Prohibited Affiliations with Individuals Debarred by Federal Agencies. The MCO may not have a director, officer, principal, partner, agent, managing employee, or other person with ownership or control interest of five percent (5%) or more in the MCO and who: • Has been convicted of a criminal offense as described in sections 1128(a) and 1128(b) (1), (2), or (3), of the Social Security Act; • Has had civil money penalties or assessments imposed under section 1128A of the Social Security Act; or • Has been excluded, suspended, or debarred from participation in Medicare or any state health care programs. The MCO must submit information as described above, for any person who was formerly described as a director, officer, principal, partner, agent, managing employee, or other person with ownership or control interest of five percent (5%) or more in the MCO, but is no longer so described because of a transfer of ownership or control interest to an immediate family member or a member of the person’s household, in anticipation of or following a conviction, assessment of a civil monetary penalty, or imposition of an exclusion. The MCO is prohibited from having a consulting, employment, or other agreement with an excluded, debarred or suspended person for the provision of items or services that are significant and material to the MCO’s contractual obligation with the State. Likewise, the MCO may not have a relationship with an affiliate of any person described above. Entities that meet any of the following criteria must be excluded from participation:
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Samples: Model Purchase of Service Provider Agreement, Service Provider Agreement, dhhr.wv.gov
Prohibited Affiliations with Individuals Debarred by Federal Agencies. The MCO may not have a director, officer, principal, partner, agent, managing employee, or other person with ownership or control interest of five percent (5%) or more in the MCO and who: • Has been convicted of a criminal offense as described in sections 1128(a) and 1128(b) (1), (2), or (3), of the Social Security Act; • Has had civil money penalties or assessments imposed under section 1128A of the Social Security Act; or • Has been excluded, suspended, or debarred from participation in Medicare or any state health care programs. The MCO must submit information as described above, for any person who was formerly described as a director, officer, principal, partner, agent, managing employee, or other person with ownership or control interest of five percent (5%) or more in the MCO, but is no longer so described because of a transfer of ownership or control interest to an immediate family member or a member of the person’s household, in anticipation of or following a conviction, assessment of a civil monetary penalty, or imposition of an exclusion. The MCO is prohibited from having a consulting, employment, or other agreement with an excluded, debarred debarred, or suspended person for the provision of items or services that are significant and material to the MCO’s contractual obligation with the State. Likewise, the MCO may not have a relationship with an affiliate of any person described above. Entities that meet any of the following criteria must be excluded from participation:
Appears in 3 contracts
Samples: Model Purchase of Service Provider Agreement, Service Provider Agreement, Service Provider Agreement
Prohibited Affiliations with Individuals Debarred by Federal Agencies. The MCO may not have a director, officer, principal, partner, agent, managing employee, or other person with ownership or control interest of five percent (5%) or more in the MCO and who: • Has been convicted of a criminal offense as described in sections 1128(a) and 1128(b) (1), (2), or (3), of the Social Security Act; • Has had civil money penalties or assessments imposed under section 1128A of the Social Security Act; or • Has been excluded, suspended, or debarred from participation in Medicare or any state health care programs. The MCO must submit information as described above, for any person who was formerly described as a director, officer, principal, partner, agent, managing employee, or other person with ownership or control interest of five percent (5%) or more in the MCO, but is no longer so described because of a transfer of ownership or control interest to an immediate family member or a member of the person’s household, in anticipation of or following a conviction, assessment of a civil monetary penalty, or imposition of an exclusion. The MCO is prohibited from having a consulting, employment, or other agreement with an excluded, debarred debarred, or suspended person for the provision of items or services that are significant and material to the MCO’s contractual obligation with the State. Likewise, the MCO may not have a relationship with an affiliate of any person described above. Entities that meet any of the following criteria must be excluded from participation:
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