Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMS, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract period. The MCO must provide BMS with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS pre-authorization, those currently receiving case management, and those with known future service needs (e.g. scheduled ambulatory surgery, pregnancy) by such date as determined by BMS, with weekly updates thereafter. The MCO must provide BMS with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS with all required reports and data through the end of the Contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar days after the end of the quarter in which the encounters occurred. BMS may request an interim encounter data submission ninety (90) calendar days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS will be responsible for all expenses relating to said notification.
Appears in 3 contracts
Samples: Model Purchase of Service Provider Agreement, Model Purchase of Service Provider Agreement, Service Provider Agreement
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMS, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract period. The MCO must provide BMS with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS pre-authorization, those currently receiving case management, and those with known future service needs (e.g. e.g., scheduled ambulatory surgery, pregnancy) by such date as determined by BMS, with weekly updates thereafter. The MCO must provide BMS with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS with all required reports and data through the end of the Contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar days after the end of the quarter in which the encounters occurred. BMS may request an interim encounter data submission ninety (90) calendar days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS will be responsible for all expenses relating to said notification.
Appears in 3 contracts
Samples: Service Provider Agreement, Model Purchase of Service Provider Agreement, Service Provider Agreement
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMSthe Department, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid or SNS claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract periodDHHR. The MCO must provide BMS DHHR with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS DHHR pre-authorization, those currently receiving case management, and those with known future service needs (e.g. scheduled ambulatory surgery, pregnancy) by such date as determined by BMSDHHR, with weekly updates thereafter. The MCO must provide BMS DHHR with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS DHHR with all required reports and data through the end of the Contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar days after the end of the quarter in which the encounters occurred. BMS The Department may request an interim encounter data submission ninety (90) calendar days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS The Department will be responsible for all expenses relating to said notification.
Appears in 2 contracts
Samples: dhhr.wv.gov, dhhr.wv.gov
Termination Obligations of Contracting Parties. Upon Contract contract termination, the MCO and Subcontractors must allow BMSthe Department, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contractcontract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract contract period. The MCO must provide BMS with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS pre-authorization, those currently receiving case management, and those with known future service needs (e.g. scheduled ambulatory surgery, pregnancy) by such date as determined by BMS, with weekly updates thereafter. The MCO must provide BMS with the names and treatment plans of enrollees with such plans. Upon Contract contract termination, the MCO and Subcontractors must provide BMS with all required reports and data through the end of the Contract contract period as described in this Contractcontract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar 90 days after the end of the quarter in which the encounters occurred. BMS may request an interim encounter data submission ninety (90) calendar 90 days after the termination of the contract. Where this Contract contract is terminated due to default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract contract is terminated for any reason other than default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS The Department will be responsible for all expenses relating to said notification.
Appears in 2 contracts
Samples: Purchase of Service Provider Agreement, Purchase of Service Provider Agreement
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMSthe Department, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract period. The MCO must provide BMS with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS pre-authorization, those currently receiving case management, and those with known future service needs (e.g. scheduled ambulatory surgery, pregnancy) by such date as determined by BMS, with weekly updates thereafter. The MCO must provide BMS with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS with all required reports and data through the end of the Contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar 90 days after the end of the quarter in which the encounters occurred. BMS The Department may request an interim encounter data submission ninety (90) calendar 90 days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS The Department will be responsible for all expenses relating to said notification.
Appears in 2 contracts
Samples: Service Provider Agreement, Service Provider Agreement
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMSthe Department, its agents agents, and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid or SNS claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract periodDHHR. The MCO must provide BMS DHHR with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS DHHR pre-authorization, those currently receiving case management, and those with known future service needs (e.g. e.g., scheduled ambulatory surgery, pregnancy) by such date as determined by BMSDHHR, with weekly updates thereafter. The MCO must provide BMS DHHR with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS DHHR with all required reports and data through the end of the Contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar days after the end of the quarter in which the encounters occurred. BMS The Department may request an interim encounter data submission ninety (90) calendar days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS The Department will be responsible for all expenses relating to said notification.
