Policies and Procedures for Core Functions Sample Clauses

Policies and Procedures for Core Functions. The Contractor shall develop, maintain, and provide to EOHHS upon request, policies and procedures for all core functions necessary to effectively and efficiently manage the MassHealth population and meet the requirements outlined in this Contract. All policies and procedures requiring EOHHS approval shall be documented and shall include the dates of approval by EOHHS. These policies and procedures shall include, but are not limited to, the following topics:
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Policies and Procedures for Core Functions. 2.3.2.7.1. The Contractor shall develop, maintain, and provide to EOHHS upon request, policies and procedures for all core functions necessary to manage the SCO eligible and enrolled population effectively and efficiently and meet the requirements outlined in this Contract. All policies and procedures requiring EOHHS approval shall be documented and shall include the dates of approval by EOHHS.
Sample 1
Policies and Procedures for Core Functions. The Contractor shall develop, maintain, and provide to EOHHS upon request, policies and procedures for all core functions necessary to effectively and efficiently manage the MassHealth population and meet the requirements outlined in this Contract. All policies and procedures requiring EOHHS approval shall be documented and shall include the dates of approval by EOHHS. These policies and procedures shall include, but are not limited to, the following topics: Response to violations of Enrollees’ privacy rights by staff, Providers or subcontractors; Non-discrimination of MassHealth Enrollees; Non-restriction of Providers advising or advocating on an Enrollee’s behalf; Appeal rights for certain minors who under the law may consent to medical procedures without parental consent; Enrollee cooperation with those providing health care services; Marketing activities that apply to the Plan, Providers and subcontractors as well as the Contractor’s procedures for monitoring these activities; Cost-sharing by Enrollees; Advance directives; Assisting Enrollees in understanding their benefits and how to access them; Access and availability standards; Enrollees’ right to be free from restraint or seclusion used as a means of coercion or retaliation; The provision of Culturally and Linguistically Appropriate Services; Practice guidelines in quality measurement and improvement activities; Compliance with Emergency Services and Poststabilization Care Services requirements as identified in 42 CFR 438.114; Procedures for tracking appeals when Enrollees become aware of the Adverse Action, in the event that no notice had been sent; Handling of complaints/Grievances sent directly to EOHHS; Process used to monitor Provider and subcontractor implementation of amendments and improvements; Retention of medical records; Engagement and coordination with BH CPs and LTSS CPs, as described in Sections 2.5.F and 2.5.G; Compliance with all CBHI requirements as set forth in this Contract; Care Management; Risk stratification; and Claims processing. Other Contract Management Requirements‌
Sample 1

Related to Policies and Procedures for Core Functions

  • Policies and Procedures i) The policies and procedures of the designated employer apply to the employee while working at both sites.

  • Violence Policies and Procedures The Employer agrees to have in place explicit policies and procedures to deal with violence. The policy will address the prevention of violence, the management of violent situations, provision of legal counsel and support to employees who have faced violence. The policies and procedures shall be part of the employee's health and safety policy and written copies shall be provided to each employee. Prior to implementing any changes to these policies, the employer agrees to consult with the Association.

  • Academic Policies and Student Support Services X. Xxxx College courses offered as dual credit, regardless of where they are taught, follow the same syllabus, course outline, textbook, grading method, and other academic policies and procedures as the courses outlined in the Hill College policy manual, catalog, and student handbook. [TAC 19, Part 1, Chapter 4, Subchapter D, 4.85(g)(1)]

