Quality and Oversight Sample Clauses

Quality and Oversight. County acknowledges that CalOptima will conduct oversight of County’s provision of ECM Services under this Contract to ensure the quality of ECM Services and compliance with program requirements, which may include audits and/or corrective actions. County shall respond to all reasonable requests from CalOptima for information and documentation related to County’s provision of ECM Services.
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Quality and Oversight. 7.1 Provider acknowledges Partnership will conduct oversight of its delivery of Community Supports to ensure the quality of Services rendered and ongoing compliance with all legal and contractual obligations both Partnership and the Provider have, including but not limited to, required reporting, audits, and corrective actions, among other oversight activities and Community Supports requirements set forth in the Medi-Cal Contract and applicable DHCS APLs, which are incorporated herein by this reference. 7.2 Provider shall respond to all Partnership requests for information and documentation to permit ongoing monitoring of Community Supports. 7.3 Provider shall be responsible for the same reporting requirements, as those Partnership must report to DHCS, including Encounter Data and other supplemental reporting, as applicable. 7.4 Failure of Provider to follow Partnership’s Policies and Procedures, reporting requirements, sub contractual requirements, or Applicable Requirements, may result, at Partnership’s option, in a corrective action plan or any sanctions incorporated in the Partnership Provider Manual or as set forth in Section 12.6.
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Quality and Oversight. Provider acknowledges PARTNERSHIP will conduct oversight of its delivery of ECM to ensure the quality of ECM rendered and ongoing compliance with program requirements, and all legal and contractual obligations both PARTNERSHIP and Provider have, including, but not limited to, required reporting, audits, and corrective actions, among other oversight activities. a. Provider shall respond to all PARTNERSHIP requests for information and documentation to permit ongoing monitoring of ECM. b. Provider shall be responsible for the same reporting requirements as those PARTNERSHIP must report to DHCS, including Encounter Data (using national standard specifications and code sets to be defined by DHCS) and other supplemental reporting, as applicable. c. Failure of Provider to follow PARTNERSHIP’s Policies and Procedures, reporting requirements, subcontractual requirements, or ECM program requirements, may result, at PARTNERSHIP’s option, in a corrective action plan or any sanctions incorporated in the PARTNERSHIP Provider Manual.
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Quality and Oversight. CS Provider acknowledges Health Net will conduct oversight of its delivery of CS services to ensure the quality of services rendered and ongoing compliance with all legal and contractual obligations both the Health Net and the CS Provider have, including but not limited to, required reporting, audits, and corrective actions, among other oversight activities. EXHIBIT B-1 COMMUNITY SUPPORTS PAYMENT RATES The following HCPCS codes must be used for CS services. The HCPCS code and modifier combined define the service as CS services. As an example, a HCPCS code by itself does not define the CS services. The HCPCS code must be reported with a modifier for the services to be defined and categorized as CS services. If CS services are provided through telehealth, the additional modifier GQ must be used. All telehealth services must be provided in accordance with DHCS policy. Subject to the terms of this Agreement Health Net shall pay and CS Provider shall accept as payment in full for Covered Services delivered pursuant to this Exhibit, the lesser of: (i) the rates listed below, or (ii) 100% of Provider’s Allowable Charges. Asthma Remediation S5165 Home modifications; per service U5 Used by Managed Care with HCPCS code S5165 to indicate Community Supports Asthma Remediation 100% of Allowable Charges* Lifetime maximum of $7,500 Community Transition Services/Nursing Facility Transition to a Home T2038 Community transition; per service. Requires billed amount(s) to be reported on the encounter. Modifier used to differentiate from Nursing Facility Transition/Diversion to Assisted Living Facilities U5 Used by Managed Care with HCPCS code T2038 to indicate Community Supports Community Transition Services/Nursing Facility Transition to a Home $432.49 per service Day Habilitation Programs Coding Guidance Forthcoming Day Habilitation Used by Managed Care to indicate Community Supports Day Habilitation Programs $6.46 per hour Not to exceed $51.68 per day Environmental Accessibility Adaptations S5165 Home modifications; per services. Requires billed amount(s) to be reported on the encounter U6, U1 Used by Managed Care with HCPCS code S5165 to indicate Community Services Accessibility Adaptations/Home Modifications 100% of Allowable Charges* Lifetime maximum of $7,500 Housing Deposits H0044 Supported housing, per month. Requires deposit amounts to be reported on the encounter. Modifier used to differentiate housing deposits from Short-Term Post- Hospitalization Housing U2 Used ...
