OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and/or objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG may, at its sole discretion, require GSK to engage a new IRO in accordance with Paragraph A of this Appendix. GSK must engage a new IRO within 60 days of termination of the IRO. Prior to requiring GSK to engage a new IRO, OIG shall notify GSK of its intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, GSK may present additional information regarding the IRO’s qualifications, independence or performance of its responsibilities. OIG will attempt in good faith to resolve any differences regarding the IRO with GSK prior to requiring GSK to terminate the IRO. However, the final determination as to whether or not to require GSK to engage a new IRO shall be made at the sole discretion of OIG. I. Covered Functions Review, General Description As specified more fully below, GlaxoSmithKline (GSK) shall retain an Independent Review Organization (IRO) (or IROs) to perform reviews (IRO Reviews) to assist GSK in assessing and evaluating its systems, processes, policies, procedures, and practices related to certain of GSK's Covered Functions (collectively, “IRO Covered Functions”). The IRO Review shall consist of two components - a systems review (Systems Review) and a transactions review (Transactions Review) as described more fully below. GSK may engage, at its discretion, a single IRO to perform both components of the IRO Review provided that the entity has the necessary expertise and capabilities to perform both. If there are no material changes in GSK’s systems, processes, policies, and procedures relating to the Covered IRO Functions, the IRO shall perform the Systems Review for the second and fifth IRO Reporting Periods. If GSK materially changes its systems, processes, policies, and procedures relating to the Covered IRO Functions, the IRO shall perform a Systems Review for the IRO Reporting Period(s) in which such changes were made in addition to conducting the Review for the second and fifth IRO Reporting Periods. The additional Systems Review(s) shall consist of: 1) an identification of the material changes; 2) an assessment of whether other systems, processes, policies, and procedures previously reported did not materially c...
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify CRC in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CRC shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CRC regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CRC in writing that CRC shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. CRC must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require CRC to engage a new IRO shall be made at the sole discretion of OIG.
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify the Friendship Entities in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. The Friendship Entities shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by the Friendship Entities regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify the Friendship Entities in writing that the Friendship Entities shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. The Friendship Entities must engage a new IRO within 60 days of their receipt of OIG’s written notice. The final determination as to whether or not to require the Friendship Entities to engage a new IRO shall be made at the sole discretion of OIG.
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Xxxxxx in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Xxxxxx shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by Xxxxxx regarding its IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Xxxxxx in writing that Xxxxxx shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Xxxxxx must engage a new IRO within 60 days of receipt of OIG’s written notice. The final determination as to whether or not to require Xxxxxx to engage a new IRO shall be made at the sole discretion of OIG. APPENDIX B QUARTERLY CLAIMS REVIEW
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG may, at its sole discretion, require Orbit to engage a new IRO in accordance with Paragraph A of this Appendix. Orbit must engage a new IRO within 60 days of termination of the IRO. Prior to requiring Orbit to engage a new IRO, OIG shall notify Orbit of its intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, Orbit may present additional information regarding the IRO’s qualifications, independence or performance of its responsibilities. OIG will attempt in good faith to resolve any differences regarding the IRO with Orbit prior to requiring Orbit to terminate the IRO. However, the final determination as to whether or not to require Orbit to engage a new IRO shall be made at the sole discretion of OIG.
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Genova in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Genova shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by Genova regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Genova in writing that Genova shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Genova must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require Genova to engage a new IRO shall be made at the sole discretion of OIG.
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Arc in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Arc shall have 30 days from the
OIG Removal of IRO. In the event OIG has reason to believe any IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG may, at its sole discretion, require Orthofix to engage a new IRO in accordance with Paragraph A of this Appendix. Orthofix must engage a new IRO within 60 days of termination of the IRO. Prior to requiring Orthofix to engage a new IRO, OIG shall notify Orthofix of its intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, Orthofix may present additional information regarding the IRO’s qualifications, independence or performance of its responsibilities. OIG will attempt in good faith to resolve any differences regarding the IRO with Orthofix prior to requiring Orthofix to terminate the IRO. However, the final determination as to whether or not to require Orthofix to engage a new IRO shall be made at the sole discretion of OIG. APPENDIX B CLAIMS REVIEW
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG may, at its sole discretion, require Good Shepherd to engage a new IRO in accordance with Paragraph A of this Appendix. Good Shepherd must engage a new IRO within 60 days of termination of the IRO. Prior to requiring Good Shepherd to engage a new IRO, OIG shall notify Good Shepherd of its intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, Good Shepherd may present additional information regarding the IRO’s qualifications, independence or performance of its responsibilities. OIG will attempt in good faith to resolve any differences regarding the IRO with Good Shepherd prior to requiring Good Shepherd to terminate the IRO. However, the final determination as to whether or not to require Good Shepherd to engage a new IRO shall be made at the sole discretion of OIG.
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Cigna in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Cigna shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by Cigna regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Cigna in writing that Cigna shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Cigna must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require Cigna to engage a new IRO shall be made at the sole discretion of OIG.
