Peer Review Authority Sample Clauses

Peer Review Authority. The plan’s quality enhancement program shall have a peer review component and a Peer Review Authority. Scope of Activities (a) The review of the practice methods and patterns of individual physicians and other health care professionals. HEALTHEASE AND STAYWELL HMO Effective Date: October 1, 2005 (b) The ability and responsibility to evaluate the appropriateness of care rendered by professionals. (c) The authority to implement corrective action when deemed necessary. (d) The responsibility to develop policy recommendations to maintain or enhance the quality of care provided to plan Participants. (e) A review process which includes the appropriateness of diagnosis and subsequent treatment, maintenance of medical record requirements, adherence to standards generally accepted by professional group peers, and the process and outcome of care. (f) The maintenance of written minutes of the meetings and provision of reports to FHKC of any activities related to FHKC Participants. (g) Peer review must include examination of morbidity and mortality.
Sample 1
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Peer Review Authority. The plan's quality enhancement program shall have a peer review component and a peer review authority. Scope of Activities (a) The review of the practice methods and patterns of individual physicians and other health care professionals. (b) The ability and responsibility to evaluate the appropriateness of care rendered by professionals. (c) The authority to implement corrective action when deemed necessary. (d) The responsibility to develop policy recommendations to maintain or enhance the quality of care provided to plan participants. (e) A review process which includes the appropriateness of diagnosis and subsequent treatment, maintenance of medical record requirements, adherence to standards generally accepted by professional group peers, and the process and outcome of care. (f) The maintenance of written minutes of the meetings and provision of reports to FHKC of any activities related to FHKC participants. (g) Peer review must include examination of morbidity and mortality.
Sample 1
Peer Review Authority. The plan's quality enhancement program shall have a peer review component and a peer review authority. (a) The review of the practice methods and patterns of individual physicians and other health care professionals. (b) The ability and responsibility to evaluate the appropriateness of care rendered by professionals. AMERIGROUP Effective Date: October 1, 2003 - September 30, 2005 (c) The authority to implement corrective action when deemed necessary. (d) The responsibility to develop policy recommendations to maintain or enhance the quality of care provided to plan participants. (e) A review process which includes the appropriateness of diagnosis and subsequent treatment, maintenance of medical record requirements, adherence to standards generally accepted by professional group peers, and the process and outcome of care. (f) The maintenance of written minutes of the meetings and provision of reports to FHKC of any activities related to FHKC participants. (g) Peer review must include examination of morbidity and mortality. 3-20-4 Referrals To Peer Review Authority (a) All written and/or oral allegations of inappropriate or aberrant service must be referred to the Peer Review Authority. (b) Recipients and staff must be advised of the role of the Peer Review Authority and the process to advise the authority of situations or problems. (c) All grievances related to medical treatment must be presented to the Authority for examination and, when a FHKC participant is involved, the outcome of the grievance resolution reported to FHKC.
Sample 1
Peer Review Authority. The plan's quality enhancement program shall have a peer review component and a Peer Review Authority.
Sample 1

Related to Peer Review Authority

  • Peer Review Dental Group, after consultation with the Joint ----------- Operations Committee, shall implement, regularly review, modify as necessary or appropriate and obtain the commitment of Providers to actively participate in peer review procedures for Providers. Dental Group shall assist Manager in the production of periodic reports describing the results of such procedures. Dental Group shall provide Manager with prompt notice of any information that raises a reasonable risk to the health and safety of Group Patients or Beneficiaries. In any event, after consultation with the Joint Operations Committee, Dental Group shall take such action as may be reasonably warranted under the facts and circumstances.

  • Review and Approval The Supplier confirms and agrees that it shall apply to receive ISR's written consent, wherever ISR's consent, explicitly or implied, is required according to this Agreement. This requirement and the provision of ISR consent, shall not derogate in any way from Supplier's responsibilities and liabilities under this Agreement, and ISR shall bear no responsibility or liability whatsoever in connection with the review (whether or not there are objections) and/or with any approval given to, or denied from, Supplier, with respect to any matter and/or document, including but without limitation, drawings, designs (at all phases), plans, tests or otherwise.

  • Log Reviews All systems processing and/or storing PHI COUNTY discloses to 11 CONTRACTOR or CONTRACTOR creates, receives, maintains, or transmits on behalf of COUNTY 12 must have a routine procedure in place to review system logs for unauthorized access.

  • Review and Appeal 1. Each Party shall ensure that the importers in its territory have access to administrative review within the customs administration that issued the decision subject to review or, where applicable, the higher authority supervising the administration and/or judicial review of the determination taken at the final level of administrative review, in accordance with the Party's domestic law. 2. The decision on appeal shall be given to the appellant and the reasons for such decision shall be provided in writing. 3. The level of administrative review may include any authority supervising the customs administration of a Party.

  • Review Scope The parties confirm that the Asset Representations Review is not responsible for (a) reviewing the Receivables for compliance with the representations and warranties under the Transaction Documents, except as described in this Agreement or (b) determining whether noncompliance with the representations and warranties constitutes a breach of the Eligibility Representations. For the avoidance of doubt, the parties confirm that the review is not designed to determine why an Obligor is delinquent or the creditworthiness of the Obligor, either at the time of any Asset Review or at the time of origination of the related Receivable. Further, the Asset Review is not designed to establish cause, materiality or recourse for any Test Fail (as defined in Section 3.05).

  • Project Review A. Programmatic Allowances 1. If FEMA determines that the entire scope of an Undertaking conforms to one or more allowances in Appendix B of this Agreement, with determinations for Tier II Allowances being made by SOI-qualified staff, FEMA shall complete the Section 106 review process by documenting this determination in the project file, without SHPO review or notification. 2. If the Undertaking involves a National Historic Landmark (NHL), FEMA shall notify the SHPO, participating Tribe(s), and the NPS NHL Program Manager of the NPS Midwest Regional Office that the Undertaking conforms to one or more allowances. FEMA shall provide information about the proposed scope of work for the Undertaking and the allowance(s) enabling FEMA’s determination. 3. If FEMA determines any portion of an Undertaking’s scope of work does not conform to one or more allowances listed in Appendix B, FEMA shall conduct expedited or standard Section 106 review, as appropriate, for the entire Undertaking in accordance with Stipulation II.B, Expedited Review for Emergency Undertakings, or Stipulation II.C, Standard Project Review. 4. Allowances may be revised and new allowances may be added to this Agreement in accordance with Stipulation IV.A.3, Amendments. B. Expedited Review for Emergency Undertakings

  • Claims Review Population A description of the Population subject to the Claims Review.

  • Review Protocol A narrative description of how the Claims Review was conducted and what was evaluated.

  • Claims Review Report The IRO shall prepare a Claims Review Report as described in this Appendix for each Claims Review performed. The following information shall be included in the Claims Review Report for each Discovery Sample and Full Sample (if applicable).

  • Developer Authority Consistent with Good Utility Practice and this Agreement, the Developer may take whatever actions or inactions with regard to the Large Generating Facility or the Developer Attachment Facilities during an Emergency State in order to (i) preserve public health and safety, (ii) preserve the reliability of the Large Generating Facility or the Developer Attachment Facilities, (iii) limit or prevent damage, and (iv) expedite restoration of service. Developer shall use Reasonable Efforts to minimize the effect of such actions or inactions on the New York State Transmission System and the Connecting Transmission Owner’s Attachment Facilities. NYISO and Connecting Transmission Owner shall use Reasonable Efforts to assist Developer in such actions.

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