Sample 1
Quality and Oversight. 1. ECM Provider acknowledges that Anthem will conduct oversight of its participation in ECM to ensure the quality of ECM and ongoing compliance with program requirements, which may include site visits, audits and/or corrective actions. 2. ECM Provider shall respond to all Anthem requests for information and documentation to permit ongoing monitoring of ECM. 3. Program (e.g., ECM Director) and organization-level (e.g. CFO) leadership shall, at a minimum, attend bi-annual Performance Review meetings. 4. Provider shall comply with applicable monitoring provisions of the contract between Anthem and DHCS and any monitoring request by DHCS. Further, Provider agrees that Anthem shall revoke the delegation of activities or obligations, or specific other remedies in instances where DHCS or Anthem determine that Provider has not performed satisfactorily. 5. Refer to the Anthem ECM Provider Guide, pg. 34-36, Section 5 for more details I. Definitions 1. Enhanced Care Management (ECM): External care coordination program that provides a whole- person approach to care that addresses the clinical and non-clinical needs of high-need Medi- Cal members.
Sample 1
Quality and Oversight. 1. CS Provider acknowledges Anthem will conduct oversight of its delivery of CS to ensure the quality of services rendered and ongoing compliance with all legal and contractual obligations both Anthem and the CS Provider have, including but not limited to, required reporting, audits, and corrective actions, among other oversight activities. The federal regulations set forth in 42 CFR 455.104, 455.105 and 455.106 require providers who are entering into or renewing a provider agreement to disclose to the U.S. Department of Health and Human Services, the state Medicaid agency, and to managed care organizations that contract with the state Medicaid agency: 1) the identity of all owners with a control interest of [5%] or greater, 2) certain business transactions as described in 42 CFR 455.105 and 3) the identity of any excluded individual or entity with an ownership or control interest in the provider, the provider group, or disclosing entity or who is an agent or managing employee of the provider group or entity. Please attach a separate sheet if necessary. Answer all questions as of the current date. If additional space is needed, note on the form that the answer is being continued and attach a sheet referencing the relevant item number. Please return the original to us and retain a copy for your files. If a question is not applicable, respond N/A for that question. You should completely answer all applicable questions — No questions should be left blank. Provider entity name: Provider DBA name (if different from provider entity name): Entity NPI: Entity TIN: 94-60000691 Medicaid ID: Provider phone #: Provider address — List all practice locations. Must include at least one street address. Attach a separate sheet if needed. City State ZIP An owner is a person or business entity that owns [5%] or more of the assets, stock, or profits of the provider entity. This [5%] may be direct ownership or indirect ownership. (for example, an individual might own [50%] of a company that owns the actual provider entity. This means that the indirect ownership is [50%.]) In addition to ownership of stock, an owner also has a legal obligation like a mortgage or loan that is secured by the assets of the provider entity.
Sample 1
Quality and Oversight. Provider acknowledges PARTNERSHIP will conduct oversight of its delivery of ECM to ensure the quality of ECM rendered and ongoing compliance with all legal and contractual obligations both PARTNERSHIP and Provider have, including, but not limited to, required reporting, audits, and corrective actions, among other oversight activities. (a) Provider shall respond to all PARTNERSHIP requests for information and documentation to permit ongoing monitoring of ECM. (b) Provider shall be responsible for the same reporting requirements as those PARTNERSHIP must report to DHCS, including Encounter Data and other supplemental reporting, as applicable. (c) Failure of Provider to follow PARTNERSHIP’s Policies and Procedures, reporting requirements, subcontractual requirements, or ECM program requirements, may result, at PARTNERSHIP’s option, in a corrective action plan or any sanctions incorporated in the PARTNERSHIP Provider Manual.
Sample 1
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Quality and Oversight. County acknowledges that CalOptima will conduct oversight of its delivery of Community Supports to ensure the quality of services rendered and ongoing compliance with all legal and contractual obligations both CalOptima and County Associates have, including but not limited to, required reporting, audits, and corrective actions, among other oversight activities.
Sample 1