Appears in 2 contracts
Samples: Service Provider Agreement, dhhr.wv.gov
Termination Obligations of Contracting Parties. Upon Contract contract termination, the MCO and Subcontractors must allow BMSthe Department, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contractcontract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract contract period. The MCO must provide BMS with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS pre-authorization, those currently receiving case management, and those with known future service needs (e.g. scheduled ambulatory surgery, pregnancy) by such date as determined by BMS, with weekly updates thereafter. The MCO must provide BMS with the names and treatment plans of enrollees with such plans. Upon Contract contract termination, the MCO and Subcontractors must provide BMS with all required reports and data through the end of the Contract contract period as described in this Contractcontract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar 90 days after the end of the quarter in which the encounters occurred. BMS may request an interim encounter data submission ninety (90) calendar 90 days after the termination of the contract. Where this Contract contract is terminated due to default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract contract is terminated for any reason other than default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS The Department will be responsible for all expenses relating to said notification.
Appears in 2 contracts
Samples: Purchase of Service Provider Agreement, Purchase of Service Provider Agreement
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMS, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract period. The MCO must provide BMS with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS pre-authorization, those currently receiving case management, and those with known future service needs (e.g. e.g., scheduled ambulatory surgery, pregnancy) by such date as determined by BMS, with weekly updates thereafter. The MCO must provide BMS with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS with all required reports and data through the end of the Contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar days after the end of the quarter in which the encounters occurred. BMS may request an interim encounter data submission ninety (90) calendar days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS will be responsible for all expenses relating to said notification.
Appears in 1 contract
Samples: Service Provider Agreement
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMSthe Department, its agents agents, and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid or SNS claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract periodDepartment. The MCO must provide BMS the Department with the names, PCP primary care provider (PCP) assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS Department pre-authorization, those currently receiving case management, and those with known future service needs (e.g. e.g., scheduled ambulatory surgery, pregnancy) by such date as determined by BMSthe Department, with weekly updates thereafter. The MCO must provide BMS the Department with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS the Department with all required reports and data through the end of the Contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar days after the end of the quarter in which the encounters occurred. BMS The Department may request an interim encounter data submission ninety (90) calendar days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS The Department will be responsible for all expenses relating to said notification.
Appears in 1 contract
Samples: dhhr.wv.gov
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMSthe Department, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract period. The MCO must provide BMS with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS pre-pre- authorization, those currently receiving case management, and those with known future service needs (e.g. scheduled ambulatory surgery, pregnancy) by such date as determined by BMS, with weekly updates thereafter. The MCO must provide BMS with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS with all required reports and data through the end of the Contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar 90 days after the end of the quarter in which the encounters occurred. BMS The Department may request an interim encounter data submission ninety (90) calendar 90 days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS The Department will be responsible for all expenses relating to said notification.
Appears in 1 contract
Termination Obligations of Contracting Parties. Upon Contract contract termination, the MCO and Subcontractors must shall allow BMSthe Department, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contractcontract, the MCO may shall no longer accept new enrollees. The MCO will shall remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract contract period. The MCO must shall provide BMS with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS pre-authorization, those currently receiving case management, and those with known future service needs (e.g. scheduled ambulatory surgery, pregnancy) by such date as determined by BMS, with weekly updates thereafter. The MCO must shall provide BMS with the names and treatment plans of enrollees with such plans. Upon Contract contract termination, the MCO and Subcontractors must shall provide BMS with all required reports and data through the end of the Contract contract period as described in this Contractcontract. This requirement includes encounter data, which must shall be submitted no later than ninety (90) calendar 90 days after the end of the quarter in which the encounters occurred. BMS may request an interim encounter data submission ninety (90) calendar 90 days after the termination of the contract. Where this Contract contract is terminated due to default by the MCO: • BMS will The Department shall be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will shall be responsible for all reasonable expenses related to said notification. Where this Contract contract is terminated for any reason other than default by the MCO: • BMS will The Department shall be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS will The Department shall be responsible for all expenses relating to said notification.
Appears in 1 contract
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMSthe Department, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract periodDHHR. The MCO must provide BMS DHHR with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS WVDHHR pre-authorization, those currently receiving case management, and those with known future service needs (e.g. scheduled ambulatory surgery, pregnancy) by such date as determined by BMSDHHR, with weekly updates thereafter. The MCO must provide BMS DHHR with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS DHHR with all required reports and data through the end of the Contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar days after the end of the quarter in which the encounters occurred. BMS The Department may request an interim encounter data submission ninety (90) calendar days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS The Department will be responsible for all expenses relating to said notification.
