Termination by the Division. The Division shall have the right to terminate this Contract upon the occurrence of any of the following events: a. The Contractor, its subcontractors or suppliers violate or fail to comply with any applicable provision of federal or State law or regulations; b. The conduct of the Contractor, any subcontractor or supplier, or the standard of services provided by or on behalf of the Contractor threatens to jeopardize the health or safety of any Enrollee or fails substantially to provide medically necessary items and services required under the Contract; c. The Contractor becomes subject to exclusion from participation in the Medicaid program or Medicare program pursuant to any federal or state administrative, civil, or criminal actions; d. The Contractor or any subcontractor provides fraudulent, misleading, or misrepresentative information to any Enrollee, potential enrollees, the Division or other representative of the State, or to the Secretary of the Department of Health and Human Services or his/her representative; e. Gratuities of any kind were offered to or received by any public official, employee or agent of the State from the Contractor, its agents, employees, subcontractors or suppliers, in violation of terms in this contract; f. Either of the sources of reimbursement for Medical Assistance, state and federal appropriations, no longer exists, or in the event that the sum of all obligations of the Division incurred pursuant to this contract and all other contracts entered into by the Division, including without limitation, all Statements of Participation entered into pursuant to the State Contractor, equals or exceeds the balance of such sources available to the Division for "Medical Assistance Benefits" for the fiscal year in which this Contract is effective less One Hundred Dollars ($100.00), then this contract shall immediately terminate without further obligation of the Division as of that moment; g. Imposes premiums or charges in excess of those permitted by the Division; h. Discriminates on the basis of Enrollee health status or requirements for health care services, including expulsion or refusal to re-enroll an individual, except as permitted by the Division or engaging in any discouraging enrollment based on medical condition or history; or i. Distributes directly or indirectly marketing material in violation of provisions relating to such materials. The findings by the Executive Director of the Division of the occurrence of any of the events stated above shall be conclusive. The Division will attempt to provide the Contractor with ten (10) days notice of the possible occurrence of events as described in this contract. Upon termination of the Contract for any reason except as described in Subsection F, the Division will provide the Contractor with a pre-termination conference. The Division will give the Contractor written notice of its intent to terminate, the reason for termination, and the time and place of the conference. After the conference, the Division will give the Contractor written notice of the decision. If the decision is to affirm the termination, the notice will provide the effective date of the termination. The Division is required to notify Enrollees of the Division’s intent to terminate the Contract and give Enrollees the opportunity to disenroll immediately from the Contractor without cause. If the contract is terminated because the Contractor is not in compliance with terms of this contract and if directed by CMS, the Division cannot renew or otherwise extend this contract for the Contractor unless CMS determines that compelling reasons exist for doing so.
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Samples: Contract Between the State of Mississippi Division of Medicaid and a Care Coordination Organization (Cco), Contract, Contract
Termination by the Division. The Division shall have the right to terminate this Contract upon the occurrence of any of the following events:
a. The Contractor, its subcontractors or suppliers violate or fail to comply with any applicable provision of federal or State law or regulations;
b. The conduct of the Contractor, any subcontractor or supplier, or the standard of services provided by or on behalf of the Contractor threatens to jeopardize the health or safety of any Enrollee or fails substantially to provide medically necessary items and services required under the Contract;
c. The Contractor becomes subject to exclusion from participation in the Medicaid program or Medicare program pursuant to any federal or state administrative, civil, or criminal actions;
d. The Contractor or any subcontractor provides fraudulent, misleading, or misrepresentative information to any Enrollee, potential enrollees, the Division or other representative of the State, or to the Secretary of the Department of Health and Human Services or his/her representative;
e. Gratuities of any kind were offered to or received by any public official, employee or agent of the State from the Contractor, its agents, employees, subcontractors or suppliers, in violation of terms in this contract;
f. Either of the sources of reimbursement for Medical Assistance, state and federal appropriations, no longer exists, or in the event that the sum of all obligations of the Division incurred pursuant to this contract and all other contracts entered into by the Division, including without limitation, all Statements of Participation entered into pursuant to the State Contractor, equals or exceeds the balance of such sources available to the Division for "Medical Assistance Benefits" for the fiscal year in which this Contract is effective less One Hundred Dollars ($100.00), then this contract shall immediately terminate without further obligation of the Division as of that moment;
