Provider Subcontracts Sample Clauses
Provider Subcontracts. See Recital A. ---------------------
Provider Subcontracts. Provider shall obtain CMHSP’s prior written approval before subcontracting any or all of Provider’s obligations hereunder. Furthermore, any subcontract shall:
A. Be in writing and include a full specification of the subcontracted supports/services.
B. Contain a provision stating this Agreement is incorporated by reference into the subcontract and made a part thereof, and as such, is subject to the terms and conditions of this Agreement.
C. Not terminate the legal responsibility of Provider to ensure that supports/services required of Provider hereunder are fulfilled.
D. Provide, prior to execution of any such subcontract, commercially reasonable efforts to furnish CMHSP with notice verifying that subcontractor and its professional staff, if any, maintain all approvals, licenses, certifications, registrations, accreditations, and authorizations required by Federal, State, and local laws, ordinances, rules, and regulations to perform the subcontracted supports/services pursuant to the subcontract.
E. Allow for the audit and inspection of records and premises by CMHSP, LRE, the Office of Inspector General, or any State of Federal government agency, or their representatives, or any other authorized body, at any time, including but not limited to, access to inspect, review, copy, and/or audit all financial records, licenses, accreditation, certification, and program reports pertaining to the performance of obligations under this Agreement, to the full extent permitted by applicable State and Federal law.
F. Provide, prior to execution of any such subcontract, assurance that the subcontractor:
1. Is not listed by MDHHS or another agency of the Federal government or State of Michigan as being suspended from participation in Medicaid or Medicare programs.
2. Is not listed by MDHHS or any other agency of the State of Michigan in its registry for unfair labor practices.
3. Is not listed by the U.S. General Services Administration in its “Excluded Parties List” as to Federal funding.
4. Maintains workers’ compensation and unemployment insurance coverage for its employees, as required by law.
5. Maintains liability insurance coverages required by CMHSP or LRE, as the case may be, for all contracted services,
6. Has procedures in place to ensure the immediate notification to CMHSP, in writing, if Provider, subsequent to the execution of any such subcontract, discovers that any of the above cited verifications are no longer true.
Provider Subcontracts. The Contractor’s Subcontracts shall contain the following provisions:
9.5.1 A statement that Subcontractors receiving GFS or FBG funds shall cooperate with the Contractor or HCA-sponsored Quality Improvement (QI) activities.
9.5.2 A means to keep records necessary to adequately document services provided to Individuals for all delegated activities including QI, Utilization Management, and Individual Rights and Protections.
9.5.3 For providers, a requirement to provide discharge planning services which shall, at a minimum:
9.5.3.1 Coordinate a community-based discharge plan for each Individual served under this Contract beginning at intake. Discharge planning shall apply to all Individuals regardless of length of stay or whether they complete treatment.
9.5.3.2 Coordinate exchange of assessment, admission, treatment progress, and continuing care information with the referring entity. Contact with the referral agency shall be made within the first week of residential treatment.
9.5.3.3 Establish referral relationships with assessment entities, outpatient providers, vocational or employment services, and courts which specify aftercare expectations and services, including procedure for involvement of entities making referrals in treatment activities;
9.5.3.4 Coordinate, as needed, with DBHR prevention services, vocational services, housing services and supports, and other community resources and services that may be appropriate, including the DCYF, and the DSHS Economic Services Administration including Community Service Offices (CSOs).
9.5.3.5 Coordinate services to financially-eligible Individuals who are in need of medical services.
9.5.4 A requirement that residential treatment providers ensure that priority admission is given to the populations identified in this contract.
9.5.5 Requirements for information and data sharing to support Care Coordination consistent with this Contract.
9.5.6 A requirement to implement a Grievance process that complies with WAC 182-538C- 110 and as described in the Grievance System Section of this Contract.
9.5.7 A requirement that termination of a Subcontract shall not be grounds for an appeal, Administrative Hearing, or a Grievance for the Individual if similar services are immediately available in the service area.
9.5.8 Requirements for how Individuals will be informed of their right to a Grievance or Appeal in the case of:
9.5.8.1 Denial or termination of service related to medical necessity determinations.
9.5.8.2 Failu...
Provider Subcontracts. See Recital B.
