Phaseout Requirements. The objective of the Phaseout Period is to ensure that, in connection with the expiration or termination of the DHCS Medi-Cal Managed Care Contract, Blue Shield ensures an orderly transfer of necessary data and history records to DHCS or to a successor Medi-Cal managed care plan. Blue Shield will not provide services to Members during the Phaseout Period. Within no later than 90 calendar days prior to termination or expiration of the DHCS Medi- Cal Managed Care Contract and through the Phaseout Period for each Service Area, Blue Shield must assist DHCS in the transition of Members and in ensuring, to the extent possible, continuity of Member-Provider relationships. In doing this, Blue Shield will make available to DHCS, without additional compensation, copies of each Member’s Medical Records and files, and any other pertinent information, including information maintained by any subcontractor, Downstream Entity, or Provider, necessary to provide effected Members with case management and continuity of care. In no circumstances will a Medi- Cal Member be billed for this activity.
Phaseout Requirements. Phaseout for this Contract will consist of the processing, payment and monetary reconciliation(s) necessary regarding claims for payment for Covered Services. Phaseout for the Contract will consist of the resolution of all financial and reporting obligations of the Contractor. The Contractor will remain liable for the processing and payment of invoices and other claims for payment for Covered Services and other services provided to Members pursuant to this Contract prior to the expiration or termination. The Contractor will submit to DHS all reports required in Article VI, Scope of Work, for the period from the last submitted report through the expiration or termination date. All data and information provided by the Contractor will be accompanied by letter, signed by the responsible authority, certifying, under penalty of perjury, to the accuracy and completeness of the materials supplied.
Phaseout Requirements. Phaseout for this Contract shall consist of the processing, payment, monetary and reporting reconciliation(s) necessary regarding claims for payment for Covered Services. Contractor shall remain liable for the processing and payment of invoices and other claims for payment for Covered Services and other services provided to Members pursuant to this Contract prior to the expiration or termination of the Contract. Contractor shall submit to the State all reports required in Article 7, for the period from the last submitted report through the expiration or termination date. All data and information provided by Contractor during Phaseout Period shall be accompanied by letter, signed by the responsible authority, certifying, under penalty of perjury, to the accuracy and completeness of the materials supplied.
Phaseout Requirements. A. CDHS shall retain the lesser of an amount equal to 10% of the last month’s Service Area capitation payment or one million dollars ($1,000,000) for each Service Area unless provided otherwise by the Financial Performance Guarantee, from the capitation payment of the last month of the Operations Period for each Service Area until all activities required during the Phaseout Period for each Service Area are fully completed to the satisfaction of CDHS, in its sole discretion. If all Phaseout activities for each Service Area are completed by the end of the Phaseout Period, the withhold will be paid to the Contractor. If the Contractor fails to meet any requirement(s) by the end of the Phaseout Period for each Service Area, CDHS will deduct the costs of the remaining activities from the withhold amount and continue to withhold payment until all activities are completed.
B. The objective of the Phaseout Period is to ensure that, at the termination of this Contract, the orderly transfer of necessary data and history records is made from the Contractor to CDHS or to a successor Contractor. The Contractor shall not provide services to Members during the Phaseout Period. Ninety (90) calendar days prior to termination or expiration of this Contract and through the Phaseout Period for each Service Area, the Contractor shall assist CDHS in the transition of Members, and in ensuring, to the extent possible, continuity of Member-Provider relationships. In doing this, the Contractor will make available to CDHS copies of Medical Records, patient files, and any other pertinent information, including information maintained by any subcontractor, necessary for efficient case management of Members, as determined by the Director. In no circumstances will a Medi-Cal Member be billed for this activity.
C. Phaseout for this Contract will consist of the processing, payment and monetary reconciliation(s) necessary regarding claims for payment for Covered Services. Phaseout for the Contract will consist of the completion of all financial and reporting obligations of the Contractor. The Contractor will remain liable for the processing and payment of invoices and other claims for payment for Covered Services and other services provided to Members pursuant to this Contract prior to the expiration or termination. The Contractor will submit to CDHS all reports required in Exhibit A, Attachment 17, Reporting Requirements, for the period from the last submitted report through the expiration...
