Monitoring of Waiver Providers Sample Clauses

Monitoring of Waiver Providers. The AE shall conduct monitoring using the Department’s standardized monitoring tool and process in order to ensure ongoing adherence to the approved Waiver qualification standards, ongoing compliance with the provisions of 55 Pa. Code, Chapter 51, the terms and conditions of this Agreement, any amendments to this Agreement, Written Policies and Procedures and Departmental Decisions. When a provider renders services in multiple AEs, the on-site audit is conducted by the lead AE, along with Reviewing AEs conducting on-site audits for those waiver Participants in the sample registered with them. The Lead AE is designated by ODP based on the AE with which the most individuals served by the provider are registered. ODP shall reassess the designation of the Lead AE or reviewing AEs at the beginning of each monitoring cycle. Lead and Reviewing AEs shall conduct on-site audits of all providers designated by ODP on an annual basis. Reviewing AEs will submit the provider monitoring results electronically to the lead AE. The lead AE shall consolidate the reviewing AEs’ provider monitoring results into one AE audit report. The AE shall request a CAP from the Provider within 15 days of notification to address issues identified during the Provider monitoring. If the CAP submitted by the Provider does not appropriately address the identified issues, the AE shall initiate remediation efforts and notify the appropriate regional ODP. The AE shall notify the appropriate regional ODP if initial remediation efforts are unsuccessful relating to the following:
Sample 1
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Monitoring of Waiver Providers. The AE shall conduct Provider monitoring of all cost-based and fee-schedule Waiver Providers and Providers of Vendor services. The AE shall conduct monitoring of Providers to ensure ongoing adherence to the approved Waiver qualification standards, ongoing compliance with the provisions outlined in the current Waiver Provider Agreement, the terms and conditions of this Agreement, any amendments to this Agreement, Written Policies and Procedures and Departmental Decisions. If a Provider is acting in accordance with OHCDS requirements, the AE shall review subcontracts held with a Provider of a Vendor service and monitor that the Provider acting as the OHCDS and subcontracted vendor is in compliance with Written Policies and Procedures, the current Provider Agreement and Departmental Decisions. The AE shall request a CAP from the Provider within thirty (30) calendar days of notification to address issues identified during the Provider monitoring. The AE shall submit a copy of the CAP as approved by the AE to the appropriate regional ODP. If the CAP submitted by the Provider does not appropriately address the identified issues, the AE shall initiate remediation efforts and notify the appropriate regional ODP. The AE shall notify the appropriate regional ODP if initial remediation efforts are unsuccessful relating to the following:
Sample 1

Related to Monitoring of Waiver Providers

  • Your Guide to Selecting a Primary Care Provider (PCP) and Other Providers Quality healthcare begins with a partnership between you and your primary care provider (PCP). When you need care, call your PCP, who will help coordinate your care. Your healthcare coverage under this plan is provided or arranged through our network of PCPs, specialists, and other providers. You’re encouraged to: • become involved in your healthcare by asking providers about all treatment plans available and their costs; • take advantage of the preventive health services offered under this plan to help you stay healthy and find problems before they become serious. Each member is required to provide the name of his or her PCP. However, if the name of a PCP is not provided with the application, your enrollment will not be delayed and your coverage will not be cancelled. How to Find a PCP or Other Providers Finding a PCP in our network is easy. To select a provider, or to check that a provider is in our network, please use the “Find a Doctor” tool on our website or call Customer Service. Please note: We are not obligated to provide you with a provider. We are not liable for anything your provider does or does not do. We are not a healthcare provider and do not practice medicine, dentistry, furnish health care, or make medical judgments.

  • Monitoring Requirements This Schedule sets out the contract management requirements which are applicable to the delivery of the Services.

  • Monitoring and Inspection The Interconnected Transmission Owner may monitor construction and installation of Interconnection Facilities that the Interconnection Customer is constructing. Upon reasonable notice, authorized personnel of the Interconnected Transmission Owner may inspect any or all of such Interconnection Facilities to assess their conformity with Applicable Standards.

  • Monitoring Services IDT staff shall, using methods that include face-to-face and other contacts with the member, monitor the services a member receives. This monitoring shall ensure that:

  • Certification Regarding Debarment, Suspension, and Other Responsibility Matters – Primary Covered Transactions The Firm certifies to the best of its knowledge and belief, that it and its principals:

  • Monitoring and Oversight 9 To permit the SCSB as the Authorizer hereunder to fulfill its monitoring and oversight functions under the Act, U.C.A. §53G-5-202(1)(c), and ensure that the School is in compliance with all applicable laws, regulations, rules, and the terms and conditions of this Agreement10, the Charter School agrees to fully support SCSB’s oversight and monitoring responsibilities including responding to all timely requests for reports,11 audits,12 formal and informal investigations, formal and informal visits and inspections of books and records of the Charter School.13 SCSB will use best efforts in exercising its oversight function to secure and review information or records that have been previously submitted by the Charter Schools to relieve administrative cost associated with duplicate requests.

  • Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions

  • Reliance on Third Party Service Providers Each Party may allow Reporting Financial Institutions to use third party service providers to fulfill the obligations imposed on such Reporting Financial Institutions by a Party, as contemplated in this Agreement, but these obligations shall remain the responsibility of the Reporting Financial Institutions.

  • Monitoring Compliance Upon the request of the Lender, but without incurring any liability beyond the Guaranteed Obligations, from time to time, Guarantor shall promptly provide to the Lender such documents, certificates and other information as may be deemed reasonably necessary to enable the Lender to perform its functions under the Servicing Agreement as the same relates to the Guarantor.

  • Monitoring of Contract Performance The Contractor shall comply with the monitoring arrangements set out in the Monitoring Schedule including, but not limited to, providing such data and information as the Contractor may be required to produce under the Contract.

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