Plan Accountability and Performance Standards Sample Clauses

Plan Accountability and Performance Standards. The Agency has enhanced the monitoring activities from the current Medicaid managed care program to provide enhanced plan accountability and clear performance standards. These enhanced requirements include, but are not limited to: posting of formulary or preferred drug list on the plan’s Website and to ensure the list is updated within 24 hours of any change; acceptance of electronic prior authorization requests; establishment of an internal health care quality improvement system with enrollee satisfaction and disenrollment surveys as well as incentives and disincentives for network providers; collection and reporting of Healthcare Effectiveness Data and Information Set (HEDIS) measures with results published on each plan Website; accreditation within one year of contract execution; establishment of programs and procedures to improve pregnancy outcomes and infant health; and notification of the Agency of the impending birth of a child to an enrollee. In addition, the Agency selected plans that were committed to assisting the Agency in our efforts to increase electronic medical record adoption. The plans agreed to: • Establish thresholds for the number of physician and hospitals that would adopt meaningful use standards by the end of the second contract year. • Establish thresholds for the number of enrollees who are assigned to primary care providers meeting meaningful use requirements. The Agency negotiated more timely claims more timely claims process timeframes than are required by state and federal regulations. Examples include: • Selected plans will pay, deny, or contest electronic claims within 15 calendar days. • Selected plans will pay, deny, or contest paper claims within 20 calendar days. • Selected plans agreed to pay 50% of all clean claims within 7 calendar days of receipt. The Agency will conduct periodic contract oversight and monitoring reviews to ensure plan compliance with contract requirements and has developed a thorough and consistent oversight review process so that plans are held to consistent standards.
Sample 1
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Related to Plan Accountability and Performance Standards

  • Financial Accountability 6.1 The Recipient must ensure that the requirements set out in this Agreement, and in any clarification or guidance issued from time to time by the Authority, are complied with. In particular the Recipient shall:

  • Fiscal Accountability A. SUBRECIPIENT shall establish and maintain a sound financial management system, based upon generally accepted accounting principles. SUBRECIPIENT’s system shall provide fiscal control and accounting procedures that will include the following:

  • COMPLIANCE AND PERFORMANCE EVALUATION Two (2) Mandatory Compliance and Performance Evaluation Meetings shall be conducted during each Term of this Agreement. Additional meetings may be scheduled at the discretion of Department to ensure Concessionaire’s effectiveness and compliance. The meetings shall review all aspects of the Concession Operation, ensuring that quality public services are being provided on a continuing basis in accordance with the Bid Specifications and this Agreement, that operational problems/concerns are addressed on a timely basis, and that all terms and conditions are clearly understood. The meetings shall be held on site with Department-designated State Park Service staff representative(s), the on-site concession manager, and a management/supervisory representative of Concessionaire’s firm. A report form shall be utilized to document the meeting, and to identify any deficiencies and the corrective action required. A copy of the completed report form shall be provided to the on- site concession manager or the management/supervisory representative of Concessionaire’s firm and shall be attached to and made a part of this Agreement. The Mandatory Compliance and Performance Evaluation Meetings shall be held as follows: • Meeting #1 - Prior to commencement of the Period of Operation or Memorial Day, whichever comes first. • Meeting #2 - Within ten (10) calendar days after the last approved day of the Period of Operation.

  • Service Accountability Agreements The HSP acknowledges that if the LHIN and the HSP enter into negotiations for a subsequent service accountability agreement, subsequent funding may be interrupted if the next service accountability agreement is not executed on or before the expiration date of this Agreement.

  • A Service Accountability Agreement This Agreement is a service accountability agreement for the purposes of section 20(1) of LHSIA.

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  • Health Care Accountability Ordinance If Administrative Code Chapter 12Q applies to this contract, Contractor shall comply with the requirements of Chapter 12Q. For each Covered Employee, Contractor shall provide the appropriate health benefit set forth in Section 12Q.3 of the HCAO. If Contractor chooses to offer the health plan option, such health plan shall meet the minimum standards set forth by the San Francisco Health Commission. Information about and the text of the Chapter 12Q, as well as the Health Commission’s minimum standards, is available on the web at xxxx://xxxxx.xxx/olse/hcao. Contractor is subject to the enforcement and penalty provisions in Chapter 12Q. Any Subcontract entered into by Contractor shall require any Subcontractor with 20 or more employees to comply with the requirements of the HCAO and shall contain contractual obligations substantially the same as those set forth in this Section.

  • Federal Funding Accountability and Transparency Act Requirements A. Any recipient of funds under this agreement agrees to comply with the Federal Funding Accountability and Transparency Act (FFATA) and implementing regulations at 2 CFR Part 170, including Appendix A. This agreement is subject to the following award terms: xxxx://xxx.xxx.xxx/fdsys/pkg/FR-2010-09-14/pdf/2010-22705.pdf and xxxx://xxx.xxx.xxx/fdsys/pkg/FR-2010-09-14/pdf/2010-22706.pdf.

  • Accountability 5.3.1 Actuaries and external auditors will be appointed by the Trust. Audited financial statements, and an actuarial evaluation report will be obtained for the Trust on an annual basis. The actuarial report will include projections regarding the adequacy of contributions to cover projected benefit and related costs for the Trust for a period of not less than 3 years into the future.

  • Federal Funding Accountability and Transparency Act of 2006 Grantee certifies that it is in compliance with the terms and requirements of 31 USC 6101.

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