Termination, Revocation and Sanctions. In addition to its termination rights under the Agreement, Subcontractor and/or Health Plan shall have the right to revoke any functions or activities Subcontractor and/or Health Plan delegates to Provider under the Agreement or impose other sanctions consistent with the State Contract if in Subcontractor’s and/or Health Plan’s reasonable judgment Provider’s performance under the Agreement is inadequate. Subcontractor and/or Health Plan shall also have the right to suspend, deny, refuse to renew or terminate Provider in accordance with the terms of the State Contract and applicable law and regulation.
Termination, Revocation and Sanctions. In addition to its termination rights under the Agreement, United shall have the right to revoke any functions or activities United delegates to Provider under the Agreement or impose other sanctions consistent with the State Contract if in United’s reasonable judgment Provider’s performance under the Agreement is inadequate. United shall also have the right to suspend, deny, refuse to renew or terminate Provider in accordance with the terms of the State Contract and applicable law and regulation.
Termination, Revocation and Sanctions. In addition to Subcontractor’s termination rights under the Agreement, Subcontractor shall have the right to revoke any functions or activities Subcontractor delegates to Provider under the Agreement or impose other sanctions consistent with the State Contract if in Subcontractor’s reasonable judgment Provider’s performance under the Agreement is inadequate. Subcontractor shall also have the right to suspend, deny, and refuse to renew or terminate Provider in accordance with the terms of the State Contract and applicable law and regulation.
Termination, Revocation and Sanctions. In addition to its termination rights under the Agreement, Subcontractor and Health Plan shall have the right to revoke any functions or activities Subcontractor and/or Health Plan delegates to Provider under the Agreement or impose other sanctions consistent with the State Contract if in Subcontractor and/or Health Plan’s reasonable judgment Provider’s performance under the Agreement is inadequate. Subcontractor and Health Plan shall also have the right to suspend, deny, refuse to renew or terminate Provider in accordance with the terms of the State Contract and applicable law and regulation. However, Subcontractor and Health Plan shall not exclude or terminate a Provider from participation in Subcontractor and/or Health Plan’s Provider Network due to the fact that the Provider has a practice that includes a substantial number of patients with expensive medical conditions, and shall not terminate a Provider for filing a Complaint, Grievance, or Appeal on a Covered Person’s behalf.
Termination, Revocation and Sanctions. In addition to Health Plan’s and Subcontractor’s termination rights under the Agreement, Health Plan and Subcontractor may terminate, rescind or cancel the Agreement in the event Provider violates any applicable HSD or Collaborative requirements or State or federal statutes, rules or regulations. Health Plan and Subcontractor also have the right to revoke any functions or activities delegated to Provider or impose other sanctions consistent with the Centennial Care Contract if in Health Plan’s and/or Subcontractor’s reasonable judgment Provider’s performance under the Agreement is inadequate. Health Plan and Subcontractor shall also have the right to suspend, deny, refuse to renew or terminate Provider in accordance with the terms of the Centennial Care Contract and applicable law and regulation. Additionally, any program violations arising out of performance of the Agreement are subject to administrative enforcement by the Health and Human Services Commission Office of Inspector General (OIG). Health Plan shall notify HSD within 5 business days, via e-mail, when a formal written action is taken by Health against a provider. Such action being defined for purposes of this provision as: (i) denial of credentialing or enrollment, or contract termination, when the denial or termination is “for cause”, as such term is defined in the provider’s agreement with Health Plan; or (ii) due to concerns other than fraud, such as integrity or quality.
Termination, Revocation and Sanctions. In addition to its termination rights under the Agreement, Subcontractor and/or Health Plan shall have the right to revoke any functions or activities delegated to Provider under the Agreement or impose other sanctions consistent with the State Contract if in Subcontractor’s or Health Plan’s reasonable judgment Provider’s performance under the Agreement is inadequate. Additionally, any program violations arising out of performance of the Agreement are subject to administrative enforcement by the Health and Human Services Commission Office of Inspector General (OIG) as specified in 1 Texas Administrative Code, Chapter 371, Subchapter G. Subcontractor and/or Health Plan shall also have the right to suspend, deny, refuse to renew or terminate Provider in accordance with the terms of the State Contract and applicable law and regulation.
Termination, Revocation and Sanctions. In addition to its termination rights under the Agreement, Subcontractor and/or CCO shall have the right to revoke any functions or activities Subcontractor and/or CCO delegates to Provider under the Agreement or impose other sanctions consistent with the MississippiCHIP Program Contract if in Subcontractor’s or CCO’s reasonable judgment Provider’s performance under the Agreement is inadequate. Subcontractor or CCO shall also have the right to suspend, deny, refuse to renew or terminate the subcontract in accordance with the terms of the MississippiCHIP Program Contract and applicable law and regulation. However, Subcontractor and CCO shall not exclude or terminate a Provider from participation in Subcontractor’s or CCO’s Provider Network due to the fact that the Provider has a practice that includes a substantial number of patients with expensive medical conditions, and shall not terminate a Provider for filing a Complaint, Grievance, or Appeal on a Member’s behalf.
Termination, Revocation and Sanctions. In addition to its termination rights under the Agreement, United shall have the right to revoke any functions or activities United delegates to Provider under the Agreement or impose other sanctions consistent with 42 CFR 438.230 (c)(iii) if in United’s reasonable judgment Provider’s performance under the Agreement is inadequate. United shall also have the right to suspend, deny, refuse to renew or terminate Provider from participation for any violation of applicable State or federal statutes and regulations, whether or not such violation results in criminal charges or sanctions... In addition, the HCA reserves the right to direct United to terminate or modify the Provider agreement when the state determines it to be in their best interest.
Termination, Revocation and Sanctions. In addition to its termination rights under the Agreement, United shall have the right to revoke any functions or activities United delegates to Provider under the Agreement or impose other sanctions consistent with the State Contract if in United’s reasonable judgment Provider’s performance under the Agreement is inadequate. United shall also have the right to suspend, deny, refuse to renew or terminate Provider in accordance with the terms of the State Contract and applicable law and regulation. However, United shall not exclude or terminate a Provider from participation in United’s Provider Network due to the fact that the Provider has a practice that includes a substantial number of patients with expensive medical conditions, and shall not terminate a Provider for filing a Complaint, Grievance, or Appeal on a Covered Person’s behalf.
Termination, Revocation and Sanctions. In addition to its termination rights under the Agreement, Subcontractor and Health Plan shall have the right to revoke any functions or activities Subcontractor and Health Plan delegates to Provider under the Agreement or impose other sanctions consistent with the State Contract if in Subcontractor’s and Health Plan ’s reasonable judgment Provider’s performance under the Agreement is inadequate. This shall include, but may not be limited to, Provider’s failure or refusal to respond to Subcontractor’s and Health Plan ’s request for information such as medical records. Subcontractor and Health Plan shall also have the right to suspend, deny, refuse to renew or terminate Provider in accordance with the terms of the State Contract and applicable law and regulation. Subcontractor and Health Plan may also suspend payments to Provider if directed by the State. Moreover, the State reserves the right to direct Subcontractor and Health Plan to terminate or modify the Agreement when the State determines it to be in the best interest of the State.
