Prohibition on Billing Recipients for Covered Services Sample Clauses

Prohibition on Billing Recipients for Covered Services. The MCO, its providers and subcontractors shall not xxxx a member for services in the benefit package provided during the member’s enrollment period in the MCO, except as provided for in the 1915(c) waiver post-eligibility treatment of income and the purchase of enhanced services as allowed under this article, Section J., Department Policy for Member Use of Personal Resources. This provision pertains even if the:
Sample 1Sample 2See All (4)
AutoNDA by SimpleDocs
Prohibition on Billing Recipients for Covered Services. The PO, its providers and subcontractors shall not bill a member for services provided during the member’s enrollment period in PACE, except for the purchase of enhanced services as allowed under this article. Post-eligibility treatment of income and PACE premiums in 42 CFR §460.184 are not bills for services. This provision pertains even if the:
Sample 1
Prohibition on Billing Recipients for Covered Services. The Indian Health Care Provider (IHCP), its providers and subcontractors shall not xxxx a member for services in the benefit package provided during the member’s enrollment period in the MCO, except as provided for in the 1915(c) waiver post-eligibility treatment of income and the purchase of enhanced services as allowed under Article II, of this agreement. This provision pertains even if the:
Sample 1
Prohibition on Billing Recipients for Covered Services. The PO, its providers and subcontractors shall not bill a member for services provided during the member’s enrollment period in PACE, except for the purchase of enhanced services as allowed under this article. Post-eligibility treatment of income and PACE premiums in 42 CFR §460.184 are not bills for services. This provision pertains even if the: PO becomes insolvent; Department does not pay the PO for covered services provided to the member; Department or the PO does not pay the provider that furnishes the services under a referral or other arrangement; and Payment for services furnished under a subcontract, referral, or other arrangement, to the extent that those payments are in excess of the amount that the member would owe if the PO provided the service directly. Prohibition on Billing in Insolvency In the event of the PO’s insolvency, the PO shall not bill members for debts of the PO or for services provided during the member’s period of PACE enrollment. Prohibition on Billing Indian Recipients Premiums and Cost-Sharing for Items and Services Furnished by an Indian Health Care Provider
Sample 1
Prohibition on Billing Recipients for Covered Services. The IHCP, its providers and subcontractors shall not bill a member for services in the benefit package provided during the member’s enrollment period in the MCO, except for the purchase of enhanced services as allowed under Article II of this agreement. Post-eligibility treatment of income is not a bill for services. This provision pertains even if any of the following occur: IHCP becomes insolvent. MCO or Department does not pay the IHCP for covered services provided to the member. Department or the MCO does not pay the provider that furnishes the services under a referral or other arrangement. Payment for services furnished under a subcontract, referral, or other arrangement, to the extent that those payments are in excess of the amount that the member would owe if the MCO provided the service directly. Prohibition on Billing in Insolvency In the event of the IHCP's insolvency, IHCP shall not bill members for debts of the IHCP or for services in the benefit package and provided during the member’s period of MCO enrollment.
Sample 1

Related to Prohibition on Billing Recipients for Covered Services

  • 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)]

  • Outpatient emergency and urgicenter services within the service area The emergency room copay applies to all outpatient emergency visits that do not result in hospital admission within twenty-four (24) hours. The urgicenter copay is the same as the primary care clinic office visit copay.

  • Business Associate’s Subcontractors and Agents BA shall ensure that any agents and subcontractors that create, receive, maintain or transmit Protected Information on behalf of BA, agree in writing to the same restrictions and conditions that apply to BA with respect to such Protected Information and implement the safeguards required by paragraph 3.4 above with respect to Electronic PHI [45 C.F.R. Section 164.504(e)(2)(ii)(D); 45 C.F.R. Section 164.308(b)] BA shall implement and maintain sanctions against agents and subcontractors that violate such restrictions and conditions and shall mitigate the effects of any such violation [45 C.F.R. Sections 164.530(f) and 164.530(e)(1)].

  • Information and Services Required of the Owner § 3.1.1 The Owner shall provide information with reasonable promptness, regarding requirements for and limitations on the Project, including a written program which shall set forth the Owner’s objectives, constraints, and criteria, including schedule, space requirements and relationships, flexibility and expandability, special equipment, systems, sustainability and site requirements.

  • Scope of Services and Term Member Agency has requested WRCOG to provide certain professional service (“Services”) offered under the Program

  • Routing for Operator Services and Directory Assistance Traffic For a Verizon Telecommunications Service dial tone line purchased by MLTC for resale pursuant to the Resale Attachment, upon request by MLTC, Verizon will establish an arrangement that will permit MLTC to route the MLTC Customer’s calls for operator and directory assistance services to a provider of operator and directory assistance services selected by MLTC. Verizon will provide this routing arrangement in accordance with, but only to the extent required by, Applicable Law. Verizon will provide this routing arrangement pursuant to an appropriate written request submitted by MLTC and a mutually agreed-upon schedule. This routing arrangement will be implemented at MLTC's expense, with charges determined on an individual case basis. In addition to charges for initially establishing the routing arrangement, MLTC will be responsible for ongoing monthly and/or usage charges for the routing arrangement. MLTC shall arrange, at its own expense, the trunking and other facilities required to transport traffic to MLTC’s selected provider of operator and directory assistance services.

  • Links to Third Party Sites/Third Party Services xxxxxxxxxxxx.xxx may contain links to other websites ("Linked Sites"). The Linked Sites are not under the control of MWR/DFS and MWR/DFS is not responsible for the contents of any Linked Site, including without limitation any link contained in a Linked Site, or any changes or updates to a Linked Site. MWR/DFS is providing these links to you only as a convenience, and the inclusion of any link does not imply endorsement by MWR/DFS of the site or any association with its operators. Certain services made available via xxxxxxxxxxxx.xxx are delivered by third party sites and organizations. By using any product, service or functionality originating from the xxxxxxxxxxxx.xxx domain, you hereby acknowledge and consent that MWR/DFS may share such information and data with any third party with whom MWR/DFS has a contractual relationship to provide the requested product, service or functionality on behalf of xxxxxxxxxxxx.xxx users and customers.

Time is Money Join Law Insider Premium to draft better contracts faster.