Other Requirements Pertaining to Covered Sample Clauses

Other Requirements Pertaining to Covered. Services 67 1.6 Requirements Pertaining to Medicaid Managed Care Programs 67 2. PROVIDER NETWORK 67
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Other Requirements Pertaining to Covered. Services 62 2.6 Requirements Pertaining to Medicaid Managed Care Programs 62 3. PROVIDER NETWORK 63 3.1 General Requirements 63 3.5 Mainstreaming 77 3.6 Provider Services 77 3.7 Provider Reimbursement 82 3.8 Prohibitions on Inappropriate Physician Incentives 87 4. ENROLLMENT & MEMBER SERVICES 87 4.1 Marketing 88 4.2 Enrollment 89 4.3 Member Services Department 92 4.4 Materials 92 4.6 Enrollee Rights 99 4.7 Enabling Services 101 4.8 Grievances and Appeals 102 4.9 Cost-Sharing Obligations 109 4.10 Value-Added Services 110 5. MEDICAID ADMINISTRATOR/CONTRACT LIAISON FUNCTIONS 110 6. HEALTH CARE MANAGEMENT 111 6.1 Second Opinions 111 6.2 Out-of-Network Services 112 6.3 Continuity and Coordination of Care 112 6.4 Service Authorization (Prior Authorization) 112 6.5 Rural Option 114
Sample 1

Related to Other Requirements Pertaining to Covered

  • COMPLIANCE WITH OTHER LAWS Secured Party may comply with any applicable state or federal law requirements in connection with a disposition of the Collateral and compliance will not be considered adversely to affect the commercial reasonableness of any sale of the Collateral.

  • Compliance with Requirements Any investment program furnished, and any activities performed, by the Manager or by a Sub-Adviser under this Section shall at all times conform to, and be in accordance with, any requirements imposed by: (1) the Act and any rules or regulations in force thereunder; (2) any other applicable laws, rules and regulations; (3) the Declaration of Trust and By-Laws of the Fund as amended from time to time; (4) any policies and determinations of the Board of Trustees of the Fund; and (5) the fundamental policies of the Fund, as reflected in its Registration Statement under the Act or as amended by the shareholders of the Fund.

  • Imposition of Other Requirements The Company reserves the right to impose other requirements on the Participant’s participation in the Plan, on the RSUs and on any Shares acquired under the Plan, to the extent the Company determines it is necessary or advisable for legal or administrative reasons, and to require the Participant to sign any additional agreements or undertakings that may be necessary to accomplish the foregoing.

  • Insurance Requirements Vendor agrees to maintain the following minimum insurance requirements for the duration of this Agreement. All policies held by Vendor to adhere to this term shall be written by a carrier with a financial size category of VII and at least a rating of “A‐” by A.M. Best Key Rating Guide. The coverages and limits are to be considered minimum requirements and in no way limit the liability of the Vendor(s). Any immunity available to TIPS or TIPS Members shall not be used as a defense by the contractor's insurance policy. Only deductibles applicable to property damage are acceptable, unless proof of retention funds to cover said deductibles is provided. "Claims made" policies will not be accepted. Vendor’s required minimum coverage shall not be suspended, voided, cancelled, non‐renewed or reduced in coverage or in limits unless replaced by a policy that provides the minimum required coverage except after thirty (30) days prior written notice by certified mail, return receipt requested has been given to TIPS or the TIPS Member if a project or pending delivery of an order is ongoing. Upon request, certified copies of all insurance policies shall be furnished to the TIPS or the TIPS Member. Vendor agrees that when Vendor or its subcontractors are liable for any damages or claims, Vendor’s policy, shall be primary over any other valid and collectible insurance carried by the Member or TIPS. General Liability: $1,000,000 each Occurrence/Aggregate Automobile Liability: $300,000 Includes owned, hired & non‐owned Workers' Compensation: Statutory limits for the jurisdiction in which the Vendor performs under this Agreement. If Vendor performs in multiple jurisdictions, Vendor shall maintain the statutory limits for the jurisdiction with the greatest dollar policy limit requirement. Umbrella Liability: $1,000,000 each Occurrence/Aggregate

  • COMPLIANCE WITH EPA REGULATIONS APPLICABLE TO GRANTS SUBGRANTS, COOPERATIVE AGREEMENTS, AND CONTRACTS Contractor certifies compliance with all applicable standards, orders, regulations, and/or requirements issued pursuant to the Clean Air Act of 1970, as amended (42 U.S.C. 1857(h)), Section 508 of the Clean Water Act, as amended (13 U.S.C. 1368), Executive Order 117389 and Environmental Protection Agency Regulation, 40 CFR Part 15.

  • Other Requirements AVIF will require that each Participating Insurance Company and Participating Plan enter into an agreement with AVIF that contains in substance the same provisions as are set forth in Sections 4.1(b), 4.1(d), 4.3(a), 4.4(b), 4.5(a), 5, and 10 of this Agreement.

  • Compliance with State and Other Laws The CONSULTANT specifically agrees that in performance of the services herein enumerated by it or by a subcontractor or anyone acting in behalf of either, that it or they will exercise the standard of care to comply with state, federal and local statutes, ordinances, and regulations applicable to the performance of this Agreement.

  • Compliance with Xxxxxxxx Act requirements The contractor shall comply with the requirements of 29 CFR part 3, which are incorporated by reference in this contract.

  • Compliance with Governmental Requirements Grantor shall comply promptly with all laws, ordinances, rules and regulations of all governmental authorities, now or hereafter in effect, applicable to the ownership, production, disposition, or use of the Collateral. Grantor may contest in good faith any such law, ordinance or regulation and withhold compliance during any proceeding, including appropriate appeals, so long as Lender's interest in the Collateral, in Lender's opinion, is not jeopardized.

  • Right to verify compliance You are required to keep records (including proof of purchase) relating to the software you use under this agreement. Microsoft has the right to verify compliance with this agreement, at Microsoft’s expense. You agree to provide reasonable cooperation in the event of a compliance audit, including by allowing Microsoft, on request, to access the usage report as a tool in conducting the audit.

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