Common use of Other Provider-Subcontractor Requirements Clause in Contracts

Other Provider-Subcontractor Requirements. (A) All of the Contractor’s Subcontracts and agreements with Participating Providers will include a provision stating that if either party wishes to terminate the subcontract or agreement, whichever party initiates the termination must give the other party written notice of termination at least 30 calendar days prior to the effective termination date. (B) The Contractor shall notify the Department of a Subcontractor or Participating Provider agreement being terminated either when the Contractor initiates termination or the Contractor receives notice of termination from the Subcontractor or Participating Provider. (C) The Contractor shall ensure that its Participating Providers abide by the requirements of Section 1877(E)(3)(B) of the Social Security Act prohibiting the Contractor Providers from making payments directly or indirectly to a physician or other provider as an inducement to reduce or limit Medically Necessary services provided to Enrollees. (D) All of the Contractor’s Participating Providers shall be aware of the Contractor’s Quality Assurance Plan and activities. All of the Contractor’s agreements with Participating Providers shall include a requirement securing cooperation with the Contractor’s Quality Assurance Plan and activities and shall allow the Contractor access to the medical records of Enrollees being treated by Participating Providers. (E) All physicians who provide services under this Contract shall have a unique identifier in accordance with the system established under Section 1173(b) of the Social Security Act and in accordance with the Health Insurance Portability and Accountability Act.

Other Provider-Subcontractor Requirements. (A) All of the Contractor’s Subcontracts and agreements with Participating Providers will include a provision stating that if either party wishes to terminate the subcontract or agreement, whichever party initiates the termination must give the other party written notice of termination at least 30 calendar days prior to the effective termination date. (B) The Contractor shall notify the Department of a Subcontractor or Participating Provider agreement being terminated either when the Contractor initiates termination or the Contractor receives notice of termination from the Subcontractor or Participating Provider. (C) The Contractor shall ensure that its Participating Providers abide by the requirements of Section 1877(E)(3)(B) of the Social Security Act prohibiting the Contractor Providers from making payments directly or indirectly to a physician or other provider as an inducement to reduce or limit Medically Necessary services provided to Enrollees. (D) All of the Contractor’s Participating Providers shall be aware of the Contractor’s Quality Assurance Plan and activities. All of the Contractor’s agreements with Participating Providers shall include a requirement securing cooperation with the Contractor’s Quality Assurance Plan and activities and shall allow the Contractor access to the medical records of Enrollees being treated by Participating Providers. (E) All physicians providers who provide administer services under this Contract shall have a unique identifier in accordance with the system established under Section 1173(b) of the Social Security Act and in accordance with the Health Insurance Portability and Accountability Act. (F) The Contractor shall ensure that Participating Providers and staff are knowledgeable about methods to detect domestic violence, about mandatory reporting laws when domestic violence is suspected, and about resources in the community to which patients can be referred.

Other Provider-Subcontractor Requirements. (A) All of the Contractor’s Subcontracts and agreements with Participating Providers will include a provision stating that if either party wishes to terminate the subcontract or agreement, whichever party initiates the termination must give the other party written notice of termination at least 30 calendar days prior to the effective termination date. (B) The Contractor shall notify the Department of a Subcontractor or Participating Provider agreement being terminated either when the Contractor initiates termination or the Contractor receives notice of termination from the Subcontractor or Participating Provider. (C) The Contractor shall ensure that its Participating Providers abide by the requirements of Section 1877(E)(3)(B) of the Social Security Act prohibiting the Contractor Providers from making payments directly or indirectly to a physician or other provider as an inducement to reduce or limit Medically Necessary services provided to Enrollees. (DB) All of the Contractor’s The Contractor shall ensure that Participating Providers and staff are knowledgeable about methods to detect domestic violence, about mandatory reporting laws when domestic violence is suspected, and about resources in the community to which patients can be referred. (C) The Contractor shall be aware notify all Participating Providers of the Contractor’s Quality Assurance Plan and activities. All of the Contractor’s agreements with Participating Providers shall include a requirement securing cooperation with the Contractor’s Quality Assurance Plan and activities and shall allow the Contractor access to the medical records of Enrollees being treated by Participating Providers. (ED) All The Contractor shall require all physicians who provide services under this Contract shall have a unique identifier in accordance with the system established under Section 1173(b) of the Social Security Act and in accordance with the Health Insurance Portability and Accountability Act. (E) The Contractor shall ensure its Participating Providers are either enrolled with the Department as a Fee-For-Service provider or are enrolled with the Department as a “limited enrollment provider.”