Related to Quality and Oversight

  • Quality and Extent of Services The Board considered the terms of the Agreement, including the scope of advisory services provided under the Agreement. The Board noted that, under the Agreement, XXXX provides portfolio management services to the Fund and that, pursuant to a separate administrative services agreement, DIMA provides administrative services to the Fund. The Board considered the experience and skills of senior management and investment personnel and the resources made available to such personnel. The Board also considered the risks to XXXX in sponsoring or managing the Fund, including financial, operational and reputational risks, the potential economic impact to XXXX from such risks and XXXX’s approach to addressing such risks. The Board reviewed the Fund’s performance over short-term and long-term periods and compared those returns to various agreed-upon performance measures, including market index(es) and a peer universe compiled using information supplied by Morningstar Direct (“Morningstar”), an independent fund data service. The Board also noted that it has put into place a process of identifying “Funds in Review” (e.g., funds performing poorly relative to a peer universe), and receives additional reporting from XXXX regarding such funds and, where appropriate, XXXX’s plans to address underperformance. The Board believes this process is an effective manner of identifying and addressing underperforming funds. Based on the information provided, the Board noted that, for the one-, three- and five-year periods ended December 31, 2020, the Fund’s performance (Class A shares) was in the 2nd quartile of the applicable Morningstar universe (the 1st quartile being the best performers and the 4th quartile being the worst performers). The Board also observed that the Fund has underperformed its benchmark in the one-, three- and five-year periods ended December 31, 2020. Fees and Expenses. The Board considered the Fund’s investment management fee schedule, operating expenses and total expense ratios, and comparative information provided by Broadridge Financial Solutions, Inc. (“Broadridge”) and the Fee Consultant regarding investment management fee rates paid to other investment advisors by similar funds

  • Confidentiality and Publication 7.1 Except as provided herein, each party shall maintain in confidence during the term of this Agreement and for seven (7) years thereafter, and shall not use for any [*] Certain information on this page has been omitted and filed separately with the Commission. Confidential treatment has been requested with respect to the omitted portions. purpose or disclose to any third party, any Technology or other information disclosed by the other party in writing and marked "Confidential" or that is disclosed orally and confirmed in writing as confidential within forty-five (45) days following such disclosure (collectively, 'CONFIDENTIAL INFORMATION'), except to the extent that any such Confidential Information - (a) is at the time of being so provided or after that time through no fault of the party to whom it was so provided becomes public knowledge; or (b) was lawfully available on a non-confidential basis to the party to whom it was so provided before that time; or (c) can be shown by the party to whom it was so provided to have been independently produced by that party without any use of such confidential information provided to it by the other party; or (d) is made available to the party to whom it was so provided otherwise than in breach of an obligation of confidentiality owed to the other party. 7.2 The results of the Project may be made public by either party (or, in the case of ICRT, by ICRF) except to the extent that - (a) publication would include any Confidential Information of the other party; or (b) publication would prejudice the obtaining of patent protection for an invention constituting Project Technology, or the commercial exploitation of any unpatented or unpatentable Project Technology which remains unpublished. 7.3 To allow time for review of any proposed disclosure of any subject matter which may be precluded from being made public under clause 7.2, each of ICRT and Introgen shall provide to the other - (a) a copy of any manuscript disclosing any results of the Project not less than 45 days notice before submitting the manuscript for publication; and (b) a copy of any slides to be used in an oral presentation disclosing any results of the Project together with an outline of the presentation not less than 20 working days before making any such oral presentation. 7.4 The party receiving any such material pursuant to clause 7.3 shall promptly and in any event prior to the proposed date of submission for publication review the proposed disclosure and notify the other party in writing of its conclusions, failing which the other party shall be free to make the proposed disclosure. 7.5 If in the reasonable opinion of the party receiving the material the proposed disclosure does not include subject matter which is precluded from being made public under clause 7.2, it shall promptly notify the other party which shall thereupon be free to make the proposed disclosure. 7.6 If in the reasonable opinion of either party - (a) the proposed disclosure includes subject matter which is precluded from being made public under clause 7.2 and which is patentable, neither party shall publish or otherwise disclose the material in question for a period of three months from the date on which the relevant material was received by the party in question and, if a patent application is made within that period of three months, for a further period as agreed but in any event not exceeding a total of 18 months from that date (including such period of three months), following which the other party shall be free to make the proposed disclosure; or (b) the proposed disclosure includes unpatented (or unpatentable) Project Technology which that party wishes to maintain as unpublished and which (c) the proposed disclosure includes Confidential Information of the reviewing party, the disclosing party shall remove such Confidential Information prior to such disclosure. 7.7 Notwithstanding the foregoing provisions of this clause 7 above, the receiving party may use or disclose Confidential Information of the disclosing party (a) to the extent necessary to exercise its rights hereunder (including providing such information to bona fide licensees or prospective licensees as contemplated by this Agreement or otherwise and to potential investors or partners on reasonable terms of confidentiality) or to fulfil its obligations and/or duties hereunder; (b) in filing for, prosecuting or maintaining any proprietary rights, prosecuting or defending litigation; and (c) in complying with applicable governmental regulations and/or submitting information to tax or other governmental authorities; or as otherwise required by law; provided that if the receiving party is required by law to make any public disclosures of Confidential Information of the disclosing party then, to the extent it may legally do so, it shall give reasonable advance notice to the disclosing party of such disclosure and shall use its reasonable efforts to secure confidential treatment of

