TERMINATION AND NON-RENEWAL. A. ODM may terminate this Agreement upon written notice pursuant to the applicable rules of the OAC. Any such termination will become effective at the end of the last calendar day of the month in which the termination is to take effect. The MCO must comply with the termination and non-renewal requirements as specified in Appendix O, MCO Termination and Non-Renewal. B. ODM may terminate this Agreement as a result of ODM's procurement of managed care organizations pursuant to ORC section 5167.10. The MCO must comply with the termination and non-renewal requirements as specified in Appendix O, MCO Termination and Non-Renewal. The termination of this Agreement due to ODM's procurement of managed care organizations shall not be considered a termination or non-renewal for purposes of the MCO's application for future procurements. C. Subsequent to receiving a notice of termination or non-renewal from ODM, the MCO, beginning on the effective date of the termination, must cease provision of services on the terminated activities under this Agreement, terminate all subcontracts relating to such terminated activities, take all necessary or appropriate steps to limit disbursements and minimize costs, and comply with the requirements specified in Appendix O, MCO Termination and Non-Renewal. D. In the event of termination or non-renewal under this article, the MCO is entitled to request reconciliation of reimbursements through the final month for which the MCO provided services under this Agreement, in accordance with the reimbursement provisions of this Agreement. The MCO waives any right to, and must make no claim for, any additional compensation or liability of or against ODM resulting from such suspension or termination. E. In the event of termination or non-renewal under this article, the MCO must transfer all data and records to ODM within the time period and in a file format as specified by ODM relating to cost, work performed, supporting documentation for invoices submitted to ODM, and copies of all materials produced under or pertaining to this Agreement. F. ODM may, in its sole discretion, terminate or decide not to renew this Agreement if the MCO or MCO's subcontractors violate or fail to comply with the provisions of this Agreement or other provisions of law or regulation governing the Medicaid program; or if the MCO or MCO's subcontractors are determined by any state or federal court to be liable for fraud or misrepresentation against the state of Ohio or any state agency including but not limited to ODM. If ODM terminates or does not renew this Agreement for a specific region or regions, ODM may, in its sole discretion, terminate or not renew this Agreement with the MCO for all regions. In the event ODM proposes to terminate or not renew this Agreement, the provisions of applicable sections of the OAC with respect to ODM's termination or refusal to enter into a provider agreement apply, including the MCO's right to request an adjudication hearing under ORC Chapter 119. G. When initiated by the MCO, the MCO's written notice of termination of or decision not to renew this Agreement must be received by ODM at least 240 calendar days in advance of the termination or renewal date, provided, however, that termination or non-renewal is effective at the end of the last calendar day of the applicable month. In the event of non-renewal of this Agreement with ODM by the MCO, if the MCO is unable to provide the required number of days of notice to ODM prior to the date when this Agreement expires, then this Agreement will be deemed extended to the last calendar day of the month that meets the required number of days from the date of the termination notice. Both parties must, for that time, continue to fulfill their duties and obligations as set forth herein. H. If the MCO terminates or does not renew this Agreement for a specific region or regions, the MCO must comply with the requirements of Appendix O, MCO Termination and Non-Renewal. If the MCO terminates or does not renew this Agreement for a specific region or regions, ODM may terminate or not renew this Agreement with the MCO for all regions. ODM, at its discretion, may use the MCO's termination or non-renewal of this Agreement as a factor in any future procurement process. I. The MCO understands that availability of funds to fulfill the terms of this Agreement is contingent on appropriations made by the Ohio General Assembly and the United States government for funding the Medicaid program. If sufficient funds are not available from the Ohio General Assembly or the United States government to make payments on behalf of a specific population (e.g., Aged, Blind, and Disabled; Modified Adjusted Gross Income; or Group VIII-Expansion) to fulfill the terms of this Agreement, the obligations, duties, and responsibilities of the parties with respect to that population will be terminated, except as specified in Appendix O, MCO Termination and Non-Renewal, as of the date funding expires. If the Ohio General Assembly or the United States government fails at any time to provide sufficient funding for ODM or the state of Ohio to make payments due under this Agreement, this Agreement will terminate as of the date funding expires without further obligation of ODM or the state of Ohio.
Appears in 6 contracts
Samples: Ohio Medicaid Provider Agreement for Managed Care Organization, Ohio Medicaid Provider Agreement for Managed Care Organization, Ohio Medicaid Provider Agreement for Managed Care Organization
TERMINATION AND NON-RENEWAL. A. ODM may terminate this Agreement upon written notice pursuant to the applicable rules of the OAC. Any such termination will become effective at the end of the last calendar day of the month in which the termination is to take effect. The MCO OhioRISE Plan must comply with the termination and non-renewal requirements as specified in Appendix O, MCO Plan Termination and Non-Renewal.
