Notice of Adverse Action. PPG shall notify FHS in writing, within five days of receiving any notice of any complaint, grievance, appeal, or adverse action, including, without limitation, (i) any action against any license, certification under Title XVIII or Title XIX or other applicable statute of the Social Security Act or other State law, or DEA narcotic registration certificate; (ii) any action which results in the filing of a report on a Member Physician under California Business & Professions Code Section 805; (iii) any action by an insurance carrier indicating that such carrier will cancel or not renew the insurance coverage required to be carried by a Member Physician as specified in this Agreement; (iv) any malpractice litigation or settlement involving a Member Physician; and (v) any other event, occurrence or situation which might materially interfere with, modify or alter performance of any of PPG’s duties or obligations under this Agreement. PPG shall maintain a written record of any Member complaint and provide such record to FHS promptly upon request.
Notice of Adverse Action. The Faculty member is entitled to notice of the President’s decision at the earliest practicable date but no later than twenty (20) days following the due date of the Faculty member’s response. The University shall deliver the notice of decision to the Faculty member at or before the time the action will be made effective. The notice shall be in writing, be dated, inform the Faculty member of the specific statement of the charges upon which such action is based, inform the Faculty member of his or her right to appeal, and inform him or her of the time limit within which an appeal may be submitted, all as provided in Article X, section D, subsection 11, of this Agreement. The Adverse Action is effective the date of the Notice of Adverse Action. Implementation of the adverse action decision, from its effective date, is subject to the provisions in Article X, section D, subsection 12, of this Agreement.
Notice of Adverse Action. Any entity taking an adverse action shall issue a written notice. Such notice shall: (1) state the cause for the action; (2) state the effective date of the action;
Notice of Adverse Action. The CONTRACTOR must notify the requesting provider, and give the member written notice of any decision by the CONTRACTOR to deny a service authorization request, or to authorize a service in an amount, duration, or scope that is less than requested. The notice must meet the requirement of 42 CFR Section 438.404, except that the notice to the provider need not be in writing.
Notice of Adverse Action. 4.14.5.1 If the Contractor upholds the Proposed Action in response to an Administrative Review filed by the Member or P4HB Member, the Contractor shall issue a Notice of Adverse Action within the timeframes described in Section 4.14.4.8 and 4.14.4.9.
4.14.5.2 The Notice of Adverse Action shall meet the language and format requirements as specified in 4.3 and include the following: · The results and date of the Adverse Action including the service or procedure that is subject to the Action. · Additional information, if any, that could alter the decision. · The specific reason used as the basis of the action. · The right to request a State Administrative Law Hearing within thirty (30) Calendar Days. The time for filing will begin when the filing is date stamped; · The right to continue to receive Benefits pending a State Administrative Law Hearing; · How to request the continuation of Benefits; · Information explaining that the Member or P4HB Member may be liable for the cost of any continued Benefits if the Contractor’s action is upheld in a State Administrative Law Hearing. · Circumstances under which expedited resolution is available and how to request it.
Notice of Adverse Action. 1) An employee whose reduction in grade or removal is proposed under this Article is entitled to thirty (30) days advance notice of the proposed action. The notice will contain the following information and employee rights:
a) The action being proposed;
b) The critical elements of the employee’s position on which the performance is considered unacceptable;
c) The specific instances of unacceptable performance on which the present action is based;
d) The employee’s right to be represented by an attorney or other representative;
e) The employee’s right to respond, orally and/or in writing, within twenty (20) calendar days, exclusive of the date of receipt of the notice of the adverse action, to the proposed action prior to a decision being made. The reply will be made to the deciding official or their designee. Upon request, a reasonable time for an extension may be granted provided the request is made prior to the expiration of the twenty-day reply period. The employee will be granted up to eight (8) hours of duty time to prepare their reply to the proposed action. The Employer will consider a written request from the employee for additional duty time to prepare their response;
f) The name of the individual to whom the response shall be made;
g) A copy of any information relied upon to support the proposed action;
h) The thirty (30) day notice period shall begin on the next day following the date of receipt of the notice of the adverse action; and
i) That a determination as to the reduction in grade or removal will be made after the expiration of the notice period.
2) If the employee elects to make an oral reply, it will be made to the deciding official or their designee, in person, unless agreed otherwise. The employee may submit a written outline of the points covered upon conclusion of the oral reply.