Provider Subcontracts. 50 ------------- (a) Generally............................................................................................51 (b) Subcontract terms...................................................................................51 SECTION 15.02 PROVIDER ACCESSIBILITY..........................................................................52 ------------- SECTION
Provider Subcontracts. If Provider, with CMHSP’s prior written consent, subcontracts any supports/services required of Provider under this Agreement, any such subcontract shall:
Provider Subcontracts. Provider shall not, without prior approval from MCNA, enter into any subcontract or other agreement for any of the work contemplated under this Agreement without receiving approval from MCNA. In the event Provider secures prior approval and enters into any subcontract agreement with another provider to provide Covered Services to Covered Persons, such agreement shall meet all requirements of the Agreement.
Provider Subcontracts. 3.15.1 If Provider, with CMHSP’s prior consent, subcontracts any Supports/Services required of Provider under this Agreement, any such subcontract shall:
3.15.1.1 Be in writing and include a full specification of the subcontracted Supports/Services;
3.15.1.2 Contain a provision stating that this Agreement is incorporated by reference into the subcontract and made a part thereof; and
3.15.1.3 Contain a provision stating that the subcontract is subject to the terms and conditions of this Agreement. Any such subcontract shall not terminate the legal responsibility of the Provider to assure that Supports/Services required of the Provider hereunder are fulfilled.
3.15.2 Prior to the execution of any such subcontract, the Provider shall furnish CMHSP with notice verifying that:
3.15.2.1 The subcontractor and its professional staff, if any, maintain all approvals, licenses, certifications, registrations, accreditations, and authorizations required by federal, state and local laws, ordinances, rules and regulations to perform the subcontracted Supports/Services for Customers.
3.15.2.2 The subcontractor is not listed by a MDHHS or agency of the federal government or the State of Michigan as being suspended from participation in Medicaid or Medicare Programs;
3.15.2.3 The subcontractor is not listed by a MDHHS or agency of the State of Michigan in its registry for unfair labor practices;
3.15.2.4 The subcontractor is not listed by the U.S. General Services Administration in its “Excluded Parties List” as to federal funding;
3.15.2.5 The subcontractor maintains workers’ compensation and unemployment insurance coverage for its employees; and
3.15.2.6 The subcontractor maintains liability insurance coverages required by CMHSP for the Supports/Services. The Provider shall immediately notify CMHSP, in writing, if, subsequent to execution of any such subcontract, the Provider discovers that any of the above cited verifications are no longer true.
3.15.3 Any subcontractor shall ensure, as applicable, that its professional staff, if any, meet CMHSP’s credentialing and privileging requirements, including privileging and competency standards and/or that its non-professional staff meets the CMHSP’s requirements for qualifications and competency standards, necessary to perform the subcontracted Supports/Services.
Provider Subcontracts. The Contractor shall provide or assure the provision of all Covered Services specified in of this Contract. The Contractor may provide these services directly or may enter into subcontracts with Providers who will provide services to the Medicaid MCO Members in exchange for payment by the Contractor for services rendered. Subcontracts are required with all Providers of services, unless otherwise previously approved by the Department. All subcontracts for the provision of services under this Contract shall contain verbatim the section containing all federal, state and Department requirements as outlined in Appendix/Attachment Four (4) which shall supersede all other requirements of the subcontract. The Contractor shall submit a version of each subcontract it intends to use with its Providers and Subcontractor to enable the Department to validate the proper inclusion of Appendix/Attachment Four (4) See the MCO Policy and Procedure Guide for more details regarding this requirement. The Contractor shall require each such Subcontractor to covenant and agree that in the event of a breach of the Subcontract by the Contractor, termination of the Subcontract, or insolvency of the Contractor, each Subcontractor shall (i) provide all services and fulfill all of its obligations pursuant to the Subcontract for the remainder of any month for which the Department has made payments to the Contractor, and (ii) fulfill all of its obligations respecting the transfer of Medicaid MCO Members to other Providers, including record maintenance, access and reporting requirements. All such covenants, agreements, and obligations expressed in this paragraph shall survive the termination of this Contract or any Subcontract. Additional information regarding these requirements may be found in the MCO Policy and Procedure Guide. The Contractor shall pay 90% of all clean claims from Providers within thirty (30) days of the date of receipt. The Contractor shall pay 99% of all clean claims from Providers, within ninety (90) days of the date of receipt. The date of receipt is the date as indicated by its data stamp on the claim. The date of payment is the date of the check or other form of payment. The Contractor and its providers may, by mutual agreement, establish an alternative payment schedule. Any alternative payment timeframe schedule must be stipulated in the Contract. The Department may conduct audits of the Contractor by using the date of service and date of payment to identify and a...
Provider Subcontracts. In the event Provider enters into any subcontract agreement with another provider to provide Covered Services to Covered Persons, such agreement shall meet all requirements of the Agreement.