Termination of Provider Agreement. 7.1. The PROVIDER status may be terminated without cause if the PROVIDER or the DEPARTMENT or its AUTHORIZED AGENTS give the other written notice of termination at least sixty (60) calendar days prior to the effective date of the termination. 7.2. The DEPARTMENT or its AUTHORIZED AGENTS may terminate this AGREEMENT for cause, with thirty (30) calendar days notice if the PROVIDER, his or her agent, a managing employee, or any person having an ownership interest equal to five percent (5%) or greater in the health care PROVIDER entity: (A) Misrepresents, by commission or omission, any information on the AGREEMENT enrollment form. (B) Has previous or current exclusion, suspension, termination from, or the involuntary withdrawal from participation in a health care program administered by the DEPARTMENT, any other state's Medicaid program, Medicare, or any other public or private health insurance program. (C) Is convicted under federal or state law of a criminal offense relating to the delivery of the goods, services, or supplies, under a health care program administered by the DEPARTMENT, any other state's Medicaid Program, Medicare, or any other public or private health insurance program. (D) Is convicted under federal or state law of a criminal offense relating to the neglect or abuse of a patient in connection with the delivery of any goods, services, or supplies. (E) Is convicted under federal or state law of a criminal offense relating to the unlawful manufacture, distribution, prescription or dispensing of a controlled substance. (F) Is convicted under federal or state law of a criminal offense relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct. (G) Is convicted under federal or state law of a criminal offense punishable by imprisonment of a year or more which involved moral turpitude or acts against the elderly, children, or infirm. (H) Is sanctioned pursuant to a violation of federal or state laws or rules relative to a health care program administered by the DEPARTMENT, any other state's Medicaid Program, Medicare, or any other public health insurance program. (I) Is convicted under federal or state law of a criminal offense in connection with the interference or obstruction of any investigations into any criminal offense listed in Paragraphs (C) through (H) of this subsection. (J) Violates licensing or certification conditions or professional standards relating to the licensure or certification of the PROVIDER or the required quality of goods, services, or supplies provided. (K) Fails to pay recovery properly assessed or pursuant to an approved repayment schedule under a health care program administered by the DEPARTMENT or its AUTHORIZED AGENTS. 7.3. The PROVIDER’s status may be terminated immediately, without notice, in instances in which the health and safety of eligible recipients in institutions are deemed to be in immediate jeopardy; are subject to an immediate or serious threat; or when it has been demonstrated, on the basis of reliable evidence, that the PROVIDER has committed fraud, abuse, or other illegal or sanctionable action. For purposes of this provision, institutional providers include nursing facilities, intermediate care facilities for the mentally retarded, all residential psychiatric treatment facilities, group homes, and other facility-based residential treatment programs. 7.4. The DEPARTMENT or its AUTHORIZED AGENTS reserve the right to terminate this AGREEMENT for cause as summarized in this AGREEMENT and as delineated in Section MAD-8.351.2, SANCTIONS AND REMEDIES of the Medical Assistance Division Program Policy Manual, or as amended and/or its successor. 7.5. Immediately upon termination for any reason, the PROVIDER shall: (A) Comply with all directives issued by the DEPARTMENT or its AUTHORIZED AGENTS; and (B) Take such action as the DEPARTMENT or its AUTHORIZED AGENTS shall direct for the protection, preservation, retention or transfer of all property, included but not limited to all recipient records.
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Termination of Provider Agreement. 7.1. The PROVIDER status may be terminated without cause if the PROVIDER or the DEPARTMENT or its AUTHORIZED AGENTS give the other written notice of termination at least sixty (60) calendar days prior to the effective date of the termination.
7.2. The DEPARTMENT or its AUTHORIZED AGENTS may terminate this AGREEMENT for cause, with thirty (30) calendar days notice if the PROVIDER, his or her agent, a managing employee, or any person having an ownership interest equal to five percent (5%) or greater in the health care PROVIDER entity:
(A) Misrepresents, by commission or omission, any information on the AGREEMENT enrollment form.
(B) Has previous or current exclusion, suspension, termination from, or the involuntary withdrawal from participation in a health care program administered by the DEPARTMENT, any other state's Medicaid program, Medicare, or any other public or private health insurance program.
(C) Is convicted under federal or state law of a criminal offense relating to the delivery of the goods, services, or supplies, under a health care program administered by the DEPARTMENT, any other state's Medicaid Program, Medicare, or any other public or private health insurance program.
(D) Is convicted under federal or state law of a criminal offense relating to the neglect or abuse of a patient in connection with the delivery of any goods, services, or supplies.
