Quality Assessment and Monitoring Activities Sample Clauses

Quality Assessment and Monitoring Activities. SCDHHS is responsible for monitoring the Contractor’s performance to assure the Contractor is in compliance with the Contract provisions and the Policy and Procedure Guide. SCDHHS or its designee, shall coordinate with the Contractor to establish the scope of review, the review site, relevant time frames for obtaining information, and the criteria for review. SCDHHS or its designee, will at least annually monitor the operation of the Contractor for compliance with the provisions of this Contract, the Policy and Procedure Guide, and applicable federal and state laws and regulations. Inspection shall include the Contractor's facilities, as well as auditing and/or review of all records developed under this Contract including periodic medical audits, grievances, enrollments, disenrollments, termination, utilization and financial records, review of the management systems and procedures developed under this Contract and any other areas or materials relevant or pertaining to this Contract. The Contractor shall have the right to review any of the findings and recommendations resulting from contract monitoring and audits. However, once SCDHHS finalizes the results of monitoring and/or audit report, the Contractor must comply with all recommendations resulting from the review. Failure to comply with recommendations for improvement may result in liquidated damages, sanctions and/or enrollment restrictions. 12.7.1 Fee-for-Service Reporting to MCOs
Sample 1
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Quality Assessment and Monitoring Activities. SCDHHS is responsible for monitoring the Contractor’s performance to assure the Contractor is in compliance with the Contract provisions and the MCO Policy and Procedure Guide. . SCDHHS or its designee, shall coordinate with the Contractor to establish the scope of review, the review site, relevant time frames for obtaining information, and the criteria for review. SCDHHS or its designee, will at least annually monitor the operation of the Contractor for compliance with the provisions of this Contract, the MCO Policy and Procedure Guide, and applicable federal and state laws and regulations. Inspection shall include the Contractor's facilities, as well as auditing and/or review of all records developed under this Contract including periodic medical audits, grievances, enrollments, disenrollments, termination, utilization and financial records, review of the management systems and procedures developed under this Contract and any other areas or materials relevant or pertaining to this Contract. The Contractor shall have the right to review any of the findings and recommendations resulting from contract monitoring and audits. However, once SCDHHS finalizes the results of monitoring and/or audit report, the Contractor must comply with all recommendations resulting from the review. Failure to comply with recommendations for improvement may result in liquidated damages, sanctions and/or enrollment restrictions.
Sample 1
Quality Assessment and Monitoring Activities. 61 12.7.1 Fee-for-Service Reporting to MCOs 61 12.7.2 Request for Plan of Correction 61 12.7.3 External Quality Review 62 12.8 Marketing 62 12.9 Grievance/Appeals 62 12.10 Training 62 12.11 Federal Fund Restrictions 62 13 TERMS AND CONDITIONS 62 13.1 Applicable Laws and Regulations 63 13.2 Termination 64 13.2.1 Termination Under Mutual Agreement 64 13.2.2 Termination by SCDHHS for Breach 64 13.2.3 Termination for Unavailability of Funds 65 13.2.4 Termination for Contractor Insolvency, Bankruptcy, Instability of Funds 65 13.2.5 Termination for Convenience 65 13.2.6 Termination by the Contractor 65 13.2.7 Termination for Loss of Licensure or Certification 66 13.2.8 Termination for Noncompliance with the Drug Free Workplace Act 66 13.2.9 Termination for Cause 66 13.2.10Termination Procedures 67 13.2.11Effect of Termination on the Contractor's HIPAA Privacy Requirements 70 13.3 Liquidated Damages for Failure to Meet Contract Requirements 71 13.4 Use of Data 73 13.5 Sanctions 73 13.6 Non-Renewal 75
