Common use of Provider Ownership Disclosure Clause in Contracts

Provider Ownership Disclosure. The Contracted Provider agrees to disclose the required information, at the time of application, and/or upon request, in accordance with 42 C.F.R.§ 455 Subpart B, related to ownership and control, business transactions, and criminal conviction for offenses against Medicare, Medicaid, CHIP and/or other federal health care programs. See 42 C.F.R. § 455, Parts 101 through 106 for definitions, percentage calculations, and requirements for disclosure of ownership, business transactions, and information on persons convicted of crimes related to any federal health care programs. The Contracted Provider agrees to notify, in writing, the Health Plan and the NC Department of Health and Human Services of any criminal conviction within twenty (20) days of the date of the conviction.

Provider Ownership Disclosure. The Contracted Provider agrees to disclose the required information, at the time of application, and/or upon request, in accordance with 42 C.F.R.§ 455 Subpart B, related to ownership and control, business transactions, and criminal conviction for offenses against Medicare, Medicaid, CHIP and/or other federal health care programs. See 42 C.F.R. § 455, Parts 101 through 106 for definitions, percentage calculations, and requirements for disclosure of ownership, business transactions, and information on persons convicted of crimes related to any federal health care programs. The Contracted Provider agrees to notify, in writing, the Health Plan Plan, Subcontractor and the NC Department of Health and Human Services of any criminal conviction within twenty (20) 20 days of the date of the conviction. Additionally, Provider must cooperate with the Department for submission of fingerprints upon a request from the Department or CMS in accordance with 42 CFR 455.434.