Ongoing Monitoring of Contractor’s Provider Network Sample Clauses

Ongoing Monitoring of Contractor’s Provider Network. Contractor shall promptly refer incidents of any suspected or confirmed fraud, waste and abuse to the DVHA PI Unit. Contractor will work cooperatively, and maintain communication, with the DVHA PI Unit to develop and implement any necessary corrective action plans required in the event of Contractor’s fraud, waste or abuse. Contractor shall further require their Participating Providers or subcontractors to comply with corrective action plans as a result of fraud, waste, and abuse activities identified by either Contractor or the DVHA PI Unit. Contractor shall cooperate with all appropriate state and federal agencies, including the Medicaid Fraud and Residential Abuse Unit (MFRAU) and the DVHA PI Unit, in their investigations of fraud, waste, and abuse. Contractor’s compliance officer shall attend and participate in DVHA-provided trainings to Participating Providers on detecting fraud, waste, and abuse. Contractor shall submit a detailed report to DVHA outlining Contractor’s compliance and program integrity related activities, as well as identifying Contractor’s progress in meeting program integrity related goals and objectives. The report shall be made in accordance with the ACO Reporting Manual. Contractor agrees that the DVHA PI Unit is responsible for overseeing the integrity of all Medicaid payment, including the underutilization of services or the over reporting of services such as split billing, unbundling of services or other billing methods that would cause the VMNG Program’s ETCOC to increase artificially in future years. Contractor agrees that the DVHA PI Unit may conduct oversight reviews of Contractor’s compliance program or other program integrity-related activities to determine the Contractor’s compliance with this Contract. Such audit activities will be conducted, to the extent feasible, with minimal disruption to Contractor’s activities, and may include conducting interviews of relevant staff, reviewing all documentation, and any performance metrics. The DVHA PI Unit may issue a corrective action plan or performance improvement plan and outline timelines for improvement measures and Contractor shall cooperate in promptly implementing such plan. EXHIBIT 1 TO ATTACHMENT A Included and Excluded Service Codes {PROVIDED SEPARATELY} EXHIBIT 2 TO ATTACHMENT A Attribution Technical Specifications Table 1. Qualifying Evaluation & Management (QEM) Services Code Description Office or Other Outpatient Services 99201 New Patient, brief 99202 New Patient...
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Related to Ongoing Monitoring of Contractor’s Provider Network

  • Provider Network The Panel of health service Providers with which the Contractor contracts for the provision of covered services to Members and Out-of-network Providers administering services to Members.

  • Selection of Subcontractors, Procurement of Materials and Leasing of Equipment The contractor shall not discriminate on the grounds of race, color, religion, sex, national origin, age or disability in the selection and retention of subcontractors, including procurement of materials and leases of equipment. The contractor shall take all necessary and reasonable steps to ensure nondiscrimination in the administration of this contract.

  • Commingling of Resold Services with Unbundled Network Elements and Combinations of Unbundled Network Elements 6.7.1 To the extent it is Technically Feasible and pursuant to the terms of Section 9.1, CLEC may Commingle Telecommunications Services purchased on a resale basis with an Unbundled Network Element or combination of Unbundled Network Elements.

  • Unbundled Network Terminating Wire (UNTW) 2.8.3.1 UNTW is unshielded twisted copper wiring that is used to extend circuits from an intra-building network cable terminal or from a building entrance terminal to an individual End User’s point of demarcation. It is the final portion of the Loop that in multi-subscriber configurations represents the point at which the network branches out to serve individual subscribers.

  • Restricted Use By Outsourcers / Facilities Management, Service Bureaus or Other Third Parties Outsourcers, facilities management or service bureaus retained by Licensee shall have the right to use the Product to maintain Licensee’s business operations, including data processing, for the time period that they are engaged in such activities, provided that: 1) Licensee gives notice to Contractor of such party, site of intended use of the Product, and means of access; and 2) such party has executed, or agrees to execute, the Product manufacturer’s standard nondisclosure or restricted use agreement which executed agreement shall be accepted by the Contractor (“Non-Disclosure Agreement”); and 3) if such party is engaged in the business of facility management, outsourcing, service bureau or other services, such third party will maintain a logical or physical partition within its computer system so as to restrict use and access to the program to that portion solely dedicated to beneficial use for Licensee. In no event shall Licensee assume any liability for third party’s compliance with the terms of the Non-Disclosure Agreement, nor shall the Non-Disclosure Agreement create or impose any liabilities on the State or Licensee. Any third party with whom a Licensee has a relationship for a state function or business operation, shall have the temporary right to use Product (e.g., JAVA Applets), provided that such use shall be limited to the time period during which the third party is using the Product for the function or business activity.

  • Replacement of Key Personnel The Engineer must notify the State in writing as soon as possible, but no later than three business days after a project manager or other key personnel is removed from association with this contract, giving the reason for removal.

  • Access to Network Interface Device (NID 2.4.3.1. Due to the wide variety of NIDs utilized by BellSouth (based on subscriber size and environmental considerations), Mpower may access the on-premises wiring by any of the following means: BellSouth shall allow Mpower to connect its loops directly to BellSouth’s multi-line residential NID enclosures that have additional space and are not used by BellSouth or any other telecommunications carriers to provide service to the premise. Mpower agrees to install compatible protectors and test jacks and to maintain the protection system and equipment and to indemnify BellSouth pursuant to Section 8 of the General Terms and Conditions of this Agreement.

  • Provisioning of High Frequency Spectrum and Splitter Space 3.2.1 BellSouth will provide <<customer_name>> with access to the High Frequency Spectrum as follows:

  • Joint Network Implementation and Grooming Process Upon request of either Party, the Parties shall jointly develop an implementation and grooming process (the “Joint Grooming Process” or “Joint Process”) which may define and detail, inter alia:

  • System for Award Management (XXX) Requirement Alongside a signed copy of this Agreement, Grantee will provide Florida Housing with a XXX.xxx proof of registration and Commercial and Government Entity (CAGE) number. Grantee will continue to maintain an active XXX registration with current information at all times during which it has an active award under this Agreement.

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