Common use of OIG Removal of IRO Clause in Contracts

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 Practitioner in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner 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 Practitioner regarding its IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner in writing that Practitioner shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner 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 Practitioner 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 Practitioner Genova in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner 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 Practitioner Genova regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Genova in writing that Practitioner Genova shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner 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 Practitioner 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 ED, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Practitioner Arc in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner Arc shall have 30 days from the 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 Practitioner Arc regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Arc in writing that Practitioner Arc shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner Xxx 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 Practitioner Arc 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 Practitioner RAPHA in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner RAPHA 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 Practitioner RAPHA regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner RAPHA in writing that Practitioner RAPHA shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner RAPHA 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 Practitioner RAPHA 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 Practitioner Kumar in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner Kumar 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 Practitioner Kumar regarding its IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Kumar in writing that Practitioner Kumar shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner Kumar 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 Practitioner Kumar 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 E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Practitioner Sava in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner Sava 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 Practitioner Sava regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Sava in writing that Practitioner Sava shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner Sava 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 Practitioner Sava to engage a new IRO shall be made at the sole discretion of OIG.OIG.‌ APPENDIX C SKILLED NURSING FACILITY 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 E, E or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Practitioner Merit in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner Merit 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 Practitioner Merit regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Merit in writing that Practitioner Merit shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner Merit 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 Practitioner Merit 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 ED, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Practitioner Solomon in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner Solomon 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 Practitioner Solomon regarding its IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Solomon in writing that Practitioner Solomon shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner Solomon 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 Practitioner Solomon 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 Practitioner Guardian in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner Guardian 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 Practitioner Guardian regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Guardian in writing that Practitioner Guardian shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner Guardian 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 Practitioner Guardian to engage a new IRO shall be made at the sole discretion of OIG.OIG.‌ APPENDIX B‌

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 ED, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Practitioner Banner in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner Banner 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 Practitioner Banner regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Banner in writing that Practitioner Banner shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner Banner 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 Practitioner Banner 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 ED, or has failed to carry out its responsibilities as described in in‌ Paragraph C, OIG shall notify Practitioner ABC in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner ABC 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 Practitioner ABC regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner ABC in writing that Practitioner ABC shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner ABC 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 Practitioner ABC to engage a new IRO shall be made at the sole discretion of OIG.OIG.‌ Appendix B‌ IRO System and Transaction Reviews

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 ED, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Practitioner Liberty in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner Liberty 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 Practitioner Liberty regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Liberty in writing that Practitioner Liberty shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner Liberty 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 Practitioner Liberty 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 ED, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Practitioner RMS in writing regarding OIG’s 's basis for determining that the IRO has not met the requirements of this Appendix. Practitioner RMS shall have 30 days from the date of OIG’s 's written notice to provide information regarding the IRO’s 's qualifications, independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s ' s review of any information provided by Practitioner RMS regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner RMS in writing that Practitioner RMS shall be required to engage a new new‌ IRO in accordance with Paragraph A of this Appendix. Practitioner RMS 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 Practitioner RMS 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 Practitioner Prime in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner Prime 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 Practitioner Prime regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Prime in writing that Practitioner Prime shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner Prime must engage a new new‌ IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require Practitioner Prime 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 Practitioner Encore in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner Encore 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 Practitioner Encore regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Encore in writing that Practitioner Encore shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner Encore 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 Practitioner Encore 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 Practitioner Provider in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner Provider 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 Practitioner Provider regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Provider in writing that Practitioner Provider shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner Provider 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 Practitioner Provider 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 Practitioner Golden in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner Golden 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 Practitioner Golden regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner Golden in writing that Practitioner Golden shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner Golden 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 Practitioner Golden 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, E or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Practitioner SUN in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner SUN 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 Practitioner SUN regarding its the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner SUN in writing that Practitioner SUN shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner XXX 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 Practitioner SUN to engage a new IRO shall be made at the sole discretion of OIG.. APPENDIX B COVERED FUNCTIONS REVIEW