B. ODM may terminate this Agreement as a result of ODM's procurement of managed care organizations pursuant to ORC section 5167.10. The MCO must comply with the termination and non-renewal requirements as specified in Appendix O, MCO Termination and Non-Renewal. The termination of this Agreement due to ODM's procurement of managed care organizations shall not be considered a termination or non-renewal for purposes of the MCO's application for future procurements.
C. Subsequent to receiving a notice of termination or non-renewal from ODM, the MCOOhioRISE Plan, beginning on the effective date of the termination, must cease provision of services on the terminated activities under this Agreement, terminate all subcontracts relating to such terminated activities, take all necessary or appropriate steps to limit disbursements and minimize costs, and comply with the requirements specified in Appendix O, MCO Plan Termination and Non-Renewal.
D. C. In the event of termination or non-renewal under this article, the MCO OhioRISE Plan is entitled to request reconciliation of reimbursements through the final month for which the MCO OhioRISE Plan provided services under this Agreement, in accordance with the reimbursement provisions of this Agreement. The MCO OhioRISE Plan waives any right to, and must make no claim for, any additional compensation or liability of or against ODM resulting from such suspension or termination.
E. D. In the event of termination or non-renewal under this article, the MCO OhioRISE Plan must transfer all data and records to ODM within the time period and in a file format as specified by ODM relating to cost, work performed, supporting documentation for invoices submitted to ODM, and copies of all materials produced under or pertaining to this Agreement.
F. E. ODM may, in its sole discretion, terminate or decide not to renew this Agreement if the MCO OhioRISE Plan or MCOOhioRISE Plan's subcontractors violate or fail to comply with the provisions of this Agreement or other provisions of law or regulation governing the Medicaid program; or if the MCO OhioRISE Plan or MCOOhioRISE Plan's subcontractors are determined by any state or federal court to be liable for fraud or misrepresentation against the state of Ohio or any state agency including but not limited to ODM. If ODM terminates or does not renew this Agreement for a specific region or regions, ODM may, in its sole discretion, terminate or not renew this Agreement with the MCO for all regions. In the event ODM proposes to terminate or not renew this Agreement, the provisions of applicable sections of the OAC with respect to ODM's termination or refusal to enter into a provider agreement apply, including the MCOOhioRISE Plan's right to request an adjudication hearing under ORC Chapter 119.
G. F. When initiated by the MCOOhioRISE Plan, the MCOOhioRISE Plan's written notice of termination of or decision not to renew this Agreement must be received by ODM at least 240 calendar days in advance of the termination or renewal date, provided, however, that termination or non-renewal is effective at the end of the last calendar day of the applicable month. In the event of non-renewal of this Agreement with ODM by the MCOOhioRISE Plan, if the MCO OhioRISE Plan is unable to provide the required number of days of notice to ODM prior to the date when this Agreement expires, then this Agreement will be deemed extended to the last calendar day of the month that meets the required number of days from the date of the termination notice. Both parties must, for that time, continue to fulfill their duties and obligations as set forth herein.
H. If the MCO terminates or does not renew this Agreement for a specific region or regions, the MCO must comply with the requirements of Appendix O, MCO Termination and Non-Renewal. If the MCO terminates or does not renew this Agreement for a specific region or regions, ODM may terminate or not renew this Agreement with the MCO for all regions. ODM, at its discretion, may use the MCO's termination or non-renewal of this Agreement as a factor in any future procurement process.
I. G. The MCO OhioRISE Plan understands that availability of funds to fulfill the terms of this Agreement is contingent on appropriations made by the Ohio General Assembly and the United States government for funding the Medicaid program. If sufficient funds are not available from the Ohio General Assembly or the United States government to make payments on behalf of a specific population (e.g., Aged, Blind, and Disabled; , Modified Adjusted Gross Income; , or Adult Extension Group VIII-Expansion) to fulfill the terms of this Agreement, the obligations, duties, and responsibilities of the parties with respect to that population will be terminated, except as specified in Appendix O, MCO Plan Termination and Non-Renewal, as of the date funding expires. If the Ohio General Assembly or the United States government fails at any time to provide sufficient funding for ODM or the state of Ohio to make payments due under this Agreement, this Agreement will terminate as of the date funding expires without further obligation of ODM or the state of Ohio.
