Common use of Remedies for Partial Breach Clause in Contracts

Remedies for Partial Breach. If the STATE determines that the MCO failed to cure the breach within the time period specified in section 5.4.2, the STATE may enforce one or more of the following remedies, which shall be consistent with the factors specified in section 5.4.1:‌ (A) Withhold Medical Assistance capitation premiums or a portion thereof until such time as the partial breach is corrected to the satisfaction of the STATE. (B) Monetary payments from the MCO to the STATE in the amount of up to one thousand dollars ($1,000) per day, offset against payments due the MCO by the STATE, until such time as the problem is corrected to the satisfaction of the STATE. (C) Monetary payments from the MCO to the STATE in the amount of up to one thousand dollars ($1,000) per day, offset against Capitation Payments, from the time the notification by the MCO should have occurred or the time the correction should have been made until the time when notification by the MCO is actually made or the correction is made. This paragraph allows the STATE to enforce a remedy against the MCO for actions that have been corrected prior to coming to the attention of the STATE. (D) Not offer the MCO as an enrollment choice for Recipients in the affected county until thirty (30) days after the Local Agency receives the required Marketing and enrollment materials. (E) If the MCO does not comply with the Marketing requirements specified in section

Remedies for Partial Breach. If the STATE determines that the MCO failed to cure the breach within the time period specified in section 5.4.2, the STATE may enforce one or more of the following remedies, which shall be consistent with the factors specified in at section 5.4.1:‌5.4.1: (A) Withhold Medical Assistance capitation premiums or a portion thereof until such time as the partial breach is corrected to the satisfaction of the STATE. (B) Monetary payments from the MCO to the STATE in the amount of up to one thousand dollars One Thousand Dollars ($1,000) per day, offset against payments due the MCO by the STATE, until such time as the problem is corrected to the satisfaction of the STATE. (C) Monetary payments from the MCO to the STATE in the amount of up to one thousand dollars ($1,000) per day, offset against Capitation Payments, from the time the notification by the MCO should have occurred or the time the correction should have been made until the time when notification by the MCO is actually made or the correction is made. This paragraph allows the STATE to enforce a remedy against the MCO for actions that have been corrected prior to coming to the attention of the STATE. (D) Not offer the MCO as an enrollment choice for Recipients in the affected county until thirty (30) days after the Local Agency or the STATE receives the required Marketing and enrollment materialsMaterials. (E) If Provide to the MCO does STATE and CMS or designated CMS evaluator, data abstracted from medical records comparable to the data that would have been available from encounter reporting required in this Contract, if encounter data is not comply submitted pursuant to section 3.5.1 of this Contract. (F) Payments provided for under the contract will be denied for new Enrollees when, and for so long as, payment for those Enrollees is denied by CMS in accordance with the Marketing requirements specified in section42 CFR § 438.730.