SERVICE PROVISION AND CONTRACT PERFORMANCE IN ACCORDANCE Sample Clauses

SERVICE PROVISION AND CONTRACT PERFORMANCE IN ACCORDANCE. WITH FIDE SNP STANDARDS The Contractor shall provide FIDE SNP benefits in accordance with the standards set forth in the Medicare Managed Care Manual, Chapter 16B, Article 40.4, restated below and expanded: 40.4.3 - Fully Integrated Dual Eligible (FIDE) SNPs (Rev. 119 , Issued:11-28-14, Effective: 11-28-14, Implementation: 11-28-14) SNPs classified as Fully Integrated Dual Eligible (FIDE) are described in Section 1853(a)(1)(B)(iv) of the Act and at 42 CFR Section 422.2. FIDE SNPs are CMS- approved SNPs that: (1) Enroll special needs individuals entitled to medical assistance under a Medicaid State Plan, as defined in Section 1859(b)(6)(B)(ii) of the Act and 42 CFR Section 422.2 and described in detail in Section 40.5.3 of this chapter; (2) Provide dually-eligible beneficiaries access to Medicare and Medicaid benefits under a single managed care organization; (3) Have a CMS-approved MIPPA compliant contract with a State Medicaid Agency that includes coverage of specified primary, acute, and long-term care benefits and services, consistent with State policy, under risk-based financing; (4) Coordinate the delivery of covered Medicare and Medicaid health and long-term care services, using aligned care management and specialty care network methods for high-risk beneficiaries; and, (5) Employ policies and procedures approved by CMS and the State to coordinate or integrate enrollment, member materials, communications, grievance and appeals, and quality improvement. As stated in number 3 above, the FIDE-SNP definition at 42 C.F.R. Section 422.2 requires the plan to have a contract with the applicable state(s) in its service area specifying that the state(s) will pay the FIDE-SNP a capitation payment for primary, acute, and long-term care Medicaid benefits and services in exchange for the FIDE- SNP’s provision of these benefits to its enrollees. In determining whether a DSNP meets the FIDE-SNP definition, CMS will allow Long Term Care benefit carve-outs or exclusions only if the plan can demonstrate that it meets the following criteria:
Sample 1
AutoNDA by SimpleDocs

Related to SERVICE PROVISION AND CONTRACT PERFORMANCE IN ACCORDANCE

  • Continuing Contract Performance Pending final resolution of a Claim including litigation, unless otherwise agreed in writing the Contractor shall proceed diligently with performance of the Contract and the Owner shall continue to make payments in accordance with the Contract Documents.

  • Reviewing Contract Performance 1.1 The Contractor shall work with the Authority to establish and maintain an effective and beneficial working relationship to ensure the Contract is delivered to at least the minimum required standard as specified in the Schedule (The Services).

  • F2 Monitoring of Contract Performance F2.1 The Contractor shall immediately inform the Authority if any aspect of the Contract is not being or is unable to be performed, the reasons for non-performance, any corrective action and the date by which that action will be completed.

  • Monitoring of Contract Performance The Contractor shall comply with the monitoring arrangements set out in the Monitoring Schedule including, but not limited to, providing such data and information as the Contractor may be required to produce under the Contract.

  • Contract Performance C19.1 The Contractor shall ensure that:

  • Services Performance All services are performed using generally recognized commercial practices and standards. Customer agrees to provide prompt notice of any such service concerns and HP will re-perform any service that fails to meet this standard.

  • Performance by Contractor Where Pur- chaser’s employees, agents, contractors, Subcontractors, or their employees or agents perform Purchaser’s Opera- tions in connection with fire responsibilities, Purchaser’s obligations shall be the same as if performance was by Purchaser.

  • Performance Provisions A. Monitoring

  • Excuse for Nonperformance or Delayed Performance Except with respect to defaults of subcontractors, Contractor/Vendor shall not be in default by reason of any failure in performance of this contract in accordance with its terms (including any failure by Contractor/Vendor to make progress in the prosecution of the work hereunder which endangers such performance) if Contractor/Vendor has notified the Commission or designee within 15 days after the cause of the delay and the failure arises out of causes such as: acts of God; acts of the public enemy; acts of the State and any other governmental entity in its sovereign or contractual capacity; fires; floods; epidemics; quarantine restrictions; strikes or other labor disputes; freight embargoes; or unusually severe weather. If the failure to perform is caused by the failure of a subcontractor to perform or to make progress, and if such failure arises out of causes similar to those set forth above, Contractor/Vendor shall not be deemed to be in default, unless the services to be furnished by the subcontractor were reasonably obtainable from other sources in sufficient time to permit Contractor to meet the contract requirements. Upon request of Contractor, the Commission or designee shall ascertain the facts and extent of such failure, and, if such officer determines that any failure to perform was occasioned by any one or more of the excusable causes, and that, but for the excusable cause, Contractor’s progress and performance would have met the terms of the contract, the delivery schedule shall be revised accordingly, subject to the rights of the State under the clause entitled (in fixed-price contracts, “Termination for Convenience,” in cost-reimbursement contracts, “Termination”). (As used in this Paragraph of this clause, the term “subcontractor” means subcontractor at any tier).

  • SERVICE PERFORMANCE WITHIN U.S Concessionaire agrees, in accordance with Executive Order 129 (2004) and N.J.S.A. 52:34- 13.2 (P.L. 2005, c. 92), that all services performed under the Agreement or any subcontract awarded under the Agreement shall be performed within the United States. In the event that all services performed under the Agreement or any subcontract awarded under the Agreement shall not be performed within the United States, Concessionaire shall send Department a letter that states with specificity the reasons why the services cannot be so performed. Any such letter shall require review and approval pursuant to N.J.S.A. 52:34- 14.2 prior to execution of the Agreement or the delivery of the services which will not be performed within the United States. Unless previously approved by Department, a shift to performance of services outside the United States during any Term of the Agreement shall be deemed a material breach, subject to Suspension of Operations and/or Termination in accordance with the terms and conditions set forth in Paragraphs 10 and 11.

Time is Money Join Law Insider Premium to draft better contracts faster.