(E) Is convicted under federal or state law of a criminal offense relating to the unlawful manufacture, distribution, prescription or dispensing of a controlled substance.
(F) Is convicted under federal or state law of a criminal offense relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct.
(G) Is convicted under federal or state law of a criminal offense punishable by imprisonment of a year or more which involved moral turpitude or acts against the elderly, children, or infirm.
(H) Is sanctioned pursuant to a violation of federal or state laws or rules relative to a health care program administered by the DEPARTMENT, any other state's Medicaid Program, Medicare, or any other public health insurance program.
(I) Is convicted under federal or state law of a criminal offense in connection with the interference or obstruction of any investigations into any criminal offense listed in Paragraphs (C) through (H) of this subsection.
(J) Violates licensing or certification conditions or professional standards relating to the licensure or certification of the PROVIDER or the required quality of goods, services, or supplies provided.
(K) Fails to pay recovery properly assessed or pursuant to an approved repayment schedule under a health care program administered by the DEPARTMENT or its AUTHORIZED AGENTS.
7.3. The PROVIDER’s status may be terminated immediately, without notice, in instances in which the health and safety of eligible recipients in institutions are deemed to be in immediate jeopardy; are subject to an immediate or serious threat; or when it has been demonstrated, on the basis of reliable evidence, that the PROVIDER has committed fraud, abuse, or other illegal or sanctionable action. For purposes of this provision, institutional providers include nursing facilities, intermediate care facilities for the mentally retarded, all residential psychiatric treatment facilities, group homes, and other facility-based residential treatment programs.
7.4. The DEPARTMENT or its AUTHORIZED AGENTS reserve the right to terminate this AGREEMENT for cause as summarized in this AGREEMENT and as delineated in Section MAD-8.351.2MAD- 8.351.2, SANCTIONS AND REMEDIES of the Medical Assistance Division Program Policy Manual, or as amended and/or its successor.
7.5. Immediately upon termination for any reason, the PROVIDER shall:
(A) Comply with all directives issued by the DEPARTMENT or its AUTHORIZED AGENTS; and
(B) Take such action as the DEPARTMENT or its AUTHORIZED AGENTS shall direct for the protection, preservation, retention or transfer of all property, included but not limited to all recipient records.
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Samples: Provider Participation Agreement
Termination of Provider Agreement. 7.1. The PROVIDER status may be terminated without cause if the PROVIDER or the DEPARTMENT or its AUTHORIZED AGENTS give the other written notice of termination at least sixty (60) calendar days prior to the effective date of the termination.
7.2. The DEPARTMENT or its AUTHORIZED AGENTS may terminate this AGREEMENT for cause, with thirty (30) calendar days notice if the PROVIDER, his or her agent, a managing employee, or any person having an ownership interest equal to five percent (5%) or greater in the health care PROVIDER entity:
(A) Misrepresents, by commission or omission, any information on the AGREEMENT enrollment form.
(B) Has previous or current exclusion, suspension, termination from, or the involuntary withdrawal from participation in a health care program administered by the DEPARTMENT, any other state's Medicaid program, Medicare, or any other public or private health insurance program.
(C) Is convicted under federal or state law of a criminal offense relating to the delivery of the goods, services, or supplies, under a health care program administered by the DEPARTMENT, any other state's Medicaid Program, Medicare, or any other public or private health insurance program.
(D) Is convicted under federal or state law of a criminal offense relating to the neglect or abuse of a patient in connection with the delivery of any goods, services, or supplies.
(E) Is convicted under federal or state law of a criminal offense relating to the unlawful manufacture, distribution, prescription or dispensing of a controlled substance.
(F) Is convicted under federal or state law of a criminal offense relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct.
(G) Is convicted under federal or state law of a criminal offense punishable by imprisonment of a year or more which involved moral turpitude or acts against the elderly, children, or infirm.
(H) Is sanctioned pursuant to a violation of federal or state laws or rules relative to a health care program administered by the DEPARTMENT, any other state's Medicaid Program, Medicare, or any other public health insurance program.
(I) Is convicted under federal or state law of a criminal offense in connection with the interference or obstruction of any investigations into any criminal offense listed in Paragraphs (C) through (H) of this subsection.
(J) Violates licensing or certification conditions or professional standards relating to the licensure or certification of the PROVIDER or the Name of Entity / Individual EIN / SSN NPI APPLICANT INITAL HERE webporta CERTIFYING YOU HAVE READ AND UNDERSTAND THE INFORMATION ON THIS PAGE required quality of goods, services, or supplies provided.
(K) Fails to pay recovery properly assessed or pursuant to an approved repayment schedule under a health care program administered by the DEPARTMENT or its AUTHORIZED AGENTS.
