Subcontractual Relationships and Delegation Sample Clauses

Subcontractual Relationships and Delegation. If the MCP’s responsibilities or services under this Agreement are delegated to any first tier, downstream, or related entity (collectively, the other entities are “FDR” and any such agreement with an FDR is the “FDR agreement”), the MCP shall ensure it has a written agreement with the FDR to perform administrative services as defined below on the MCP’s behalf. The following requirements apply to all FDR agreements. Additional FDR requirements specific to Pharmacy Benefit Manager agreements are described in Appendix R of this Agreement. a. Parties to administrative services arrangements are defined as: i. First tier entity: any party that enters into a written arrangement, acceptable to ODM, with the MCP to provide administrative services for Ohio Medicaid eligible individuals. ii. Downstream entity: any party that enters into a written arrangement, acceptable to ODM, with a first tier or related entity or below the level of a first tier or related entity to provide administrative services for Ohio Medicaid eligible individuals. These arrangements continue down to the level of the ultimate provider of the administrative services. iii. Related entity: any party related to the MCP by common ownership or control, and under an oral or written arrangement performs some of the administrative services under the MCP’s contract with ODM. b. The following provisions apply and shall be followed before any FDR agreement is executed or renewed: i. At least 30 days prior to the MCP executing any FDR agreement (hereinafter referred to as “the FDR agreement review period”), the MCP shall provide the proposed FDR agreement to ODM for review. ODM, in its sole discretion, can agree to a shorter FDR agreement review period. ii. During the FDR agreement review period, ODM has the right to ask questions and request information from the MCP and the FDR about any provisions in the proposed FDR agreement. iii. The MCP and the FDR shall promptly respond to and provide complete answers and information to ODM in response to ODM’s questions and requests. iv. ODM has the right and authority to designate the FDR agreement, or any portion thereof, as incompatible with this Agreement, incompatible with ODM’s state plan amendment (SPA), incompatible with federal, state, or local regulations and laws, or unacceptable to ODM for any other reason, without limitation. If ODM determines that any provision of the proposed FDR agreement (or the FDR agreement as a whole) is unacceptable or incompa...
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Subcontractual Relationships and Delegation. If the MCP delegates to any first tier, downstream and related entity (FDR), they shall ensure it has an arrangement with the FDR to perform administrative services as defined below on the MCP’s behalf. a. Unless otherwise specified by ODM, administrative services include: care management, marketing, utilization management, quality improvement, enrollment, disenrollment, membership functions, claims administration, licensing and credentialing, provider network management, and coordination of benefits. b. Parties to administrative services arrangements are defined as: i. First tier entity: any party that enters into a written arrangement, acceptable to ODM, with the MCP to provide administrative services for Ohio Medicaid eligible individuals. ii. Downstream entity: any party that enters into a written arrangement, acceptable to ODM, with a first tier or related entity or below the level of a first tier or related entity to provide administrative services for Ohio Medicaid eligible individuals. These arrangements continue down to the level of the ultimate provider of the administrative services. iii. Related entity: any party related to the MCP by common ownership or control, and under an oral or written arrangement performs some of the administrative services under the MCP’s contract with ODM. c. Before the MCP enters into an arrangement with an FDR to perform an administrative function not listed above that could impact a member’s health, safety, welfare or access to Medicaid covered services, the MCP shall contact ODM to request a determination of whether or not the function should be included as an administrative service that complies with the provisions listed herein.
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Subcontractual Relationships and Delegation. An MCOP that delegates to any first tier, downstream and related entity (FDRs) as defined in 42 CFR 423.4, must ensure that it has an arrangement with the FDR to perform administrative services as defined below on the MCOP’s behalf. a. Unless otherwise specified by ODM, administrative services include: care management, marketing, utilization management, quality improvement, enrollment, disenrollment, membership functions, claims administration, licensing and credentialing, provider network management, and coordination of benefits. b. Before an MCOP enters into an arrangement with an FDR to perform an administrative function not listed above that could impact a member’s health, safety, welfare or access to Medicaid covered services, the MCOP must contact ODM to request a determination of whether or not the function should be included as an administrative service that complies with the provisions listed herein. c. An MCOP that enters into a written arrangement with an FDR shall include the following enforceable provisions: i. A description of the administrative services to be provided by the FDR and any requirements for the FDR to report information to the MCOP. ii. The beginning date and expiration date or automatic renewal clause for the arrangement, as well as applicable methods of extension, renegotiation and termination. iii. Identification of the service area and Medicaid population, either “dual” or “dual and non‐dual” the FDR will serve. iv. A provision stating that the FDR shall release to the MCOP and ODM any information necessary for the MCOP to perform any of its obligations under the MCOP’s provider agreement with ODM, including but not limited to compliance with reporting and quality assurance requirements. v. A provision that the FDR’s applicable facilities and records will be open to inspection by the MCOP, ODM, its designee or other entities as specified in OAC rule. vi. A provision that the arrangement is governed by, and construed in accordance with all applicable state or federal laws, regulations and contractual obligations of the MCOP. The arrangement shall be automatically amended to conform to any changes in laws, regulations and contractual obligations without the necessity for written amendment. vii. A provision that Medicaid eligible individuals and ODM are not liable for any cost, payment, copayment, cost‐sharing, down payment, or similar charge, refundable or otherwise for services performed, including in the viii. The procedures...