g. Imposes premiums or charges in excess of those permitted by the Division;
h. Discriminates on the basis of Enrollee health status or requirements for health care services, including expulsion or refusal to re-enroll an individual, except as permitted by the Division or engaging in any discouraging enrollment based on medical condition or history; or
i. Distributes directly or indirectly marketing material in violation of provisions relating to such materials. The findings by the Executive Director of the Division of the occurrence of any of the events stated above shall be conclusive. The Division will attempt to provide the Contractor with ten (10) days days’ notice of the possible occurrence of events as described in this contract. Upon termination of the Contract for any reason except as described in Subsection F, the Division will provide the Contractor with a pre-termination conference. The Division will give the Contractor written notice of its intent to terminate, the reason for termination, and the time and place of the conference. After the conference, the Division will give the Contractor written notice of the decision. If the decision is to affirm the termination, the notice will provide the effective date of the termination. The Division is required to notify Enrollees of the Division’s intent to terminate the Contract and give Enrollees the opportunity to disenroll dis-enroll immediately from the Contractor without cause. If the contract is terminated because the Contractor is not in compliance with terms of this contract and if directed by CMS, the Division cannot renew or otherwise extend this contract for the Contractor unless CMS determines that compelling reasons exist for doing so.
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Samples: Contract
Termination by the Division. The Division shall have the right to terminate this Contract upon the occurrence of any of the following events:
a. The the Contractor, its subcontractors or suppliers violate or fail to comply with any applicable provision of federal or State law or regulations;
b. The the conduct of the Contractor, any subcontractor or supplier, or the standard of services provided by or on behalf of the Contractor threatens to jeopardize the health or safety of any Enrollee or fails substantially to provide medically necessary items and services required under the Contract;
c. The the Contractor becomes subject to exclusion from participation in the Medicaid program or Medicare program pursuant to any federal or state administrative, civil, or criminal actions;
d. The the Contractor or any subcontractor provides fraudulent, misleading, or misrepresentative information to any Enrollee, potential enrollees, the Division or other representative of the State, or to the Secretary of the Department of Health and Human Services or his/her representative;
e. Gratuities gratuities of any kind were offered to or received by any public official, employee or agent of the State from the Contractor, its agents, employees, subcontractors or suppliers, in violation of terms in this contract;.
f. Either either of the sources of reimbursement for Medical Assistance, state and federal appropriations, no longer exists, or in the event that the sum of all obligations of the Division incurred pursuant to this contract and all other contracts entered into by the Division, including without limitation, all Statements of Participation entered into pursuant to the State Contractor, equals or exceeds the balance of such sources available to the Division for "Medical Assistance Benefits" for the fiscal year in which this Contract is effective less One Hundred Dollars ($100.00), then this contract shall immediately terminate without further obligation of the Division as of that moment;
g. Imposes imposes premiums or charges in excess of those permitted by the Division;
h. Discriminates discriminates on the basis of Enrollee health status or requirements for health care services, including expulsion or refusal to re-enroll an individual, except as permitted by the Division or engaging in any discouraging enrollment based on medical condition or history; or
i. Distributes distributes directly or indirectly marketing material in violation of provisions relating to such materials. The findings by the Executive Director of the Division of the occurrence of any of the events stated above shall be conclusive. The Division will attempt to provide the Contractor with ten (10) days notice of the possible occurrence of events as described in this contract. Upon termination of the Contract for any reason except as described in Subsection F, the Division will provide the Contractor with a pre-termination conference. The Division will give the Contractor written notice of its intent to terminate, the reason for termination, and the time and place of the conference. After the conference, the Division will give the Contractor written notice of the decision. If the decision is to affirm the termination, the notice will provide the effective date of the termination. The Division is required to notify Enrollees of the Division’s intent to terminate the Contract and give Enrollees the opportunity to disenroll immediately from the Contractor without cause. If the contract is terminated because the Contractor is not in compliance with terms of this contract and if directed by CMS, the Division cannot renew or otherwise extend this contract for the Contractor unless CMS determines that compelling reasons exist for doing so.ten
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