Appears in 1 contract
Samples: Service Provider Agreement
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMSthe Department, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract contract period. The MCO must provide BMS with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS pre-authorization, those currently receiving case management, and those with known future service needs (e.g. scheduled ambulatory surgery, pregnancy) by such date as determined by BMS, with weekly updates thereafter. The MCO must provide BMS with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS with all required reports and data through the end of the Contract contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar 90 days after the end of the quarter in which the encounters occurred. BMS The Department may request an interim encounter data submission ninety (90) calendar 90 days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS The Department will be responsible for all expenses relating to said notification.
Appears in 1 contract
Samples: Service Provider Agreement
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMS, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract period. The MCO must provide BMS with the names, PCP primary care provider (PCP) assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS Department pre-authorization, those currently receiving case management, and those with known future service needs (e.g. e.g., scheduled ambulatory surgery, pregnancy) by such date as determined by BMS, with weekly updates thereafter. The MCO must provide BMS with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS with all required reports and data through the end of the Contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar days after the end of the quarter in which the encounters occurred. BMS may request an interim encounter data submission ninety (90) calendar days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS will be responsible for all expenses relating to said notification.
Appears in 1 contract
Samples: Service Provider Agreement
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMSthe Department, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract contract period. The MCO must provide BMS with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS pre-authorization, those currently receiving case management, and those with known future service needs (e.g. scheduled ambulatory surgery, pregnancy) by such date as determined by BMS, with weekly updates thereafter. The MCO must provide BMS with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS with all required reports and data through the end of the Contract contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar 90 days after the end of the quarter in which the encounters occurred. BMS The Department may request an interim encounter data submission ninety (90) calendar 90 days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS The Department will be responsible for all expenses relating to said notification.
Appears in 1 contract
Samples: Service Provider Agreement
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMSthe Department, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract periodDHHR. The MCO must provide BMS DHHR with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS WVDHHR pre-authorization, those currently receiving case management, and those with known future service needs (e.g. scheduled ambulatory surgery, pregnancy) by such date as determined by BMSDHHR, with weekly updates thereafter. The MCO must provide BMS DHHR with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS DHHR with all required reports and data through the end of the Contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar days after the end of the quarter in which the encounters occurred. BMS The Department may request an interim encounter data submission ninety (90) calendar days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS The Department will be responsible for all expenses relating to said notification.
Appears in 1 contract
Samples: Service Provider Agreement
Termination Obligations of Contracting Parties. Upon Contract termination, the MCO and Subcontractors must allow BMSthe Department, its agents and representatives full access to the MCO’s and Subcontractor facilities and records to arrange the orderly transfer of the contracted activities. These records include the information necessary for the reimbursement of any outstanding Medicaid claims. Upon the date of notification of its intent to terminate the Contract, the MCO may no longer accept new enrollees. The MCO will remain responsible for providing services, including coverage of inpatient services, through the effective date of the Contract termination, to individuals enrolled with the MCO on or before the date of notification to BMS and to newborns born to enrolled mothers during the remaining Contract period. The MCO must provide BMS with the names, PCP assignments, and primary diagnosis of all enrollees with care needs that require WVDHHS pre-pre- authorization, those currently receiving case management, and those with known future service needs (e.g. scheduled ambulatory surgery, pregnancy) by such date as determined by BMS, with weekly updates thereafter. The MCO must provide BMS with the names and treatment plans of enrollees with such plans. Upon Contract termination, the MCO and Subcontractors must provide BMS with all required reports and data through the end of the Contract period as described in this Contract. This requirement includes encounter data, which must be submitted no later than ninety (90) calendar 90 days after the end of the quarter in which the encounters occurred. BMS The Department may request an interim encounter data submission ninety (90) calendar 90 days after the termination of the contract. Where this Contract is terminated due to default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • The MCO will be responsible for all reasonable expenses related to said notification. Where this Contract is terminated for any reason other than default by the MCO: • BMS The Department will be responsible for notifying all enrollees of the date of termination and process by which the enrollees will continue to receive services; and • BMS The Department will be responsible for all expenses relating to said notification.
Appears in 1 contract