7.3. The PROVIDER’s status may be terminated immediately, without notice, in instances in which the health and safety of eligible recipients in institutions are deemed to be in immediate jeopardy; are subject to an immediate or serious threat; or when it has been demonstrated, on the basis of reliable evidence, that the PROVIDER has committed fraud, abuse, or other illegal or sanctionable action. For purposes of this provision, institutional providers include nursing facilities, intermediate care facilities for the mentally retarded, all residential psychiatric treatment facilities, group homes, and other facility-based residential treatment programs.
7.4. The DEPARTMENT or its AUTHORIZED AGENTS reserve the right to terminate this AGREEMENT for cause as summarized in this AGREEMENT and as delineated in Section MAD-8.351.2, SANCTIONS AND REMEDIES of the Medical Assistance Division Program Policy Manual, or as amended and/or its successor.
7.5. Immediately upon termination for any reason, the PROVIDER shall:
(A) Comply with all directives issued by the DEPARTMENT or its AUTHORIZED AGENTS; and
(B) Take such action as the DEPARTMENT or its AUTHORIZED AGENTS shall direct for the protection, preservation, retention or transfer of all property, included but not limited to all recipient records.
Appears in 1 contract
Samples: Medicaid Provider Application
Termination of Provider Agreement. 7.1. The PROVIDER status may be terminated without cause if the PROVIDER or the DEPARTMENT or its AUTHORIZED AGENTS give the other written notice of termination at least sixty (60) calendar days prior to the effective date of the termination.
7.2. The DEPARTMENT or its AUTHORIZED AGENTS may terminate this AGREEMENT for cause, with thirty (30) calendar days notice if the PROVIDER, his or her agent, a managing employee, or any person having an ownership interest equal to five percent (5%) or greater in the health care PROVIDER entity:
(A) Misrepresents, by commission or omission, any information on the AGREEMENT enrollment form.
(B) Has previous or current exclusion, suspension, termination from, or the involuntary withdrawal from participation in a health care program administered by the DEPARTMENT, any other state's Medicaid program, Medicare, or any other public or private health insurance program.
(C) Is convicted under federal or state law of a criminal offense relating to the delivery of the goods, services, or supplies, under a health care program administered by the DEPARTMENT, any other state's Medicaid Program, Medicare, or any other public or private health insurance program.
(D) Is convicted under federal or state law of a criminal offense relating to the neglect or abuse of a patient in connection with the delivery of any goods, services, or supplies.
(E) Is convicted under federal or state law of a criminal offense relating to the unlawful manufacture, distribution, prescription or dispensing of a controlled substance.
(F) Is convicted under federal or state law of a criminal offense relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct.
(G) Is convicted under federal or state law of a criminal offense punishable by imprisonment of a year or more which involved moral turpitude or acts against the elderly, children, or infirm.
(H) Is sanctioned pursuant to a violation of federal or state laws or rules relative to a health care program administered by the DEPARTMENT, any other state's Medicaid Program, Medicare, or any other public health insurance program.
(I) Is convicted under federal or state law of a criminal offense in connection with the interference or obstruction of any investigations into any criminal offense listed in Paragraphs (C) through (H) of this subsection.
(J) Violates licensing or certification conditions or professional standards relating to the licensure or certification of the PROVIDER or the required quality of goods, services, or supplies provided.
(K) Fails to pay recovery properly assessed or pursuant to an approved repayment schedule under a health care program administered by the DEPARTMENT or its AUTHORIZED AGENTS.
7.3. The PROVIDER’s status may be terminated immediately, without notice, in instances in which the health and safety of eligible recipients in institutions are deemed to be in immediate jeopardy; are subject to an immediate or serious threat; or when it has been demonstrated, on the basis of reliable evidence, that the PROVIDER has committed fraud, abuse, or other illegal or sanctionable action. For purposes of this provision, institutional providers include nursing facilities, intermediate care facilities for the mentally retarded, all residential psychiatric treatment facilities, group homes, and other facility-based residential treatment programs.
7.4. The DEPARTMENT or its AUTHORIZED AGENTS reserve the right to terminate this AGREEMENT for cause as summarized in this AGREEMENT and as delineated in Section MAD-8.351.2, SANCTIONS AND REMEDIES of the Medical Assistance Division Program Policy Manual, or as amended and/or its successor.
7.5. Immediately upon termination for any reason, the PROVIDER shall:
(A) Comply with all directives issued by the DEPARTMENT or its AUTHORIZED AGENTS; and
(B) Take such action as the DEPARTMENT or its AUTHORIZED AGENTS shall direct for the protection, preservation, retention or transfer of all property, included but not limited to all recipient records.the
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