Appears in 2 contracts
Samples: Provider Agreement, Provider Agreement
TERMINATION AND NON-RENEWAL. A. ODM may terminate this Agreement upon written notice pursuant to the applicable rules of the OAC. Any such termination will become effective at the end of the last calendar day of the month in which the termination is to take effect. The MCO must comply with the termination and non-renewal requirements as specified in Appendix O, MCO Termination and Non-Renewal.
B. ODM may terminate this Agreement as a result of ODM's procurement of managed care organizations pursuant to ORC section 5167.10. The MCO must comply with the termination and non-renewal requirements as specified in Appendix O, MCO Termination and Non-Renewal. The termination of this Agreement due to ODM's procurement of managed care organizations shall not be considered a termination or non-renewal for purposes of the MCO's application for future procurements.
C. Subsequent to receiving a notice of termination or non-renewal from ODM, the MCO, beginning on the effective date of the termination, must cease provision of services on the terminated activities under this Agreement, terminate all subcontracts relating to such terminated activities, take all necessary or appropriate steps to limit disbursements and minimize costs, and comply with the requirements specified in Appendix O, MCO Termination and Non-Renewal.
D. In the event of termination or non-renewal under this article, the MCO is entitled to request reconciliation of reimbursements through the final month for which the MCO provided services under this Agreement, in accordance with the reimbursement provisions of this Agreement. The MCO waives any right to, and must make no claim for, any additional compensation or liability of or against ODM resulting from such suspension or termination.
E. In the event of termination or non-renewal under this article, the MCO must transfer all data and records to ODM within the time period and in a file format as specified by ODM relating to cost, work performed, supporting documentation for invoices submitted to ODM, and copies of all materials produced under or pertaining to this Agreement.
F. ODM may, in its sole discretion, terminate or decide not to renew this Agreement if the MCO or MCO's subcontractors violate or fail to comply with the provisions of this Agreement or other provisions of law or regulation governing the Medicaid program; or if the MCO or MCO's subcontractors are determined by any state or federal court to be liable for fraud or misrepresentation against the state of Ohio or any state agency including but not limited to ODM. If ODM terminates or does not renew this Agreement for a specific region or regions, ODM may, in its sole discretion, terminate or not renew this Agreement with the MCO for all regions. In the event ODM proposes to terminate or not renew this Agreement, the provisions of applicable sections of the OAC with respect to ODM's termination or refusal to enter into a provider agreement apply, including the MCO's right to request an adjudication hearing under ORC Chapter 119.
G. When initiated by the MCO, the MCO's written notice of termination of or decision not to renew this Agreement must be received by ODM at least 240 calendar days in advance of the termination or renewal date, provided, however, that termination or non-renewal is effective at the end of the last calendar day of the applicable month. In the event of non-renewal of this Agreement with ODM by the MCO, if the MCO is unable to provide the required number of days of notice to ODM prior to the date when this Agreement expires, then this Agreement will be deemed extended to the last calendar day of the month that meets the required number of days from the date of the termination notice. Both parties must, for that time, continue to fulfill their duties and obligations as set forth herein.
H. If the MCO terminates or does not renew this Agreement for a specific region or regions, the MCO must comply with the requirements of Appendix O, MCO Termination and Non-Renewal. If the MCO terminates or does not renew this Agreement for a specific region or regions, ODM may terminate or not renew this Agreement with the MCO for all regions. ODM, at its discretion, may use the MCO's termination or non-non- renewal of this Agreement as a factor in any future procurement process.
I. The MCO understands that availability of funds to fulfill the terms of this Agreement is contingent on appropriations made by the Ohio General Assembly and the United States government for funding the Medicaid program. If sufficient funds are not available from the Ohio General Assembly or the United States government to make payments on behalf of a specific population (e.g., Aged, Blind, and Disabled; Modified Adjusted Gross Income; or Adult Extension Group VIII-Expansion) to fulfill the terms of this Agreement, the obligations, duties, and responsibilities of the parties with respect to that population will be terminated, except as specified in Appendix O, MCO Termination and Non-Renewal, as of the date funding expires. If the Ohio General Assembly or the United States government fails at any time to provide sufficient funding for ODM or the state of Ohio to make payments due under this Agreement, this Agreement will terminate as of the date funding expires without further obligation of ODM or the state of Ohio.
Appears in 1 contract
Samples: Ohio Medicaid Provider Agreement
TERMINATION AND NON-RENEWAL. A. ODM may terminate this Agreement upon written notice pursuant to the applicable rules of the OAC. Any such termination will become effective at the end of the last calendar day of the month in which the termination is to take effect. The MCO OhioRISE Plan must comply with the termination and non-renewal requirements as specified in Appendix O, MCO Plan Termination and Non-Renewal.
