Payor of Last Resort. The Department is the payer of last resort and all third party sources must be billed before billing Department for program services.
Payor of Last Resort. Funds may not be used to cover the costs for any item or service covered by other state, federal or private benefits or service programs and shall be used as dollars of last resort.
Payor of Last Resort. The Contractor must:
Payor of Last Resort. The Contractor ensures the subcontractor:
Payor of Last Resort. A. Financial Responsibility
Payor of Last Resort a. Except as provided in paragraph (b) of this section, funds under Part C of IDEA may not be used to satisfy a financial commitment for services that would otherwise have been paid for from another public or private source, including any medical program administered by the Department of Defense, but for the enactment of Part C of IDEA. Therefore, funds under Part C of IDEA may be used only for early intervention services that an infant or toddler with a disability needs but is not currently entitled to receive or have payment made from any other Federal, State, local, or private source, subject to §§303.520 Policies Related to Use of Public Benefits or Insurance or Private Insurance To Pay for Part C Services and 303.521 System of Payments and Fees.
Payor of Last Resort. 7.2.1. Funds provided through this Contract are part C of IDEA payor of last resort and the Contractor shall ensure these funds are:
Payor of Last Resort. CONTRACTOR shall initiate application for, charge, xxxx, and diligently seek to collect all third party reimbursements from medical insurers and government agencies for any services rendered by CONTRACTOR under this Contract to CMHSP consumers for whom such reimbursement may be available. This includes, but is not limited to, public and private insurance plans, Medicare, and other health plans. CONTRACTOR shall fulfill recertification requirements for CMHSP consumers with insurances that require the same. CONTRACTOR acknowledges that CMHSP is the payer of last resort. CONTRACTOR shall not be reimbursed or otherwise compensated by CMHSP for any loss of reimbursement resulting directly from CONTRACTOR error(s) of omission or commission, including CONTRACTOR’s failure to xxxx for eligible services. CMHSP payments to CONTRACTOR shall be contingent upon receipt of accurate xxxxxxxx, which indicate the CMHSP consumer was served and the services were provided. CONTRACTOR or its subcontractors shall not seek to collect any service fee payments directly from consumers, legal guardians, parents, or relatives for services provided under this agreement unless authorized to do so by CMHSP in accordance with the CMHPSM Ability to Pay policy or allowed to do so by the consumer’s third-party insurance. CONTRACTOR or its subcontractors shall not require any recipient pay amount, or other cost-sharing arrangement, service charge, or additional supplemental payments when a consumer is insured by Medicaid. CONTRACTOR agrees to assist the consumer and CMHSP, according to the consumer’s individual plan of service, in securing entitlements in a timely fashion including, but not limited to, Supplemental Security Income (SSI), cash assistance, food stamps, Medicaid, and Medicare. Such assistance may include transportation of consumers to the Department of Health and Human Services and Social Security offices, as well as hands-on assistance in the application process.
Payor of Last Resort. While Part C IDEA funding requirements must be met, and will be monitored, the availability of these funds to EIPAs, will be determined based on availability of funds. When available, SRHD will ensure that The Other Party:
Payor of Last Resort. 3.1 FINANCIAL RESPONSIBILITY ACRC and SELPA will operate within the provisions of the applicable laws and regulations.