Sample 1
Quality Assessment and Monitoring Activities. 99 12.7.1 Fee-for-Service Reporting to CCNs 100 12.7.2 Request for Corrective Action Plan 100 12.7.3 External Quality Review 100 12.8 Marketing 100 12.9 Grievances 101 12.10 Training 101 12.11 Federal Fund Restrictions 101 12.12 Emergency Services 101 13.1 Administrative Actions 102 13.2 Corrective Action Plan 102 13.3 Sanctions. 102 13.3.1 Table of Monetary Penalties 102 13.3.2 Monetary Penalties 103 13.3.2.1 Key Personnel 103 13.3.2.2 Member Services Activities 104 13.3.2.3 Provider Services Activies 104 13.3.2.4 Timely Deliverables and Reports 105 Deliverable and Date Due Table 106 13.3.2.5 Emergency Management Plan Submission 107 13.3.2.6 Additional Monetary Penalties 107 13.3.3 Intermediate Sanctions 108 13.3.4 Violations Subject to Intermediate Sanctions 111 13.3.5 Termination for Cause 112 13.3.5.1 Issuance of Notice of Termination 112 13.3.5.2 Termination due to Serious Threat to Health of Members 113 13.3.5.3 Payment of Outstanding Monies or Collections from CCN 113 13.3.5.4 Termination for CCN Insolvency, Bankruptcy, Instability of Funds 113 13.3.5.5 Termination for Ownership Violations 114
Sample 1
Quality Assessment and Monitoring Activities. SCDHHS is responsible for monitoring the Contractor’s performance to assure the Contractor is in compliance with the Contract provisions and the MCO Policy and Procedure Guide. SCDHHS or its designee shall coordinate with the Contractor to establish the scope of review, the review site, relevant time frames for obtaining information, and the criteria for review. SCDHHS or its designee will at least annually monitor the operation of the Contractor for compliance with the provisions of this Contract, the MCO Policy and Procedure Guide, and applicable federal and state laws and regulations.
Sample 1
Quality Assessment and Monitoring Activities. The Department is responsible for monitoring the Contractor’s performance to assure the Contractor is in compliance with this Contract provisions and the MCO Policy and Procedure Guide. The Department, or its designee, shall coordinate with the Contractor to establish the scope of review, the review site, relevant time frames for obtaining information, and the criteria for review. On at least an annual basis, the Department, or its designee, shall inspect the Contractor's facilities, as well as auditing and/or review of all records developed under this Contract including periodic medical audits, Grievances, enrollments, disenrollments, termination, utilization and all financial records, review of the management systems and procedures developed under this Contract and any other areas or materials relevant or pertaining to this Contract. The Contractor shall have the right to review any of the findings and recommendations resulting from such contract monitoring and audits. However, once the Department finalizes the results of monitoring and/or auditing, the Contractor must comply with all recommendations resulting from the review. Failure to comply with recommendations for improvement may result in liquidated damages, sanctions, enrollment restriction, marketing restrictions, change in the assignment algorithm, or termination of this Contract. 12.6.1 Fee-for-Service Reporting to MCOs To facilitate the treatment of Medicaid MCO Members the Department will be responsible for providing the Contractor with a recent retrospective fee-for-service history on all of the Contractor’s then current Medicaid MCO Members, if available. This history will contain a maximum of twenty-four (24) months from the month the Medicaid MCO Member was determined to be an Eligible.
Sample 1

