Common use of Payments to Providers Under Suspension Clause in Contracts

Payments to Providers Under Suspension. Suspended Providers may be paid for authorized and substantiated Covered Services provided to Participants/Service Recipients before or during a suspension. If the suspension is for a specific service or specific service within a specific program, the Provider may be paid for other approved Covered Services provided during the suspension period. However, Purchaser reserves the right to withhold payment for all authorized and billed Covered Services if the nature of the suspension is for undocumented or otherwise unsubstantiated care provided by the Provider to a Purchaser Participant/Service Recipient or other actions by Provider which have harmed or threaten to harm the welfare of Participants/Service Recipients. Withholding such payments will remain in effect until a Purchaser review of the suspension is completed and a determination for reinstatement or termination of the Provider is made.

Payments to Providers Under Suspension. Suspended Providers may be paid for authorized and substantiated Covered Services services provided to Participants/Service Recipients in accordance with this Agreement before or during a suspension. If the suspension is for a specific service or specific service within a specific program, the Provider may be paid for other approved Covered Services Purchaser contracted services provided during the suspension period. However, Purchaser reserves the right to withhold payment for all authorized and billed Covered Services services funded by Purchaser if the nature of the suspension is for undocumented or otherwise unsubstantiated care provided by the Provider to a Purchaser Participant/Service Recipient or other actions by Provider which have harmed or threaten to harm the welfare of Participants/Service Recipients. Withholding such payments will remain in effect until a Purchaser review of the suspension is completed and a determination for reinstatement or termination of the Provider is made.

Payments to Providers Under Suspension. Suspended Providers may be paid for authorized and substantiated Covered Services provided to Participants/Service Recipients before or during a suspension. If the suspension is for a specific service or specific service within a specific program, the Provider may be paid for other approved Covered Services provided during the suspension period. However, Purchaser reserves the right to withhold payment for all authorized and billed Covered Services if the nature of the suspension is for undocumented or otherwise unsubstantiated care provided by the Provider to a Purchaser Participant/Service Recipient or other actions by Provider which have harmed or threaten to harm the welfare of Participants/Service Recipients. Withholding such payments will remain in effect until a Purchaser review of the suspension is completed and a determination for reinstatement or termination of the Provider is made.. SECTION EIGHTEEN

Payments to Providers Under Suspension. Suspended Providers may be paid for authorized and substantiated Covered Services provided to Participants/Service Recipients before or during a suspension. If the suspension is for a specific service or specific service within a specific program, the Provider may be paid for other approved Covered Services provided during the suspension period. However, Purchaser reserves the right to withhold payment for all authorized and billed Covered Services if the nature of the suspension is for undocumented or otherwise unsubstantiated care provided by the Provider to a Purchaser Participant/Service Recipient or other actions by Provider which have harmed or threaten to harm the welfare of Participants/Service Recipients. Withholding such payments will remain in effect until a Purchaser review of the suspension is completed and a determination for reinstatement or termination of the Provider is made.. SECTION NINETEEN