Reconsideration Review Process Sample Clauses

Reconsideration Review Process. (1) Unless CMS has issued a revised Reconciliation Report pursuant to Article 7.3(b)(4), the Participant may request a reconsideration review of the CMS Calculation Error Response issued pursuant to Article 7.3(b)(2) by a designee of CMS who is authorized to receive such requests and did not participate in the determination that is the subject of the reconsideration request (“Reconsideration (2) Within 15 Days of receiving the Participant’s reconsideration review request, the Reconsideration Official will acknowledge the request and notify the Parties of the issues in dispute, the review procedures, and the procedures (including the format and deadlines) for submission of documentation (the “Scheduling Notice”). (3) The Reconsideration Official will make reasonable efforts to review the reconsideration review request and documentation submitted in accordance with the Scheduling Notice no later than 30 Days after such documents are received and will make reasonable efforts to issue a written determination within 30 Days of this review. This determination will be deemed to be final on the date the determination is issued by the Reconsideration Official. (4) The Participant shall proceed diligently with performance of this Agreement, pending final resolution of any dispute arising under the Agreement unless and until this Agreement expires or is terminated pursuant to Article 21. Neither the Calculation Error Notice process under Article 7.3(b), nor the reconsideration review process under this Article 7.3(c), shall be construed to negate, diminish, or otherwise alter the applicability of existing laws, rules, or determinations made by other Federal Government agencies.
Sample 1
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Reconsideration Review Process. (1) Unless CMS has issued a revised Post-Episode Spending Calculation Report correcting the error pursuant to Article 7.4(b)(4), the Participant may request a reconsideration review of the CMS Post-Episode Spending Calculation Error Response provided pursuant to Article 7.4(b)(2) by a designee of CMS who is authorized to receive such requests and did not participate in the determination that is the subject of the reconsideration request (“Reconsideration Official”). The reconsideration review request must be submitted within 10 Days from the issue date of the CMS Post-Episode Spending Calculation Error Response, in a form and manner and to an individual or office specified by CMS. The reconsideration review request must provide a detailed explanation of the basis for the dispute and include supporting documentation for the Participant’s assertion that CMS or its representatives did not accurately calculate the Excess Spending Amount in accordance with this Agreement. (2) Within 15 Days of receiving the Participant’s reconsideration review request pursuant to Article 7.4(c)(1), the Reconsideration Official will acknowledge the request and notify the Parties of the issues in dispute, the review procedures, and the procedures (including the format and deadlines) for submission of documentation (the “Scheduling Notice”). (3) The Reconsideration Official will make reasonable efforts to review the reconsideration review request and documentation submitted in accordance with the procedures specified in the Scheduling Notice no later than 30 Days after such documents are received, and will make reasonable efforts to issue a written determination within 30 Days of this review. This determination will be deemed to be final on the date the determination is issued by the Reconsideration Official. (4) The Participant shall proceed diligently with performance of this Agreement, pending final resolution of any dispute arising under the Agreement unless and until this Agreement expires or is terminated pursuant to Article 21. Neither the Calculation Error Notice process under Article 7.4(b) nor the reconsideration review process under this Article 7.4(c) shall not be construed to negate, diminish, or otherwise alter the applicability of existing laws, rules, and regulations or determinations made by other Federal Government agencies.
Sample 1

Related to Reconsideration Review Process

  • Review Process A/E's Work Product will be reviewed by County under its applicable technical requirements and procedures, as follows:

  • Claims Review Population A description of the Population subject to the Claims Review.

  • Review Procedure If the Plan Administrator denies part or all of the claim, the claimant shall have the opportunity for a full and fair review by the Plan Administrator of the denial, as follows:

  • Transition Review Period In accordance with Article 35, Layoff and Recall, the Employer may require an employee to complete a transition review period.

  • Claims Review The IRO shall perform the Claims Review annually to cover each of the five Reporting Periods. The IRO shall perform all components of each Claims Review.

  • Completion of Review for Certain Review Receivables Following the delivery of the list of the Review Receivables and before the delivery of the Review Report by the Asset Representations Reviewer, the Servicer may notify the Asset Representations Reviewer if a Review Receivable is paid in full by the Obligor or purchased from the Issuer in accordance with the terms of the Basic Documents. On receipt of such notice, the Asset Representations Reviewer will immediately terminate all Tests of the related Review Receivable, and the Review of such Review Receivables will be considered complete (a “Test Complete”). In this case, the related Review Report will indicate a Test Complete for such Review Receivable and the related reason.

  • Review Protocol A narrative description of how the Claims Review was conducted and what was evaluated.

  • Claims Review Methodology ‌‌ a. C laims Review Population. A description of the Population subject‌‌ to the Quarterly Claims Review.

  • Claims Review Report The IRO shall prepare a Claims Review Report as described in this Appendix for each Claims Review performed. The following information shall be included in the Claims Review Report for each Discovery Sample and Full Sample (if applicable).

  • AUDIT REVIEW PROCEDURES Any dispute concerning a question of fact arising under an interim or post audit of this AGREEMENT that is not disposed of by agreement, shall be reviewed by ALAMEDA CTC’s Deputy Executive Director of Finance and Administration. Not later than thirty (30) calendar days after issuance of the final audit report, CONSULTANT may request a review by ALAMEDA CTC’s Deputy Executive Director of Finance and Administration of unresolved audit issues. The request for review will be submitted in writing. Neither the pendency of a dispute nor its consideration by ALAMEDA CTC will excuse CONSULTANT from full and timely performance, in accordance with the terms of this AGREEMENT. CONSULTANT and subconsultants’ contracts, including cost proposals and ICRs, may be subject to audits or reviews such as, but not limited to, an AGREEMENT Audit, an Incurred Cost Audit, an ICR Audit, or a certified public accountant (“CPA”) ICR Audit Workpaper Review. If selected for audit or review, the AGREEMENT, cost proposal and ICR and related workpapers, if applicable, will be reviewed to verify compliance with 48 CFR, Chapter 1, Part 31 and other related laws and regulations. In the instances of a CPA ICR Audit Workpaper Review it is CONSULTANT’s responsibility to ensure federal, state, or local government officials are allowed full access to the CPA’s workpapers including making copies as necessary. The AGREEMENT, cost proposal, and ICR shall be adjusted by CONSULTANT and approved by ALAMEDA CTC to conform to the audit or review recommendations. CONSULTANT agrees that individual terms of costs identified in the audit report shall be incorporated into the contract by this reference if directed by ALAMEDA CTC at its sole discretion. Refusal by CONSULTANT to incorporate audit or review recommendations, or to ensure that the federal, state, or local governments have access to CPA workpapers, will be considered a breach of contract terms and cause for termination of the AGREEMENT and disallowance of prior reimbursed costs.

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