Requirements Pertaining to Medicaid Managed Care Programs Sample Clauses

Requirements Pertaining to Medicaid Managed Care Programs. The MCO must follow the benefit packages and policies of Medicaid managed care programs as required by this Contract and Contract Appendices. The MCO should refer to the FFS Medicaid provider manuals available on the DHHR website for an explanation of service limitations.
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Requirements Pertaining to Medicaid Managed Care Programs. The MCO must follow the benefit packages and policies of Medicaid managed care programs as required by this Contract and Contract Exhibits. The MCO should refer to the fee-for-service Medicaid provider manuals available on the WV DHHR website for an explanation of service limitations under the Mountain Health Trust or West Virginia Health Bridge. PCP Responsibilities PCPs will be the MCO enrollee’s initial and most important contact with the Medicaid MCO. The PCPs’ responsibilities are outlined in Article III, Section 2.2 of the contract. According to West Virginia State Code 16-29 H-9, a patient-centered medical home is, “a health care setting that facilitates partnerships between individual patients and their personal physicians and, when appropriate, the patients’ families and communities. A patient-centered medical home integrates patients as active participants in their own health and well-being. Patients are cared for by a physician or physician practice that leads a multidisciplinary health team, which may include, but is not limited to, nurse practitioners, nurses, physician’s
Sample 1
Requirements Pertaining to Medicaid Managed Care Programs. The MCO must follow the benefit packages and policies of Medicaid managed care programs as required by this Contract and Contract Appendices. The MCO should refer to the fee-for- service Medicaid provider manuals available on the WV DHHR website for an explanation of service limitations under the Mountain Health Trust or West Virginia Health Bridge. 4 Infertility services are excluded per West Virginia State law, section 33-25A-4(2)(b).
Sample 1

Related to Requirements Pertaining to Medicaid Managed Care Programs

  • Federal Medicaid System Security Requirements Compliance Party shall provide a security plan, risk assessment, and security controls review document within three months of the start date of this Agreement (and update it annually thereafter) in order to support audit compliance with 45 CFR 95.621 subpart F, ADP System Security Requirements and Review Process.

  • Federal Requirements Pertaining to Grants and Subrecipient Agreements A. Requirement to Have a Single Audit: In the case that this Agreement is a Grant that is funded in whole or in part by federal funds, the Subrecipient will complete the Subrecipient Annual Report annually within 45 days after its fiscal year end, informing the State of Vermont whether or not a Single Audit is required for the prior fiscal year. If a Single Audit is required, the Subrecipient will submit a copy of the audit report to the granting Party within 9 months. If a single audit is not required, only the Subrecipient Annual Report isrequired. For fiscal years ending before December 25, 2015, a Single Audit is required if the subrecipient expends $500,000 or more in federal assistance during its fiscal year and must be conducted in accordance with OMB Circular A-133. For fiscal years ending on or after December 25, 2015, a Single Audit is required if the subrecipient expends $750,000 or more in federal assistance during its fiscal year and must be conducted in accordance with 2 CFR Chapter I, Chapter II, Part 200, Subpart F. The Subrecipient Annual Report is required to be submitted within 45 days, whether or not a Single Audit is required.

  • Contractor Standards Contractor shall comply with Contractor Standards provisions codified in the SDMC. Contractor understands and agrees that violation of Contractor Standards may be considered a material breach of the Contract and may result in Contract termination, debarment, and other sanctions.

  • COMPLIANCE WITH HEALTH & SAFETY CODE § 25249 7(f) Xxxxxxxx agrees to comply with the reporting requirements referenced in Health & Safety Code § 25249.7(f).

  • COMPLIANCE WITH THE CONTRACT WORK HOURS AND SAFETY STANDARDS ACT (1) Overtime requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek.

  • Health and Safety Standards Contractor shall abide by all health and safety standards set forth by the State of California and/or the County of Xxxxxx pursuant to the Injury and Illness Prevention Program. If applicable, Contractor must receive all health and safety information and training from County.

  • Compliance with Texas Privacy Laws and Regulations In performing their respective obligations under the Agreement, the LEA and the Provider shall comply with all Texas laws and regulations pertaining to LEA data privacy and confidentiality, including but not limited to the Texas Education Code Chapter 32, and Texas Government Code Chapter 560.

  • Compliance with Data Privacy and Security Laws and Standards Contractor shall comply with all applicable State and federal data privacy and data security laws, rules, and regulations.

  • CONTRACT WORK HOURS AND SAFETY STANDARDS As per the Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708), where applicable, all Customer Purchase Orders in excess of ,000 that involve the employment of mechanics or laborers must include a provision for compliance with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C. 3702 of the Act, each contractor must be required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence.

  • Medicaid Program Contractors Inspection of Records: Any contracts accessing payments for services through the Global Commitment to Health Waiver and Vermont Medicaid program must fulfill state and federal legal requirements to enable the Agency of Human Services (AHS), the United States Department of Health and Human Services (DHHS) and the Government Accounting Office (GAO) to: Evaluate through inspection or other means the quality, appropriateness, and timeliness of services performed; and Inspect and audit any financial records of such Contractor or subcontractor.

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