Sanctions and Remedies. 6.1. As a result of an investigation (whether following a complaint or otherwise), if IMPRESS is of the view that a publisher has been responsible for serious or systemic breaches of the Code or governance requirements, it will notify the publisher of its view together with any proposed sanction, in a provisional determination. The notification will invite the publisher to respond to IMPRESS within a period specified.
Sanctions and Remedies. Arkansas Code Annotated (ACA) The laws of the State of Arkansas. See Applicable Law definition. Arkansas Insurance Department (AID) Arkansas agency that licenses and oversees Risk Based Provider Organizations (RBPO). Arkansas Medicaid Provider-Led Organized Care Program Created pursuant to Arkansas Act 775 of 2017 (Ark. Code Xxx. §20- 77-2701 et seq.) See Applicable Law definition. Attribution The method by which DHS assigns an eligible Medicaid Enrollee to a PASSE as a PASSE Member. Behavioral Health (BH) The Division of Behavioral Health Services within DHS ensures that services are provided to those eligible individuals for which BH services are needed. BH providers and services are required to be included in a PASSE’s Referral Network. Business Associate Agreement (BAA) A contract between a HIPAA-covered entity and a HIPAA business associate (BA). The contract protects private medical information (PHI) in accordance with HIPAA guidelines. Business Continuity and Recovery Plan A plan to be created by the PASSE that sets forth the steps to be taken in advance of, and in the case of, a disaster that could affect the continuing operations of the PASSE. See Section XXXV, Business Continuity and Recovery Plan. Business Continuity/Disaster Recovery See Business Continuity and Recovery Plan definition. Care Coordination Also Care Coordination Services. See Section XV, Care Coordination Services. Care Coordination Payment Monthly PMPM payment to the PASSE for each attributed PASSE Member beginning in the second month of attribution. See Section IX, Payments. Care Coordinators PASSE personnel who will deliver Care Coordination Services to attributed PASSE Members. See Care Coordination definition. Center for Medicare and Medicaid Services (CMS) Federal agency that administers Medical Assistance (Medicaid) benefits and services. Chief Executive Officer (CEO) PASSE Key Staff. See Section VII, Staff Requirements and Support Services. Chief Financial Officer (CFO) PASSE Key Staff. See Section VII, Staff Requirements and Support Services. Chief Operating Officer (COO) PASSE Key Staff. See Section VII, Staff Requirements and Support Services. Closure A determination by DHS that a PASSE Member is no longer eligible to receive PASSE services. See Section XVIII, Abeyance and Closure. Code of Federal Regulations (CFR) Rules and regulations issued by federal agencies, including CMS. See Applicable Law definition. Community and Employment Support (CES) Current Arkansas Medi...
Sanctions and Remedies. Data For the purposes of this Agreement, any and all data, information and records captured, recorded, generated, obtained, sent or received will be referred to collectively as “data” and will be maintained in electronic form. See Section XXX, Systems and Data Requirements. Data Use Agreement (DUA) A contractual document used for the transfer of data that has been developed by nonprofit, government or private industry, where the data is nonpublic or is otherwise subject to some restrictions on its use, including HIPAA. See Section XXX, Systems and Data Requirements. Department of Human Services (DHS) Arkansas agency that includes the Division of Medical Services (Medicaid.) Developmental Disabilities (DD) The Division of Developmental Disabilities Services within DHS ensures that services are provided to those eligible individuals for which DD services are needed. DD providers and services are required to be included in a PASSE’s Referral Network. Direct Service Provider An organization or individual that delivers healthcare services to attributed PASSE Members of a PASSE. Participating providers can be direct service providers. Division of Medical Services (DMS) In Arkansas, division of DHS that oversees the Medicaid program. Dual Eligible Individuals who are eligible for both Medicare and Medicaid. Electronic Exchange Partners For the purposes of this Agreement, the collective name for the entities with which the PASSE sends, accepts/receives, generates or exchanges electronic data include, but are not limited to DHS, designated vendors, subcontractors or any Provider, or their assigned representative/authorized vendor. See Section XXX, Systems and Data Requirements. Electronic Health Records (EHR) Health records of a patient that are gathered and stored electronically. Electronic Medical Records (EMR) Medical records of a patient that are gathered and stored electronically. Exchange of Data For the purposes of this Agreement, the activities between Electronic Exchange Partners. See Section XXX, Systems and Data Requirements. For-Cause Change A type of Enrollment change from one PASSE to another by PASSE Members. See Section XIX, Enrollment Options for PASSE Members. Foundation Payment Initial, and one-time-only, payment to the first PASSE for each attributed PASSE Member upon attribution. See Section X, Payments. Grievance A matter disputed by an attributed PASSE Member. See Section XXIII, Grievance System. Health and Human Services (HHS) (United States...