  • PROCEDURES FOR CONDUCTING NEGOTIATIONS Either party may request negotiations for a successor Agreement by issuing a notice to negotiate to the other party between one hundred twenty (120) and ninety (90) days prior to the expiration of this Agreement. The State Employment Relations Board will also be notified of the intent to open negotiations at this time. Within fifteen (15) days of receipt of said notice, representatives of the parties shall meet and submit proposals for the successor Agreement. Said proposals shall be comprehensive in nature and no additional issues shall be introduced after the first session without mutual agreement. Subsequent bargaining sessions shall be set at times and dates as are mutually agreed to by the teams. Negotiation teams will be limited to five (5) members each. Both sides may agree to change this size by mutual agreement. Negotiation sessions shall be conducted in executive session; however, this does not prohibit the flow of information to either party’s constituency. The style of bargaining shall be mutually decided by the parties prior to negotiations. Upon request of either bargaining team, a bargaining session may be recessed to permit a caucus. When negotiations are conducted during regular school hours, release time shall be provided for the Association’s bargaining team. (Reference: Article 18) There shall be three (3) signed copies of the final agreement. One (1) copy shall be retained by the Board, one (1) by the Association, and one (1) shall be submitted to the State Employment Relations Board. As tentative agreement is reached on each issue, it shall be so noted and initialed by each party. When consensus is reached covering the areas under discussion, the proposed Agreement shall be reduced to writing as a tentative agreement and submitted to the Association and the Board for approval. Following approval by the Association and Board, a contract shall be entered into by both parties. The Association and the Board agree to abide by the terms of the Agreement. The final Agreement, as adopted by the Board and ratified by the Association, will be printed and presented within thirty (30) days. The cost of such printing, including labor and material shall be borne by the Board In the event an agreement is not reached after forty-five (45) days from the first bargaining session, either of the parties shall have the option of requesting the assistance of a federal mediator under the guidelines of the Federal Mediation and Conciliation Service. In the event that the services of a mediator are called upon, the mediation process will last twenty-one

  • Overpayment Policies and Procedures Within 90 days after the Effective Date, Xxxxx shall develop and implement written policies and procedures regarding the identification, quantification and repayment of Overpayments received from any Federal health care program.

  • Mechanisms for Cooperation 1. Pursuant to Article 149 (Objectives), the Parties hereby establish a Committee on Cooperation comprising representatives of each Party. 2. The Parties will designate nationals contact points to facilitate communication on possible cooperation activities. The contact points will work with government agencies, business sector representatives and educational and research institutions for the operation of this Chapter. 3. The Parties shall use diplomatic channels to promote dialogue and cooperation consistent with this Agreement. 4. The Committee shall have the following functions: (a) to monitor and assess the progress in implementing of the cooperation projects agreed by the Parties; (b) to establish rules and procedures for the conduct of its work; (c) to make recommendations of the cooperation activities under this Chapter, in accordance with the strategic priorities of the Parties; and (d) to review through regular reporting from the Parties, the operation of this Chapter and the application and fulfillment of its objectives between the relevant institutions of the Parties.

  • Procedures for Providing NP Through Full NXX Code Migration Where a Party has activated an entire NXX for a single Customer, or activated at least eighty percent (80%) of an NXX for a single Customer, with the remaining numbers in that NXX either reserved for future use by that Customer or otherwise unused, if such Customer chooses to receive Telephone Exchange Service from the other Party, the first Party shall cooperate with the second Party to have the entire NXX reassigned in the LERG (and associated industry databases, routing tables, etc.) to an End Office operated by the second Party. Such transfer will be accomplished with appropriate coordination between the Parties and subject to appropriate industry lead times for movements of NXXs from one switch to another. Neither Party shall charge the other in connection with this coordinated transfer.

  • Required Procurement Procedures for Obtaining Goods and Services The Grantee shall provide maximum open competition when procuring goods and services related to the grant-assisted project in accordance with Section 287.057, Florida Statutes.

  • PROCEDURES AND/OR CRITERIA FOR COURSE ARTICULATION a. Complete the ROP Careers with Children course at Freedom High School with a grade of “B” or better.

  • Ordering Guidelines and Processes 1.14.1 For information regarding Ordering Guidelines and Processes for various Network Elements, Combinations and Other Services, TWTC should refer to the “Guides” section of the AT&T Interconnection Web site. TWTC will be notified of any material changes to such “Guides”.

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