Sample 1
Subcontractual Relationships and Delegation. If the MCP’s responsibilities or services under this Agreement are delegated to any first tier, downstream, or related entity (collectively, the other entities are “FDR” and any such agreement with an FDR is the “FDR agreement” or “FDR arrangement”), the MCP shall ensure it has an arrangement with the FDR to perform administrative services as defined below on the MCP’s behalf. a. The following provisions apply and shall be followed before any FDR agreement is executed or renewed: i. At least 30 days prior to the MCP executing any FDR agreement (hereinafter referred to as “the FDR agreement review period”), the MCP shall provide the proposed FDR agreement to ODM for review. ODM, in its sole discretion, can agree to a shorter FDR agreement review period. ii. During the FDR agreement review period, ODM has the right to ask questions and request information from the MCP and the FDR about any provisions in the proposed FDR agreement. iii. The MCP and the FDR shall promptly respond to and provide complete answers and information to ODM in response to ODM’s questions and requests. iv. ODM has the right and authority to designate the FDR agreement, or any portion thereof, as incompatible with this Agreement, incompatible with ODM’s state plan amendment (SPA), incompatible with federal, state, or local regulations and laws, or unacceptable to ODM for any other reason, without limitation. If ODM determines that any provision of the proposed FDR agreement (or the FDR agreement as a whole) is unacceptable or incompatible as state above, the MCP shall either revise the proposed FDR agreement to ODM’s satisfaction or otherwise the MCP will seek a new proposed FDR agreement. The new proposed FDR agreement, and any thereafter, will be subject to an FDR agreement review period. v. The MCP shall not execute the proposed FDR agreement until ODM has stated in writing that the FDR agreement is acceptable. ODM’s approval does not need to be made within 30 days of receiving the proposed FDR agreement. vi. In addition to the provision above in subsections i. through v., ODM also has the right to forego the FDR agreement review period for any proposed FDR agreement. In such cases, ODM shall notify the MCP in writing that the MCP can execute the proposed FDR agreement without ODM conducting a review. b. ODM shall have the right to review the terms of any FDR arrangement upon request, and such arrangements shall include terms requiring the FDR to grant ODM access to documents and ot...
Sample 1
Subcontractual Relationships and Delegation. 3.1.5.1. The Contractor shall be accountable for any functions and responsibilities that it delegates to any subcontractor. The Contractor shall: 3.1.5.1.1. Evaluate the prospective Subcontractor’s ability to perform the activities to be delegated. 3.1.5.1.2. Require a written agreement with the Subcontractor that specifies the activities and report responsibilities delegated to the Subcontractor; and provides for revoking delegation or imposing other sanctions if the Subcontractor’s performance is inadequate. 3.1.5.1.3. Monitor the Subcontractor’s performance on an ongoing basis and subject it to formal review according to a periodic schedule established by the State, consistent with industry standards or State MCO laws and regulations. 3.1.5.1.4. Identify deficiencies or areas for improvement, and shall ensure that the Subcontractor takes corrective action.
Sample 1
Subcontractual Relationships and Delegation. If the MCP delegates to any first tier, downstream and related entity (FDR), they shall ensure it has an arrangement with the FDR to perform administrative services as defined below on the MCP’s behalf. a. Unless otherwise specified by ODM, administrative services include: care management, marketing, utilization management, quality improvement, enrollment, disenrollment, membership functions, claims administration, licensing and credentialing, provider network management, and coordination of benefits. b. Parties to administrative services arrangements are defined as: i. First tier entity: any party that enters into a written arrangement, acceptable to ODM, with the MCP to provide administrative services for Ohio Medicaid eligible individuals. ii. Downstream entity: any party that enters into a written arrangement, acceptable to ODM, with a first tier or related entity or below the level of a first tier or related entity to provide administrative services for Ohio Medicaid eligible individuals. These arrangements continue down to the level of the ultimate provider of the administrative services. iii. Related entity: any party related to the MCP by common ownership or control, and under an oral or written arrangement performs some of the administrative services under the MCP’s contract with ODM. c. Before the MCP enters into an arrangement with an FDR to perform an administrative function not listed above that could impact a member’s health, safety, welfare or access to Medicaid covered services, the MCP shall contact ODM to request a determination of whether or not the function should be included as an administrative service that complies with the provisions listed herein. d. The MCP that enters into a written arrangement with an FDR shall include the following enforceable provisions: i. A description of the administrative services to be provided by the FDR and any requirements for the FDR to report information to the MCP. ii. The beginning date and expiration date or automatic renewal clause for the arrangement, as well as applicable methods of extension, renegotiation and termination. iii. Identification of the service area and Medicaid population, either “non-dual” or “non-dual and dual” the FDR will serve. iv. A provision stating that the FDR shall release to the MCP and ODM any information necessary for the MCP to perform any of its obligations under the MCP’s provider agreement with ODM, including but not limited to compliance with reporting and quali...
Sample 1
Subcontractual Relationships and Delegation 
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Related to Subcontractual Relationships and Delegation

