after approval by the contracting officer. If the contractor has exercised reasonable efforts to eliminate the deficit, HHS will reimburse pay the Contractor for all claims and administrative expense in excess of the amounts established in the contract or modification to the contract insofar as permitted under Section 1101 of the Affordable Care Act. HHS reserves the right right, to adjust the aggregate amounts available for payment of expenses in the high risk pool as are necessary to eliminate an aggregate deficit as provided in 1101(g)(2) of the Affordable Care Act and to direct the Contractor to cease taking applications for participation in the program as provided in 1101(g)(4) of the Affordable Care Act.. HHS will not make a retroactive adjustment that impacts previously incurred allowable costs, including costs that were incurred but not yet reported.l
Appears in 1 contract
Samples: Contract Agreement