  • Responsibility and Control Notwithstanding any other provision of this Agreement, it is understood and agreed that the Trust reserves the right to direct, approve or disapprove any action hereunder taken on its behalf by the Subadviser, provided, however, that the Subadviser shall not be liable for any losses to the Trust resulting from the Trust’s direction, or from the Trust’s disapproval of any action proposed to be taken by the Subadviser.

  • Quality Assurance The parties endorse the underlying principles of the Company’s Quality Management System, which seeks to ensure that its services are provided in a manner which best conforms to the requirements of the contract with its customer. This requires the Company to establish and maintain, implement, train and continuously improve its procedures and processes, and the employees to follow the procedures, document their compliance and participate in the improvement process. In particular, this will require employees to regularly and reliably fill out documentation and checklists to signify that work has been carried out in accordance with the customer’s specific requirements. Where necessary, training will be provided in these activities.

  • Confidentiality and Publicity 26.1 All proprietary or confidential information (“Proprietary Information”) disclosed by either Party during the negotiations and the term of this Agreement will be protected by both Parties in accordance with the terms provided herein. 26.2 As used in this Agreement, the term “Proprietary Information” will mean written, recorded, machine readable or other information provided in tangible form to one Party by the other Party regarding the above referenced subject matter and which is marked proprietary or confidential with the appropriate owner corporation name, e.g., “Frontier Proprietary”. Information disclosed orally will not be considered proprietary unless such information is reduced to writing by the disclosing Party and a copy is delivered to the other Party within thirty (30) business days after such oral disclosure. The writing will also state the place, date and person(s) to whom disclosure was made. 26.3 Each Party agrees that it will not disclose any Proprietary Information of the other Party in whole or in part, including derivations, to any third party for a period of three (3) years from the date of disclosure unless the Parties agree to modify this Agreement to provide for a different nondisclosure period for specific materials. Neither Party will be liable for inadvertent or accidental disclosure of Proprietary Information of the other Party provided that: 26.3.1 each Party uses at least the same degree of care in safeguarding such Proprietary Information as it uses for its own proprietary information of like importance, and such degree of care will be reasonably calculated to prevent such inadvertent disclosure; 26.3.2 it limits access to such Proprietary Information to its employees and agents who are directly involved in the consideration of the Proprietary Information and informs its employees and agents who have access to such Proprietary Information of its duty not to disclose; and 26.3.3 upon discovery of any such inadvertent disclosure of Proprietary Information, it will endeavor to prevent any further inadvertent disclosure. 26.4 Information will not be deemed proprietary and the receiving Party will have no obligation with respect to any such information which: 26.4.1 is or becomes publicly known through no wrongful act, fault or negligence of the receiving Party; or 26.4.2 was known by the receiving Party or by any other affiliate or subsidiary of the receiving Party prior to disclosure, or is at any time developed by the receiving Party independently of any such disclosure; or 26.4.3 was disclosed to the receiving Party by a third party who was free of obligations of confidentiality to the disclosing Party; or 26.4.4 is disclosed or used by the receiving Party, not less than three (3) years following its initial disclosure or such other nondisclosure period as may be agreed in writing by the Parties; or 26.4.5 is approved for release by written authorization of the disclosing Party; or 26.4.6 is disclosed pursuant to a requirement or request of a governmental agency or disclosure is required by operation of law; or 26.4.7 is furnished to a third party by the disclosing Party without a similar restriction on the third party’s rights. 26.5 Since either Party may choose not to use or announce any services, products or marketing techniques relating to these discussions or information gained or exchanged during the discussions, both Parties acknowledge that one is not responsible or liable for any business decisions made by the other in reliance upon any disclosures made during any meeting between the Parties or in reliance on any results of the discussions. The furnishing of Proprietary Information to one Party by the other Party will not obligate either Party to enter into any further agreement or negotiation with the other. 26.6 Nothing contained in this Agreement will be construed as granting to one Party a license, either express or implied, under any patent, copyright, or trademark, now or hereafter owned, obtained, controlled, or which is or may be licensable by the other Party. 26.7 All publicity regarding this Agreement and its Attachments is subject to the Parties’ prior written consent. 26.8 Unless otherwise agreed upon, neither Party will publish or use the other Party’s name, language, pictures, or symbols from which the other Party’s name may be reasonably inferred or implied in any advertising, promotion, or any other publicity matter relating directly or indirectly to this Agreement.

