Common use of Reporting Transactions with Parties of Interest Clause in Contracts

Reporting Transactions with Parties of Interest. Any Contractor that is not a federally qualified HMO (as defined in Section 1310 of the Public Health Service Act) shall disclose to OMPP information on certain types of transactions they have with a “party in interest,” as defined in the Public Health Service Act. (See §§1903(m)(2)(A)(viii) and 1903(m)(4) of the Social Security Act.) For purposes of this Scope of Work, the following reporting requirements will apply to all Contractors in the same manner that they apply to federally qualified HMOs under the Public Health Service Act.  Any director, officer, partner or employee responsible for management or administration of an HMO; any person who is directly or indirectly the beneficial owner of more than five percent (5%) of the equity of the HMO; any person who is the beneficial owner of a mortgage, deed of trust, note or other interest secured by, and valuing more than five percent (5%) of the HMO; and, in the case of an HMO organized as a nonprofit corporation, an incorporator or member of such corporation under applicable state corporation law;  Any entity in which a person described in the paragraph above is director or officer; is a partner; has directly or indirectly a beneficial interest of more than five percent (5%) of the equity of the HMO; or has a mortgage, deed of trust, note or other interest valuing more than five percent (5%) of the assets of the HMO;  Any person directly or indirectly controlling, controlled by or under common control with a HMO; and  Any spouse, child or parent of an individual described above.  Any sale, exchange or lease of any property between the HMO and a party in interest;  Any lending of money or other extension of credit between the HMO and a party in interest; and  Any furnishing for consideration of goods, services (including management services) or facilities between the HMO and the party in interest. This does not include salaries paid to employees for services provided in the normal course of their employment. The information which must be disclosed in the transactions between the Contractor and a party in interest listed above includes:  The name of the party in interest for each transaction;  A description of each transaction and the quantity or units involved;  The accrued dollar value of each transaction during the fiscal year; and  Justification of the reasonableness of each transaction. In addition to the above information on business transactions, the Contractor may be required to submit a consolidated financial statement for the Contractor and the party in interest. If the Contract is an initial contract with FSSA, but the Contractor has operated previously in commercial or Medicare markets, information on business transactions for the entire year preceding the initial contract period shall be disclosed. If the Contract is being renewed or extended, the Contractor shall disclose information on business transactions which occurred during the prior contract period. The business transactions which shall be reported are not limited to transactions related to serving the Medicaid enrollment, that is, all of the Contractor's business transactions shall be reported.

Reporting Transactions with Parties of Interest. Any Contractor that is not a federally qualified HMO (as defined in Section 1310 of the Public Health Service Act) shall disclose to OMPP FSSA and, upon request, to certain federal agencies as described in the regulation, information on certain types of transactions they have with a “party in interest,” as defined in the Public Health Service Act. (See §§1903(m)(2)(A)(viii) and 1903(m)(4) of the Social Security Act.) For purposes of this Scope of Work, the following reporting requirements will apply to all Contractors in the same manner that they apply to federally qualified HMOs under the Public Health Service Act.  ▪ Any director, officer, partner or employee responsible for management or administration of an HMO; any person who is directly or indirectly the beneficial owner of more than five percent (5%) of the equity of the HMO; any person who is the beneficial owner of a mortgage, deed of trust, note or other interest secured by, and valuing more than five percent (5%) of the HMO; and, in the case of an HMO organized as a nonprofit corporation, an incorporator or member of such corporation under applicable state corporation law;  ▪ Any entity in which a person described in the paragraph above is director or officer; is a partner; has directly or indirectly a beneficial interest of more than five percent (5%) of the equity of the HMO; or has a mortgage, deed of trust, note or other interest valuing more than five percent (5%) of the assets of the HMO;  ▪ Any person directly or indirectly controlling, controlled by or under common control with a an HMO; and  ▪ Any spouse, child or parent of an individual described above.  Types of Transactions Which Shall Be Disclosed – Business transactions which shall be disclosed includes: ▪ Any sale, exchange or lease of any property between the HMO and a party in interest;  ▪ Any lending of money or other extension of credit between the HMO and a party in interest; and  ▪ Any furnishing for consideration of goods, services (including management services) or facilities between the HMO and the party in interest. This does not include salaries paid to employees for services provided in the normal course of their employment. The information which must be disclosed in the transactions between the Contractor and a party in interest listed above includes:  ▪ The name of the party in interest for each transaction;  ▪ A description of each transaction and the quantity or units involved;  ▪ The accrued dollar value of each transaction during the fiscal year; and  ▪ Justification of the reasonableness of each transaction. In addition to the above information on business transactions, the Contractor may be required to submit a consolidated financial statement for the Contractor and the party in interest. Per section 1903(m)(4)(B) of the Social Security Act, any reports of transactions between the Contractor and parties in interest that are provided to the State or other agencies shall be made available to the Contractor’s members upon reasonable request. If the Contract is an initial contract with FSSA, but the Contractor has operated previously in commercial or Medicare markets, information on business transactions for the entire year preceding the initial contract period shall be disclosed. If the Contract is being renewed or extended, the Contractor shall disclose information on business transactions which occurred during the prior contract period. The business transactions which shall be reported are not limited to transactions related to serving the Medicaid enrollment, that is, all of the Contractor's business transactions shall be reported.