Related to Quality Assessment and Monitoring Activities

  • Evaluation, Testing, and Monitoring 1. The System Agency may review, test, evaluate and monitor Grantee’s Products and services, as well as associated documentation and technical support for compliance with the Accessibility Standards. Review, testing, evaluation and monitoring may be conducted before and after the award of a contract. Testing and monitoring may include user acceptance testing. Neither the review, testing (including acceptance testing), evaluation or monitoring of any Product or service, nor the absence of review, testing, evaluation or monitoring, will result in a waiver of the State’s right to contest the Grantee’s assertion of compliance with the Accessibility Standards. 2. Grantee agrees to cooperate fully and provide the System Agency and its representatives timely access to Products, records, and other items and information needed to conduct such review, evaluation, testing, and monitoring.

  • Project Monitoring Reporting and Evaluation The Recipient shall furnish to the Association each Project Report not later than forty-five (45) days after the end of each calendar semester, covering the calendar semester.

  • ANALYSIS AND MONITORING The Custodian shall (a) provide the Fund (or its duly-authorized investment manager or investment adviser) with an analysis of the custody risks associated with maintaining assets with the Eligible Securities Depositories set forth on Schedule B hereto in accordance with section (a)(1)(i)(A) of Rule 17f-7, and (b) monitor such risks on a continuing basis, and promptly notify the Fund (or its duly-authorized investment manager or investment adviser) of any material change in such risks, in accordance with section (a)(1)(i)(B) of Rule 17f-7.

  • 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.

  • Information Systems Acquisition Development and Maintenance a. Client Data – Client Data will only be used by State Street for the purposes specified in this Agreement.

  • Commercial Operation Date Testing and Modifications Prior to the Commercial Operation Date, the Connecting Transmission Owner shall test the Connecting Transmission Owner’s Attachment Facilities and System Upgrade Facilities and System Deliverability Upgrades and Developer shall test the Large Generating Facility and the Developer Attachment Facilities to ensure their safe and reliable operation. Similar testing may be required after initial operation. Developer and Connecting Transmission Owner shall each make any modifications to its facilities that are found to be necessary as a result of such testing. Developer shall bear the cost of all such testing and modifications. Developer shall generate test energy at the Large Generating Facility only if it has arranged for the injection of such test energy in accordance with NYISO procedures.

  • Search, Enquiry, Investigation, Examination And Verification a. The Property is sold on an “as is where is basis” subject to all the necessary inspection, search (including but not limited to the status of title), enquiry (including but not limited to the terms of consent to transfer and/or assignment and outstanding charges), investigation, examination and verification of which the Purchaser is already advised to conduct prior to the auction and which the Purchaser warrants to the Assignee has been conducted by the Purchaser’s independent legal advisors at the time of execution of the Memorandum. b. The intending bidder or the Purchaser is responsible at own costs and expenses to make and shall be deemed to have carried out own search, enquiry, investigation, examination and verification on all liabilities and encumbrances affecting the Property, the title particulars as well as the accuracy and correctness of the particulars and information provided. c. The Purchaser shall be deemed to purchase the Property in all respects subject thereto and shall also be deemed to have full knowledge of the state and condition of the Property regardless of whether or not the said search, enquiry, investigation, examination and verification have been conducted. d. The Purchaser shall be deemed to have read, understood and accepted these Conditions of Sale prior to the auction and to have knowledge of all matters which would have been disclosed thereby and the Purchaser expressly warrants to the Assignee that the Purchaser has sought independent legal advice on all matters pertaining to this sale and has been advised by his/her/its independent legal advisor of the effect of all the Conditions of Sale. e. Neither the Assignee nor the Auctioneer shall be required or bound to inform the Purchaser of any such matters whether known to them or not and the Purchaser shall raise no enquiry, requisition or objection thereon or thereto.

  • Monitoring Services IDT staff shall, using methods that include face-to-face and other contacts with the member, monitor the services a member receives. This monitoring shall ensure that: a. The member receives the services and supports authorized, arranged for and coordinated by the IDT staff; b. The services and supports identified in the MCP as being provided by natural and community supports are being provided; and c. The quality of the services and supports received is adequate and still necessary to continue to meet the needs and preferences of the member and support the member’s outcomes identified in the MCP.

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

  • Office of Inspector General Investigative Findings Expert Review In accordance with Senate Bill 799, Acts 2021, 87th Leg., R.S., if Texas Government Code, Section 531.102(m-1)(2) is applicable to this Contract, Contractor affirms that it possesses the necessary occupational licenses and experience.

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