  • Responsibility and Liability 6.1 Apple shall have no responsibility for the installation and/or use of any of the Licensed Applications by any End-User. You shall be solely responsible for any and all product warranties, End-User assistance and product support with respect to each of the Licensed Applications. 6.2 You shall be solely responsible for, and Apple shall have no responsibility or liability whatsoever with respect to, any and all claims, suits, liabilities, losses, damages, costs and expenses arising from, or attributable to, the Licensed Applications and/or the use of those Licensed Applications by any End-User, including, but not limited to: (i) claims of breach of warranty, whether specified in the XXXX or established under applicable law; (ii) product liability claims; and (iii) claims that any of the Licensed Applications and/or the End-User’s possession or use of those Licensed Applications infringes the copyright or other intellectual property rights of any third party. 6.3 In the event that Apple receives any notice or claim from any End-User that: (i) the End-User wishes to cancel its license to any of the Licensed Applications within ninety (90) days of the date of download of that Licensed Application by that End-User or the end of the auto-renewing subscription period offered pursuant to section 3.8, if such period is less than ninety (90) days; or (ii) a Licensed Application fails to conform to Your specifications or Your product warranty or the requirements of any applicable law, Apple may refund to the End-User the full amount of the price paid by the End-User for that Licensed Application. In the event that Apple refunds any such price to an End-User, You shall reimburse, or grant Apple a credit for, an amount equal to the price for that Licensed Application. In the event that Apple receives any notice or claim from a payment provider that an End-User has obtained a refund for a Licensed Application, You shall reimburse, or grant Apple a credit for, an amount equal to the price for that Licensed Application.

  • Quality Assurance Requirements There are no special Quality Assurance requirements under this Agreement.

  • Quality Agreement Concurrently with execution of this Agreement, the Parties will enter into an agreement that details the quality assurance obligations of each Party with respect to the Manufacture and supply of Supplied Products under this Agreement (the “Quality Agreement”). Each Party shall perform its obligations under the Quality Agreement in accordance with the terms and conditions thereof. In the event of a conflict between the terms of the Quality Agreement and the terms of this Agreement, the provisions of the Quality Agreement shall govern.

  • Quality Specifications SANMINA-SCI shall comply with the quality specifications set forth in its Quality Manual, incorporated by reference herein, a copy of which is available from SANMINA-SCI upon request.

  • Confidentiality and Data Protection We are a data controller for the information you provide to us including individual, identification and financial details, policy history and special category data (such as medical or criminal history). Details of our legal basis for processing your information, along with details of any third party recipient whom it may be necessary to share your personal data with in order to fulfil the contract, retention period for data held, security of your data, your rights under the UK General Data Protection Regulations (UK GDPR) including the right to complain can be found in our full ‘Privacy Notice’ attached to these terms of business and/or on our website at xxx.xxxxxxxxxxxxxxxx.xx.xx.

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