Reporting Transactions with Parties of Interest. Any Contractor that is not a federally qualified HMO (as defined in Section 1310 of the Public Health Service Act) shall disclose to OMPP information on certain types of transactions they have with a “party in interest,” as defined in the Public Health Service Act. (See §§1903(m)(2)(A)(viii) and 1903(m)(4) of the Social Security Act.) For purposes of this Scope of Work, the following reporting requirements will apply to all Contractors in the same manner that they apply to federally qualified HMOs under the Public Health Service Act.  ▪ Any director, officer, partner or employee responsible for management or administration of an HMO; any person who is directly or indirectly the beneficial owner of more than five percent (5%) of the equity of the HMO; any person who is the beneficial owner of a mortgage, deed of trust, note or other interest secured by, and valuing more than five percent (5%) of the HMO; and, in the case of an HMO organized as a nonprofit corporation, an incorporator or member of such corporation under applicable state corporation law;  ▪ Any entity in which a person described in the paragraph above is director or officer; is a partner; has directly or indirectly a beneficial interest of more than five percent (5%) of the equity of the HMO; or has a mortgage, deed of trust, note or other interest valuing more than five percent (5%) of the assets of the HMO;  ▪ Any person directly or indirectly controlling, controlled by or under common control with a HMO; and  ▪ Any spouse, child or parent of an individual described above.  ▪ Any sale, exchange or lease of any property between the HMO and a party in interest;  ▪ Any lending of money or other extension of credit between the HMO and a party in interest; and  ▪ Any furnishing for consideration of goods, services (including management services) or facilities between the HMO and the party in interest. This does not include salaries paid to employees for services provided in the normal course of their employment. The information which must be disclosed in the transactions between the Contractor and a party in interest listed above includes:  ▪ The name of the party in interest for each transaction;  ▪ A description of each transaction and the quantity or units involved;  ▪ The accrued dollar value of each transaction during the fiscal year; and  ▪ Justification of the reasonableness of each transaction. In addition to the above information on business transactions, the Contractor may be required to submit a consolidated financial statement for the Contractor and the party in interest. If the Contract is an initial contract with FSSA, but the Contractor has operated previously in commercial or Medicare markets, information on business transactions for the entire year preceding the initial contract period shall be disclosed. If the Contract is being renewed or extended, the Contractor shall disclose information on business transactions which occurred during the prior contract period. The business transactions which shall be reported are not limited to transactions related to serving the Medicaid enrollment, that is, all of the Contractor's business transactions shall be reported.

Reporting Transactions with Parties of Interest. Any Contractor that is not a federally qualified HMO (as defined in Section 1310 of the Public Health Service Act) shall disclose to OMPP information on certain types of transactions they have with a “party in interest,” as defined in the Public Health Service Act. (See §§1903(m)(2)(A)(viii) and 1903(m)(4) of the Social Security Act.) For purposes of this Scope of Work, the following reporting requirements will apply to all Contractors in the same manner that they apply to federally qualified HMOs under the Public Health Service Act.  ▪ Any director, officer, partner or employee responsible for management or administration of an HMO; any person who is directly or indirectly the beneficial owner of more than five percent (5%) of the equity of the HMO; any person who is the beneficial owner of a mortgage, deed of trust, note or other interest secured by, and valuing more than five percent (5%) of the HMO; and, in the case of an HMO organized as a nonprofit corporation, an incorporator or member of such corporation under applicable state corporation law;  ▪ Any entity in which a person described in the paragraph above is director or officer; is a partner; has directly or indirectly a beneficial interest of more than five percent (5%) of the equity of the HMO; or has a mortgage, deed of trust, note or other interest valuing more than five percent (5%) of the assets of the HMO;  ▪ Any person directly or indirectly controlling, controlled by or under common control with a HMO; and  ▪ Any spouse, child or parent of an individual described above.  ▪ Any sale, exchange or lease of any property between the HMO and a party in interest;  ▪ Any lending of money or other extension of credit between the HMO and a party in interest; and  ▪ Any furnishing for consideration of goods, services (including management services) or facilities between the HMO and the party in interest. This does not include salaries paid to employees for services provided in the normal course of their employment. The information which must be disclosed in the transactions between the Contractor and a party in interest listed above includes:  The name of the party in interest for each transaction;  A description of each transaction and the quantity or units involved;  The accrued dollar value of each transaction during the fiscal year; and  Justification of the reasonableness of each transaction. In addition to the above information on business transactions, the Contractor may be required to submit a consolidated financial statement for the Contractor and the party in interest. If the Contract is an initial contract with FSSA, but the Contractor has operated previously in commercial or Medicare markets, information on business transactions for the entire year preceding the initial contract period shall be disclosed. If the Contract is being renewed or extended, the Contractor shall disclose information on business transactions which occurred during the prior contract period. The business transactions which shall be reported are not limited to transactions related to serving the Medicaid enrollment, that is, all of the Contractor's business transactions shall be reported.:

Reporting Transactions with Parties of Interest. Any Contractor that is not a federally qualified HMO (as defined in Section 1310 1310(d) of the Public Health Service Act) shall disclose to OMPP FSSA information on certain types of transactions they have with a “party in interest,” as defined in the Public Health Service Act. (See §§1903(m)(2)(A)(viii) and 1903(m)(4) of the Social Security Act.) For purposes of this Scope of Work, the following reporting requirements will apply to all Contractors in the same manner that they apply to federally qualified HMOs under the Public Health Service Act.  ▪ Any director, officer, partner or employee responsible for management or administration of an HMO; any person who is directly or indirectly the beneficial owner of more than five percent (5%) of the equity of the HMO; any person who is the beneficial owner of a mortgage, deed of trust, note or other interest secured by, and valuing more than five percent (5%) of the HMO; and, in the case of an HMO organized as a nonprofit corporation, an incorporator or member of such corporation under applicable state corporation law;  ▪ Any entity in which a person described in the paragraph above is a director or officer; is a partner; has directly or indirectly a beneficial interest of more than five percent (5%) of the equity of the HMO; or has a mortgage, deed of trust, note or other interest valuing more than five percent (5%) of the assets of the HMO;  ▪ Any person directly or indirectly controlling, controlled by or under common control with a an HMO; and  or ▪ Any spouse, child child, or parent of an individual described above.  ▪ Any sale, exchange exchange, or lease of any property between the HMO and a party in interest;  ▪ Any lending of money or other extension of credit between the HMO and a party in interest; and  ▪ Any furnishing for consideration of goods, services (including management services) or facilities between the HMO and the party in interest. This does not include salaries paid to employees for services provided in the normal course of their employment. The information which must be disclosed in the transactions between the Contractor and a party in interest listed above includes:  ▪ The name of the party in interest for each transaction;  ▪ A description of each transaction and the quantity or units involved;  ▪ The accrued dollar value of each transaction during the fiscal year; and  ▪ Justification of the reasonableness of each transaction. In addition to the above information on business transactions, the Contractor may be required to submit a consolidated financial statement for the Contractor and the party in interest. Per Section 1903(m)(4)(B) of the Social Security Act, any reports of transactions between the Contractor and parties in interest that are provided to the State, or other agencies shall be made available to the Contractor’s members upon reasonable request. If the Contract is an initial contract with FSSA, but the Contractor has operated previously in commercial or Medicare markets, information on business transactions for the entire year preceding the initial contract period shall be disclosed. If the Contract is being renewed or extended, the Contractor shall disclose information on business transactions which occurred during the prior contract period. The business transactions which shall be reported are not limited to transactions related to serving the Medicaid enrollment, that is, all of the Contractor's business transactions shall be reported.disclosed within thirty

