Provider Duties. In addition to its other obligations with respect to BFA Confidential Information, Provider will:
(i) not permit any BFA Confidential Information to be disclosed to any entity that competes with any BFA Recipient or any products thereof (including the asset management division of Provider or its asset management Affiliates) or other clients;
(ii) provide access to BFA Confidential Information to its employees only on a need-to-know basis for the provision of Services hereunder and will not provide such access to Confidential Information to any employee who directly services a business that competes now or in the future with BFA Recipients (provided that BFA Data may be provided to Provider employees performing Services on a shared services basis so long as such employees are advised as to Provider’s confidentiality obligations hereunder and instructed to comply therewith and are only permitted to share such BFA Data with other shared services employees);
(iii) protect BFA Confidential Information, by configuration of its information and processing systems or by adopting other appropriate measures;
(iv) include in its agreements with each of its Subcontractors confidentiality terms, which, taken as a whole, will be protective of BFA Confidential Information; and
(v) take such other actions as the Parties may agree from time to time.
Provider Duties. In addition to its other obligations with respect to BTC Confidential Information, Provider will:
(i) not permit any BTC Confidential Information to be disclosed to any entity that competes with any Lending Fund or any products thereof (including the asset management and principal securities lending divisions of Provider or its asset management and principal securities lending Affiliates) or other clients;
(ii) provide access to BTC Confidential Information to its employees only on a need-to-know basis for the provision of Services hereunder and will not provide such access to Confidential Information to any employee who directly services a business that competes now or in the future with the Lending Funds (provided that BTC Data may be provided to Provider employees performing Services on a shared services basis so long as such employees are advised as to Provider’s confidentiality obligations hereunder and instructed to comply therewith and are only permitted to share such BTC Data with other shared services employees);
(iii) protect BTC Confidential Information, by configuration of its information and processing systems or by adopting other appropriate measures; and
(iv) take such other actions as the Parties may agree from time to time.
Provider Duties. Your provider will maintain the privacy of PHI and give you a notice of practices with respect to PHI. • Your provider reserves the right to change the privacy policies and practices described in this notice. Unless Your provider notifies you of such changes, however, he is required to abide by the terms currently in effect. • If your provider revises his policies and procedures, you will be sent a notice by mail.
Provider Duties. The Provider agrees:
(a) To abide by all applicable provisions of PORI's contract with DHS in effect as of the date of this Contract and as it may be amended from time to time by PORI and DHS. A copy of the DHS Agreement is available for review by the Provider at PORI.
(b) To provide timely emergency and urgent care. Where applicable, the Provider agrees to follow required hospital/emergency room procedures for urgent and emergency care cases.
(c) To submit utilization data in the format specified by PORI in order to meet DHS specifications.
(d) To comply with all record retention requirements.
(e) To provide representatives of PORI, as well as duly authorized agents and representatives of DHS and CMS, access to its premises, contracts, and medical records as required by law or this Contract.
(f) To preserve the confidentiality and security of medical records and protect from unauthorized disclosure all information, records, and data collected pursuant to this Contract. Access to this information shall be limited to persons who, or agencies which, require the information in order to perform their duties related to this Contract, including CMS and such others as required by DHS.
(g) To maintain and transfer medical records as stipulated by this Contract and to make medical records available to Participants and their authorized representatives in a timely manner.
(h) Not to impose requirements on Participants that are inconsistent with the provision of medically necessary care or covered Medicaid and Medicare benefits or that create barriers to access to care.
(i) To clearly specify referral approval requirements in any sub-subcontracts.
(j) To abide by PORI's marketing and information requirements. The Provider shall forward to PORI for prior approval all flyers, brochures, letters, pamphlets, and other information the Provider intends to distribute to Participants that relate to Rhode Island's PACE Program. The Provider will not distribute any marketing or recipient informing materials related to this Contract without the consent of PORI and DHS.
(k) To abide by the terms of the Contract regarding appeals for non-payment of services.
Provider Duties. Provider agrees that:
2.1 Provider shall accept (and shall cause each Contracting Provider to accept) as patients all Enrollees referred by March Vision Care without discrimination. Provider shall provide March Vision Care with a minimum of sixty (60) days’ advance written notice of Provider’s inability to accept new patients hereunder. Eye Health Care Services provided under this Agreement shall be of the same type and quality, and provided in the same manner, as said services provided to all other patients of Provider.
2.2 Provider shall provide Eye Health Care Services to Enrollees at a level of care and competence that equals or exceeds the generally accepted and professionally recognized standard of practice at the time of treatment in accordance with applicable law and rules and/or standards of professional conduct, and any controlling governmental licensing requirements. Provider shall cause every Contracting Provider to, at all times during the term of the Agreement, maintain a license to practice his or her profession in the applicable State(s). In the event of any suspension, restriction or revocation of any license required to be maintained by a Contracting Provider, Provider shall: (a) immediately cause such Contracting Provider to stop providing Eye Health Care Services under this Agreement; (b) immediately provide notice of such suspension, restriction, or revocation to March Vision Care by both telephone and in writing; and (c) shall not resume performance under this Agreement unless and until his or her license is restored and he or she has received written notice of reinstatement from March Vision Care.