  • SUBCONTRACTUAL RELATIONS 5.3.1 By written agreement, the Contractor shall require each Subcontractor, to the extent of the Work to be performed by the Subcontractor, to be bound to the Contractor by the terms of the Contract Documents, and to assume toward the Contractor all the obligations and responsibilities

  • Contractual Relationship It is understood and agreed that the relationship described in this Agreement between the Parties is contractual in nature and is not to be construed to create a partnership or joint venture or agency relationship between the parties. Neither party shall have the right to act on behalf of the other except as expressly set forth in this Agreement. Contractor will be solely responsible for and will pay all taxes related to the receipt of payments hereunder and shall give reasonable proof and supporting documents, if reasonably requested, to verify the payment of such taxes. No Contractor personnel shall obtain the status of or otherwise be considered an employee of NCTCOG or Participating Entity by virtue of their activities under this Agreement.

  • No Contractual Relationship Between Sub Servicer, Trustee or the Certificateholders. Any Sub-Servicing Agreement and any other transactions or services relating to the Mortgage Loans involving a Sub-Servicer shall be deemed to be between the Sub-Servicer and the Servicer alone and the Trustee and the Certificateholders shall not be deemed parties thereto and shall have no claims, rights, obligations, duties or liabilities with respect to any Sub-Servicer except as set forth in Section 3.05.

  • Independent Contractor; Authority Notwithstanding the Services provided by the Administrator pursuant to this Agreement, the Administrator shall be deemed to be an independent contractor with respect to the Services. The management, policies and operations of the Parties (including the ultimate approval of the making or disposition of the Painting by the Issuer or Masterworks Cayman, and the terms and conditions thereof) shall be the responsibility of the Parties other than the Administrator.

  • No Contractual Relationship Between Subservicers and the Trustee Any subservicing arrangement that may be entered into and any other transactions or services relating to the Mortgage Loans involving a Subservicer in its capacity as such and not as an originator shall be deemed to be solely between the Subservicer and the Master Servicer alone, and the Trustee and Certificateholders shall not be deemed parties thereto and shall have no claims, rights, obligations, duties, or liabilities with respect to the Subservicer in its capacity as such except as set forth in Section 3.05.

  • Independent Contractor Relationship Both parties hereto, in the performance of this Contract, shall act in an individual capacity and not as agents, employees, partners, joint ventures or associates of one another. The employees or agents of one party shall not be deemed or construed to be the employees or agents of the other party for any purposes whatsoever.

  • Subcontractor Any vendor, subcontractor or other Person that is not responsible for the overall servicing (as “servicing” is commonly understood by participants in the mortgage-backed securities market) of Mortgage Loans but performs one or more discrete functions identified in Item 1122(d) of Regulation AB with respect to Mortgage Loans under the direction or authority of the Servicer or a Subservicer.

  • Delegation to Affiliates The Borrower and the Lenders agree that the Administrative Agent may delegate any of its duties under this Agreement to any of its Affiliates. Any such Affiliate (and such Affiliate’s directors, officers, agents and employees) which performs duties in connection with this Agreement shall be entitled to the same benefits of the indemnification, waiver and other protective provisions to which the Administrative Agent is entitled under Articles IX and X.

  • Subcontracting 6.1 The Grantee is responsible for the performance of its obligations under this Agreement, including in relation to any tasks undertaken by subcontractors. 6.2 The Grantee agrees to make available to the Commonwealth the details of any of its subcontractors engaged to perform any tasks in relation to this Agreement upon request.

  • CONTRACTUAL AGREEMENT This Invitation for Bids shall be included and incorporated in the final contract or purchase order. The order of contract precedence will be the contract (purchase order), bid document, and response. Any and all legal actions associated with this Invitation for Bids and/or the resultant contract (purchase order) shall be governed by the laws of the State of Florida. Venue for any litigation involving this contract shall be the Ninth Circuit Court in and for Orange County, Florida.

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