Reporting Transactions with Parties of Interest. Any Contractor that is not a federally qualified HMO (as defined in Section 1310 of the Public Health Service Act) shall disclose to OMPP information on certain types of transactions they have with a “party in interest,” as defined in the Public Health Service Act. (See §§1903(m)(2)(A)(viii1903(m) (2) (A) (viii) and 1903(m)(41903(m) (4) of the Social Security Act.) For purposes of this Scope of Work, the following reporting requirements will apply to all Contractors in the same manner that they apply to federally qualified HMOs under the Public Health Service Act.  Any director, officer, partner or employee responsible for management or administration of an HMO; any person who is directly or indirectly the beneficial owner of more than five percent (5%) of the equity of the HMO; any person who is the beneficial owner of a mortgage, deed of trust, note or other interest secured by, and valuing more than five percent (5%) of the HMO; and, in the case of an HMO organized as a nonprofit corporation, an incorporator or member of such corporation under applicable state corporation law;  Any entity in which a person described in the paragraph above is director or officer; is a partner; has directly or indirectly a beneficial interest of more than five percent (5%) of the equity of the HMO; or has a mortgage, deed of trust, note or other interest valuing more than five percent (5%) of the assets of the HMO;  Any person directly or indirectly controlling, controlled by or under common control with a HMO; and  Any spouse, child or parent of an individual described above.  Any sale, exchange or lease of any property between the HMO and a party in interest;  Any lending of money or other extension of credit between the HMO and a party in interest; and  Any furnishing for consideration of goods, services (including management services) or facilities between the HMO and the party in interest. This does not include salaries paid to employees for services provided in the normal course of their employment. The information which must shall be disclosed in the transactions between the Contractor and a party in interest listed above includes:  The name of the party in interest for each transaction;  A description of each transaction and the quantity or units involved;  The accrued dollar value of each transaction during the fiscal year; and  Justification of the reasonableness of each transaction. In addition to the above information on business transactions, the Contractor may be required to submit a consolidated financial statement for the Contractor and the party in interest. If the Contract is an initial contract with FSSAOMPP, but the Contractor has operated previously in commercial or Medicare markets, information on business transactions for the entire year preceding the initial contract period shall be disclosed. If the Contract is being renewed or extended, the Contractor shall disclose information on business transactions which occurred during the prior contract period. The business transactions which shall be reported are not limited to transactions related to serving the Medicaid enrollment, that is, all of the Contractor's business transactions shall be reported.

Reporting Transactions with Parties of Interest. Any Contractor that is not a federally qualified HMO (as defined in Section 1310 of the Public Health Service Act) shall disclose to OMPP information on certain types of transactions they have with a “party in interest,” as defined in the Public Health Service Act. (See §§1903(m)(2)(A)(viii) and 1903(m)(4) of the Social Security Act.) For purposes of this Scope of Work, the following reporting requirements will apply to all Contractors in the same manner that they apply to federally qualified HMOs under the Public Health Service Act.   Any director, officer, partner or employee responsible for management or administration of an HMO; any person who is directly or indirectly the beneficial owner of more than five percent (5%) of the equity of the HMO; any person who is the beneficial owner of a mortgage, deed of trust, note or other interest secured by, and valuing more than five percent (5%) of the HMO; and, in the case of an HMO organized as a nonprofit corporation, an incorporator or member of such corporation under applicable state corporation law;   Any entity in which a person described in the paragraph above is director or officer; is a partner; has directly or indirectly a beneficial interest of more than five percent (5%) of the equity of the HMO; or has a mortgage, deed of trust, note or other interest valuing more than five percent (5%) of the assets of the HMO;   Any person directly or indirectly controlling, controlled by or under common control with a HMO; and   Any spouse, child or parent of an individual described above.   Any sale, exchange or lease of any property between the HMO and a party in interest;   Any lending of money or other extension of credit between the HMO and a party in interest; and   Any furnishing for consideration of goods, services (including management services) or facilities between the HMO and the party in interest. This does not include salaries paid to employees for services provided in the normal course of their employment. The information which must be disclosed in the transactions between the Contractor and a party in interest listed above includes:   The name of the party in interest for each transaction;   A description of each transaction and the quantity or units involved;   The accrued dollar value of each transaction during the fiscal year; and   Justification of the reasonableness of each transaction. In addition to the above information on business transactions, the Contractor may be required to submit a consolidated financial statement for the Contractor and the party in interest. If the Contract is an initial contract with FSSA, but the Contractor has operated previously in commercial or Medicare markets, information on business transactions for the entire year preceding the initial contract period shall be disclosed. If the Contract is being renewed or extended, the Contractor shall disclose information on business transactions which occurred during the prior contract period. The business transactions which shall be reported are not limited to transactions related to serving the Medicaid enrollment, that is, all of the Contractor's business transactions shall be reported.