3) In reaching a final decision, the Employer may not rely on any alleged deficiency or criticism of the employee’s performance which the employee has not been given the opportunity to reply to either orally or in writing. The Employer also agrees to give consideration to any mitigating circumstances before reaching a final decision, including but not limited to an employee’s medical condition pursuant to 5 CFR Part 432.105(a)(4)(iv). The decision notice will include a statement indicating that the adverse action will be placed in the employee’s e- OPF.
Notice of Adverse Action. 4.14.5.1 If the Contractor upholds the Proposed Action in response to a Grievance or Appeal filed by the Member, the Contractor shall issue a Notice of Adverse Action within the timeframes as described in Section 4.14.4.8 and 4.14.4.9.
4.14.5.2 The Notice of Adverse Action shall meet the language and format requirements as specified in 4.3 and include the following:
4.14.5.2.1 The results and date of the adverse Action;
4.14.5.2.2 The right to request a State Administrative Law Hearing within thirty (30) Calendar Days and how to do so;
4.14.5.2.3 The right to continue to receive Benefits pending a State Administrative Law Hearing;
4.14.5.2.4 How to request the continuation of Benefits;
4.14.5.2.5 Information explaining that the Member may be liable for the cost of any continued Benefits if the Contractor’s action is upheld in a State Administrative Law Hearing.
4.14.5.2.6 The action the Contractor has taken on intends to take;
4.14.5.2.7 The reasons for the action;
4.14.5.2.8 The Member’s or the Provider’s right to file an appeal;
4.14.5.2.9 The Member’s right to request a State fair hearing;
4.14.5.2.10 Procedures for exercising the Member’s rights to appeal or grieve;
4.14.5.2.11 Circumstances under which expedited resolution is available and how to request it; and
4.14.5.2.12 The Member’s rights to have benefits continue pending the resolution of the appeal, how to request that benefits be continued, and the circumstances under which the Member may be required to pay the costs of these services.
Notice of Adverse Action. (a) The CONTRACTOR shall notify the requesting Network Provider or Non-Network Provider, and give the Member written notice of any decision by the CONTRACTOR to deny a service authorization request or to authorize a service in an amount, duration, or scope that is less than requested. The notice must meet the requirements set forth in 42 C.F.R. §438.404.
(b) HSD shall review and approve all notification templates that will be sent to Members.
Notice of Adverse Action. (1) An employee whose reduction in grade or removal is proposed under this Article is entitled to thirty (30) days advance notice of the proposed action. The notice should contain a statement that indicates:
(a) The action being proposed;
(b) The critical elements of the employee’s position on which the performance is considered unacceptable;
(c) The specific instances of unacceptable performance on which the present action is based;
(d) The employee’s right to be represented by an attorney or other representative;
(e) The employee’s right to respond, orally or in writing, within fifteen (15) workdays;
(f) The name of the individual to whom the response shall be made;
(g) The employee’s right to review the material relied upon to support the reasons in the notice;
(h) That the thirty (30) day notice period shall begin when the employee received the notice; and
(i) That a determination as to the reduction in grade or removal will be made after the expiration of the notice period.
(2) Any request for an oral or written reply shall be submitted within five (5) workdays of the employee’s receipt of the letter of proposed action.
(3) In reaching a final decision, the Employer may not rely on any employee performance which the employee has not been given the opportunity to reply to either orally or in writing.
Notice of Adverse Action. Provider shall provide written notice to United within five (5) calendar days of the occurrence of any of the following:
i. Any action taken to restrict, suspend or revoke Provider’s or a Provider Professional’s license or authorization to provide Contracted Services;
ii. Any suit or arbitration action brought by a patient against Provider or a Provider Professional for malpractice. In addition, Provider shall send United a summary of the final disposition of such action;
iii. Any misdemeanor conviction or felony information or indictment naming Provider or a Provider Professional. In addition, Provider shall send United a summary of the final disposition thereof;
iv. Any disciplinary proceeding or action naming Provider or a Provider Professional before an administrative agency in any state. In addition, Provider shall send United a summary of the final disposition thereof;
v. Any cancellation or material modification of the professional liability insurance required to be carried by Provider or a Provider Professional under the terms of this Agreement;
vi. Any action taken to restrict, suspend or revoke Provider’s or a Provider Professional’s participation in Medicare, Medicaid or CHAMPUS, VA CCN or any succeeding program. In addition, Provider shall send United a summary of the final disposition thereof;
vii. Any material Enrolled Eligible Veteran complaints against Provider or a Provider Professional; or
viii. Any other event or situation that could materially affect Provider’s ability to carry out Provider’s duties and obligations under this Agreement.