2.3 Provider warrants and represents that it has not been convicted of crimes as specified in Section 1128 of the Social Security Act (42 U.S.C. 1320a-7), excluded from participation in the Medicare or Medicaid program, assessed a civil penalty under the provisions of Section 1128, entered into a contractual relationship with an entity convicted of a crime specified in Section 1128, or taken any other action that would prohibit it from participation in Medicare, Medicaid or any state health care programs. Provider agrees to notify March Vision Care immediately in the event it or any Contracting Provider is or becomes disbarred, excluded, suspended, or is otherwise determined to be ineligible to participate in any federal or state health care program(s). Provider shall not employ or contract with, with or without compensation, any individual...
Provider Duties. The Provider shall:
1. Conduct presumptive eligibility determinations in compliance with all applicable Department Medicaid presumptive eligibility policies and procedures, standards set forth in the Presumptive Eligibility by Hospitals State Plan Amendment, and federal laws and regulations.
2. Require each hospital employee eligible to conduct presumptive eligibility determinations to remain current and comply with all applicable Presumptive Eligibility Standards.
3. Ensure that each staff person eligible to conduct presumptive eligibility determinations is a hospital employee and not a contractor.
4. Not delegate the authority to conduct presumptive eligibility determinations to another entity.
5. Require each hospital employee eligible to conduct presumptive eligibility determinations to complete Department-approved, preliminary and annual renewal training on Presumptive Eligibility policies and procedures.
6. Require each hospital employee eligible to conduct presumptive eligibility determinations to complete additional training on Presumptive Eligibility policies and procedures and implement a DHB-approved, three-month prospective corrective action plan in the event that DHB notifies the Provider that it is not in compliance with the Presumptive Eligibility Standards.
7. Use the North Carolina Families Accessing Services Through Technology (NC FAST) portal to submit an applicant’s presumptive and regular Medicaid applications electronically unless the applicant requests a paper application form for the regular Medicaid application.
8. Not participate as an applicant’s authorized representative on either a presumptive or a regular Medicaid eligibility application during the presumptive eligibility period.
9. Accept self-attestation from a presumptive eligibility applicant and shall not require verification documentation for a presumptive eligibility application.
10. Notify the presumptive eligibility applicant in writing and, if appropriate, verbally of the determination and the reason why an application is not approved, and that the applicant may submit a regular Medicaid application whether presumptive eligibility is approved.
11. Assist the presumptive eligibility applicant with completion and submission of a regular Medicaid application on the same day as the presumptive eligibility application.
12. Notify the applicant in writing and, if appropriate, verbally that approved presumptive eligibility will end on the last day of the month following the...
Provider Duties. Provider will: (a) not use or disclose Customer PHI except (i) as required or permitted by law; (ii) as permitted under the terms of the Agreement or any permission of Customer under the Agreement; or (iii) as incidental under HIPAA to another permitted use or disclosure; (b) use reasonable and appropriate safeguards to prevent use or disclosure of Customer PHI other than as provided in the Agreement; (c) implement administrative, physical, and technical standards in accordance with the Security Rule to protect the confidentiality, integrity, and availability of Customer PHI in electronic form ("EPHI"); (d) mitigate, to the extent practicable, any harmful effect of a use or disclosure of Customer PHI by Provider that is known to Provider to violate the requirements of the Agreement; (e) limit its request for Customer PHI to the minimum amount necessary to accomplish the intended purpose of requests for, and uses and disclosures of, Customer PHI in accordance with 45 C.F.R. 502(b)(1); (f) report to Customer as soon as practicable and as required by HIPAA and the HITECH Act any known use or disclosure of Customer PHI by Provider not as provided by the Agreement and any "Security Incident" with respect to Customer EPHI as defined in the Security Rule. Additionally, Provider will notify Customer of any Breach of Unsecured PHI, and such notification shall be made without unreasonable delay following the date of discovery to enable Customer to comply with the Breach disclosure requirements under the HITECH Act. Provider shall include within such notice identification, to the extent possible, of each Individual whose Unsecured PHI has been, or is reasonably believed by Provider to have been, accessed, used, or disclosed through the Breach and any other valuable information known to Provider that Customer is required to include in its notice to affected Individuals. The reporting requirement set forth hereunder shall include, without limitation, disclosures that Provider is aware of that would need to be included in Customer's Accounting of Disclosures under HIPAA and/or HITECH Act, provided that Provider is required by HIPAA and the HITECH Act as a Business Associate of Customer to include such disclosures; (g) require any agent, including a subcontractor, under the Agreement that creates, receives, maintains, or transmits Customer PHI on behalf of Provider to agree in writing to substantially the same restrictions and conditions with respect to Customer PHI and ...
Provider Duties