Reporting Transactions with Parties of Interest. Any Contractor that is not a federally qualified HMO (as defined in Section 1310 of the Public Health Service Act) shall disclose to OMPP information on certain types of transactions they have with a “party in interest,” as defined in the Public Health Service Act. (See §§1903(m)(2)(A)(viii) and 1903(m)(4) of the Social Security Act.) For purposes of this Scope of Work, the following reporting requirements will apply to all Contractors in the same manner that they apply to federally qualified HMOs under the Public Health Service Act.  Any director, officer, partner or employee responsible for management or administration of an HMO; any person who is directly or indirectly the beneficial owner of more than five percent (5%) of the equity of the HMO; any person who is the beneficial owner of a mortgage, deed of trust, note or other interest secured by, and valuing more than five percent (5%) of the HMO; and, in the case of an HMO organized as a nonprofit corporation, an incorporator or member of such corporation under applicable state corporation law;  Any entity in which a person described in the paragraph above is director or officer; is a partner; has directly or indirectly a beneficial interest of more than five percent (5%) of the equity of the HMO; or has a mortgage, deed of trust, note or other interest valuing more than five percent (5%) of the assets of the HMO;  Any person directly or indirectly controlling, controlled by or under common control with a HMO; and  Any spouse, child or parent of an individual described above.  Any sale, exchange or lease of any property between the HMO and a party in interest;  Any lending of money or other extension of credit between the HMO and a party in interest; and  Any furnishing for consideration of goods, services (including management services) or facilities between the HMO and the party in interest. This does not include salaries paid to employees for services provided in the normal course of their employment. The information which must be disclosed in the transactions between the Contractor and a party in interest listed above includes:  The name of the party in interest for each transaction;  A description of each transaction and the quantity or units involved;  The accrued dollar value of each transaction during the fiscal year; and  Justification of the reasonableness of each transaction. In addition to the above information on business transactions, the Contractor may be required to submit a consolidated financial statement for the Contractor and the party in interest. If the Contract is an initial contract with FSSA, but the Contractor has operated previously in commercial or Medicare markets, information on business transactions for the entire year preceding the initial contract period shall be disclosed. If the Contract is being renewed or extended, the Contractor shall disclose information on business transactions which occurred during the prior contract period. The business transactions which shall be reported are not limited to transactions related to serving the Medicaid enrollment, that is, all of the Contractor's business transactions shall be reported.

Reporting Transactions with Parties of Interest. Any Contractor that is not a federally qualified HMO (as defined in Section 1310 of the Public Health Service Act) shall disclose to OMPP information on certain types of transactions they have with a “party in interest,” as defined in the Public Health Service Act. (See §§1903(m)(2)(A)(viii1903(m) (2) (A) (viii) and 1903(m)(41903(m) (4) of the Social Security Act.) For purposes of this Scope of Work, the following reporting requirements will apply to all Contractors in the same manner that they apply to federally qualified HMOs under the Public Health Service Act.   Any director, officer, partner or employee responsible for management or administration of an HMO; any person who is directly or indirectly the beneficial owner of more than five percent (5%) of the equity of the HMO; any person who is the beneficial owner of a mortgage, deed of trust, note or other interest secured by, and valuing more than five percent (5%) of the HMO; and, in the case of an HMO organized as a nonprofit corporation, an incorporator or member of such corporation under applicable state corporation law;   Any entity in which a person described in the paragraph above is director or officer; is a partner; has directly or indirectly a beneficial interest of more than five percent (5%) of the equity of the HMO; or has a mortgage, deed of trust, note or other interest valuing more than five percent (5%) of the assets of the HMO;   Any person directly or indirectly controlling, controlled by or under common control with a HMO; and   Any spouse, child or parent of an individual described above.   Any sale, exchange or lease of any property between the HMO and a party in interest;   Any lending of money or other extension of credit between the HMO and a party in interest; and   Any furnishing for consideration of goods, services (including management services) or facilities between the HMO and the party in interest. This does not include salaries paid to employees for services provided in the normal course of their employment. The information which must shall be disclosed in the transactions between the Contractor and a party in interest listed above includes:   The name of the party in interest for each transaction;   A description of each transaction and the quantity or units involved;   The accrued dollar value of each transaction during the fiscal year; and   Justification of the reasonableness of each transaction. In addition to the above information on business transactions, the Contractor may be required to submit a consolidated financial statement for the Contractor and the party in interest. If the Contract is an initial contract with FSSAOMPP, but the Contractor has operated previously in commercial or Medicare markets, information on business transactions for the entire year preceding the initial contract period shall be disclosed. If the Contract is being renewed or extended, the Contractor shall disclose information on business transactions which occurred during the prior contract period. The business transactions which shall be reported are not limited to transactions related to serving the Medicaid enrollment, that is, all of the Contractor's business transactions shall be reported.