Provider Monitoring. 5.1.1 The Provider must put in place the necessary internal control framework, including an internal audit function to ensure that it meets its obligations and those of its sub-contractors under this Agreement.
Provider Monitoring. The Contractor’s system shall support monitoring and tracking of provider/enrollee grievances and appeals from receipt to disposition. The system shall be able to produce provider reports for quality of medical, behavioral, dental and MLTSS service analysis, flag and identify providers with restrictive conditions (e.g., fraud monitoring), and identify the confidentiality level of information (i.e., to manage who has access to the information).
Provider Monitoring. Contractor shall perform Quality Assurance evaluations of Provider practices, which shall include monitoring of Enrollee accessibility to ensure linguistic and physical accessibility. Contractor shall support Providers in achieving accessibility.
Provider Monitoring. Contractor shall perform QA evaluations of Provider practices, which shall include monitoring of Enrollee accessibility to ensure linguistic and physical accessibility. Contractor shall support Providers in achieving accessibility.
Provider Monitoring. A. The Provider agrees to maintain all records pertaining to the services provided under this Agreement and for which payment is claimed for a period of four years from the date the xxxx was paid by the Department.
B. The Provider shall be subject to periodic on-site review by the Department or its designee.
C. The Provider shall submit to the Department, within fifteen calendar days of request, such records, including but not limited to, patient utilization and patient needs assessments, as may be required or requested by the Department. This paragraph supplements paragraphs 11 and 12 of the Standard General Terms and Conditions (Rev. 2/21), which is incorporated herein by reference.
Provider Monitoring. County shall monitor the use by Providers of .all Award funds distributed to such Providers. County shall advise all Providers of the requirements applicable to them and to the use of Award funds under this Agreement, state and federal laws, state and federal regulations, the provisions of other applicable contracts and any supplemental requirements imposed by the County. County shall require by contract that Providers comply with such requirements and satisfy Plan and other program goals related to their Award financing. County shall monitor relevant activities of Providers to ensure that Award funds are used for authorized purposes in compliance with such requirements and to determine whether Plan and other performance goals are being achieved. If findings/recommendations occur from such audits, or from other audits or other County monitoring with respect to Award funds, County shall issue management decisions to relevant Providers within 30 calendar days after receipt of such audit reports or generation of monitoring findings/recommendations and shall ensure that Providers take appropriate and timely corrective action. County also shall provide copies of such audit and monitoring findings/recommendations and of corresponding County management decisions to the Agency within thirty (30) days of County's deadline herein for issuing its respective management decision.
Provider Monitoring. Contractor shall monitor the Long-Term Care providers to ensure that services are provided promptly, are reasonably accessible in terms of the location and hours of services, and meet the quality standards prescribed in the Contractor’s agreement with the provider. Member’s satisfaction shall be considered in monitoring long-term care providers. Provider practices that endanger the health or safety of members shall be reported to the appropriate State authorities.
Provider Monitoring. DHH/OCDD has developed a quality management system to address areas of compliance to Federal and State policies and procedures. The provider agrees to:
1. Cooperate with state personnel and their agents as they conduct periodic inspections, reviews and audits in the routine monitoring and supervision activities as set forth by DHH, or their agent, including self-assessment, data collection, reporting obligations, child record review, financial audits, complaint investigation, and consumer satisfaction surveys.
2. Cooperate with DHH/OCDD or their agent in the application of utilization control as provided in state statutes and rules as they may be amended from time to time.
3. Comply with civil rights requirements as mandated by federal and state statutes and regulations by ensuring that no child or family, on the basis of race, color, national origin, disability, age, gender, sexual orientation, marital status, or religion, be excluded from participating, being denied the benefits of, or be otherwise subjected to discrimination in the provision of services.
Provider Monitoring. LPHA shall monitor each Provider’s delivery of Program Element services and promptly report to Department when LPHA identifies a major deficiency in a Provider’s delivery of a Program Element service or in a Provider’s compliance with the Provider Contract between the Provider and LPHA. LPHA shall promptly take all necessary action to remedy any identified deficiency. LPHA shall also monitor the fiscal performance of each Provider and shall take all lawful management and legal action necessary to pursue this responsibility. In the event of a major deficiency in a Provider’s delivery of a Program Element service or in a Provider’s compliance with the Provider Contract between the Provider and LPHA, nothing in this Agreement shall limit or qualify any right or authority Department has under state or federal law to take action directly against the Provider.
Provider Monitoring. Notwithstanding clause 7, the Provider is to regularly monitor its performance under this Agreement and each Services Agreement.
