Reporting and Disclosure; Submission of Encounter and Other Data. Upon request by Company, Provider shall certify, and cause its Downstream Entities to certify, that any data and other information submitted to Company are accurate, complete and truthful based on best knowledge, information and belief. Provider shall provide reasonable cooperation and assistance with Company’s requests for information and shall promptly submit encounter data, medical records and such other information as requested by Company to allow Company to respond in a timely manner to any data validation audits or requests for information by CMS, and to monitor and audit the obligation of Provider and Downstream Entities to provide accurate, complete and truthful data and other information. This paragraph 5 shall survive termination of the Agreement, regardless of the cause giving rise to termination.
Reporting and Disclosure; Submission of Encounter and Other Data a. As applicable, Provider shall submit (and require Practice Providers and Suppliers to submit) encounter data with respect to Provider’s and Practice Provider’s participation under this Agreement, medical records, and such other information and data as DCE may reasonably request, including, without limitation and as applicable, as may be required in connection with DCE’s reporting and other obligations under the CMS Agreement, including, but not limited to (a) actual or suspected fraud, waste and abuse or non-compliance with Applicable Requirements by Provider, Practice Provider, a Supplier or others; or (b) responses to CMS requests for information and/or surveys. Such information shall be submitted by Provider and its Practice Providers and Suppliers in compliance with Applicable Requirements.
Reporting and Disclosure; Submission of Encounter and Other Data. Downstream Entity shall cooperate and assist with Medicare Plan Entity’s requests for information and promptly submit such other information and data held by it as may be reasonably requested by the Medicare Plan Entity for: MA Program administration; Medicare Plan Entity’s compliance with its reporting requirements; Medicare Plan Entity’s utilization review/quality improvement or grievance programs; or Medicare Plan Entity’s response to requests or requirements for information and/or surveys by HHS, CMS, the Comptroller General or their designees. Such information shall be submitted by Downstream Entity in compliance with Applicable Laws.
Reporting and Disclosure; Submission of Encounter and Other Data. Upon request by Aetna, Upline shall certify, and cause its Downstream Entities to certify, that any data and other information submitted to Aetna are accurate, complete and truthful based on best knowledge, information and belief. Upline shall provide reasonable cooperation and assistance with Aetna’s requests for information and shall promptly submit encounter data, medical records and such other information as requested by Aetna to allow Aetna to respond in a timely manner to any data validation audits or requests for information by CMS, and to monitor and audit the obligation of Upline and Downstream Entities to provide accurate, complete and truthful data and other information. This paragraph 5 shall survive termination of the Agreement, regardless of the cause giving rise to termination.
Reporting and Disclosure; Submission of Encounter and Other Data a. Practice and Participating Physicians shall promptly submit (and Practice shall require Providers to submit) to EIP, or to CMS as directed by EIP, encounter data with respect to Practice’s, the Participating Providers’ and the Providers’ participation under this Agreement and such other information required to be submitted in connection with EIP’s reporting obligations under the Model 4 Agreement. Such data and information includes, but is not limited to, data relating to the nature, outcome, quality of and payment for healthcare provided by Participating Physicians and other Providers. Such data and information shall be submitted by Practice and the Participating Physicians in compliance with the Applicable Requirements.
Reporting and Disclosure; Submission of Encounter and Other Data a. Practice and Participating Physicians shall promptly submit (and Practice shall require Providers to submit) to ACO, or to CMS as directed by ACO, encounter data with respect to Practice’s, the Participating Providers’ and the Providers’ participation under this Agreement and such other information required to be submitted in connection with ACO’s reporting obligations under the MSSP Agreement. Such data and information includes, but is not limited to, data relating to the nature, outcome, quality of and payment for healthcare provided by Providers and other Network providers. Such data and information shall be submitted by Practice and its Providers in compliance with the Applicable Requirements.
Reporting and Disclosure; Submission of Encounter and Other Data. As applicable, Participant shall submit (and require Practice Providers and Suppliers to submit) encounter data with respect to Provider’s and Practice Provider’s participation under this Agreement, medical records, and such other information and data as ACO may reasonably request, including, without limitation and as applicable, as may be required in connection with ACO’s reporting and other obligations under the MSSP Agreement, including, but not limited to (a) actual or suspected fraud, waste and abuse or non-compliance with Applicable Requirements by Participant, Practice Provider, a Supplier or others; or (b) responses to CMS requests for information and/or surveys. Such information shall be submitted by Participant and its Practice Providers and Suppliers in compliance with Applicable Requirements. Practice Providers and Suppliers shall cooperate and assist with, ACO’s requests for information and shall promptly submit encounter data, medical records and such other information as requested by ACO to allow ACO to respond in a timely manner to any data validation audits or requests for information by CMS, and to monitor and audit the obligation of Participant, Practice Providers, and Suppliers to provide accurate, complete and truthful data and other information in accordance with Applicable Requirements. This Section 12 shall survive termination of this Agreement, regardless of the cause giving rise to termination.
Reporting and Disclosure; Submission of Encounter and Other Data. Upon request by Aetna, Upline shall certify, and cause its Downstream Entities to certify, that any data and other information submitted to Aetna are accurate, complete and truthful based on best knowledge, information and belief. Upline shall provide reasonable cooperation and assistance with Aetna’s requests for information and shall promptly submit encounter data, medical records and such other information as requested by Aetna to allow Aetna to respond in a timely manner to any data validation audits or requests for information by CMS, and to monitor and audit the obligation of Upline and Downstream Entities to provide accurate, complete and truthful data and other information. Upline agrees to immediately notify Aetna if any encounter data that Upline submitted to Aetna is inaccurate, incomplete or erroneous, and cooperate with Aetna to correct erroneous encounter data to ensure Aetna’s compliance with Medicare laws, rules and regulations and CMS instructions. This paragraph 6 shall survive termination of the Agreement, regardless of the cause giving rise to termination
Reporting and Disclosure; Submission of Encounter and Other Data a. As applicable, Provider shall submit (and cause contractually require its Subcontractors to submit) encounter data with respect to Provider’s participation under this Agreement, medical records, and such other information and data as ACO and HFN may reasonably request, including, without limitation and as applicable, as may be required in connection with ACO’s reporting and other obligations under the MSSP Agreement, including, but not limited to (a) actual or suspected fraud, waste and abuse or non-compliance with Applicable Requirements by Provider, a Subcontractor or others; or (b) responses to CMS requests for information and/or surveys. Such information shall be submitted by Provider and its Subcontractors in compliance with Applicable Requirements.
Reporting and Disclosure; Submission of Encounter and Other Data a. The Participant shall promptly submit to the ACO, or to CMS as directed by the ACO, encounter data with respect to the Participating Provider’s participation under this Agreement and such other information required to be submitted in connection with the ACO’s reporting obligations under the MSSP Agreement. Such data and information includes, but is not limited to, data relating to the nature, outcome, quality of and payment for healthcare provided by Participating Providers and other Network providers and suppliers. Such data and information shall be submitted by the Participating Providers in compliance with the Applicable Requirements.