B. ODM may terminate this Agreement as a result of ODM's procurement of managed care organizations pursuant to ORC section 5167.10. The MCO must comply with the termination and non-renewal requirements as specified in Appendix O, MCO Termination and Non-Renewal. The termination of this Agreement due to ODM's procurement of managed care organizations shall not be considered a termination or non-renewal for purposes of the MCO's application for future procurements.
C. Subsequent to receiving a notice of termination or non-renewal from ODM, the MCOOhioRISE Plan, beginning on the effective date of the termination, must cease provision of services on the terminated activities under this Agreement, terminate all subcontracts relating to such terminated activities, take all necessary or appropriate steps to limit disbursements and minimize costs, and comply with the requirements specified in Appendix O, MCO Plan Termination and Non-Renewal.
D. C. In the event of termination or non-renewal under this article, the MCO OhioRISE Plan is entitled to request reconciliation of reimbursements through the final month for which the MCO OhioRISE Plan provided services under this Agreement, in accordance with the reimbursement provisions of this Agreement. The MCO OhioRISE Plan waives any right to, and must make no claim for, any additional compensation or liability of or against ODM resulting from such suspension or termination.
E. D. In the event of termination or non-renewal under this article, the MCO OhioRISE Plan must transfer all data and records to ODM within the time period and in a file format as specified by ODM relating to cost, work performed, supporting documentation for invoices submitted to ODM, and copies of all materials produced under or pertaining to this Agreement.
F. E. ODM may, in its sole discretion, terminate or decide not to renew this Agreement if the MCO OhioRISE Plan or MCOOhioRISE Plan's subcontractors violate or fail to comply with the provisions of this Agreement or other provisions of law or regulation governing the Medicaid program; or if the MCO OhioRISE Plan or MCOOhioRISE Plans's subcontractors are determined by any state or federal court to be liable for fraud or misrepresentation against the state of Ohio or any state agency including but not limited to ODM. If ODM terminates or does not renew this Agreement for a specific region or regions, ODM may, in its sole discretion, terminate or not renew this Agreement with the MCO for all regions. In the event ODM proposes to terminate or not renew this Agreement, the provisions of applicable sections of the OAC with respect to ODM's termination or refusal to enter into a provider agreement apply, including the MCOOhioRISE Plan's right to request an adjudication hearing under ORC Chapter 119.
G. F. When initiated by the MCOOhioRISE Plan, the MCOOhioRISE Plan's written notice of termination of or decision not to renew this Agreement must be received by ODM at least 240 calendar days in advance of the termination or renewal date, provided, however, that termination or non-renewal is effective at the end of the last calendar day of the applicable month. In the event of non-renewal of this Agreement with ODM by the MCOOhioRISE Plan, if the MCO OhioRISE Plan is unable to provide the required number of days of notice to ODM prior to the date when this Agreement expires, then this Agreement will be deemed extended to the last calendar day of the month that meets the required number of days from the date of the termination notice. Both parties must, for that time, continue to fulfill their duties and obligations as set forth herein.
H. If the MCO terminates or does not renew this Agreement for a specific region or regions, the MCO must comply with the requirements of Appendix O, MCO Termination and Non-Renewal. If the MCO terminates or does not renew this Agreement for a specific region or regions, ODM may terminate or not renew this Agreement with the MCO for all regions. ODM, at its discretion, may use the MCO's termination or non-renewal of this Agreement as a factor in any future procurement process.
I. G. The MCO OhioRISE Plan understands that availability of funds to fulfill the terms of this Agreement is contingent on appropriations made by the Ohio General Assembly and the United States government for funding the Medicaid program. If sufficient funds are not available from the Ohio General Assembly or the United States government to make payments on behalf of a specific population (e.g., Aged, Blind, and Disabled; , Modified Adjusted Gross Income; , or Adult Extension Group VIII-Expansion) to fulfill the terms of this Agreement, the obligations, duties, and responsibilities of the parties with respect to that population will be terminated, except as specified in Appendix O, MCO Plan Termination and Non-Renewal, as of the date funding expires. If the Ohio General Assembly or the United States government fails at any time to provide sufficient funding for ODM or the state of Ohio to make payments due under this Agreement, this Agreement will terminate as of the date funding expires without further obligation of ODM or the state of Ohio.
Appears in 1 contract
Samples: Provider Agreement