The Right Choices Program (RCP) Sample Clauses

The Right Choices Program (RCP). The Right Choices Program (RCP) is Indiana’s restricted card program. The purpose of the RCP is to identify members who use covered services more extensively than their peers. The program, set forth in 405 IAC 1-1-2(c) and 405 IAC 5-6, is designed to monitor member utilization, and when appropriate, implement restrictions for those members who would benefit from increased care coordination. The Contractor will provide appropriate disease management, care management or complex case management services to RCP members. Program policies, set forth by the OMPP for the RCP, are delineated in the Right Choices Program Policy Manual. The Contractor shall comply with the program policies set forth in this Manual and subsequent revisions. The Contractor shall be responsible for RCP duties, as outlined in the Right Choices Program Policy Manual, including, but not limited to, the following:  Evaluate claims (including medical and pharmacy claims), medical information, referrals and data to identify members to be enrolled in the RCP— before enrolling a member in the RCP, the Contractor must ensure a physician, pharmacist or nurse confirms the appropriateness of the enrollment;  Document member enrollment and compliance in Portal  Enroll members in the RCP;  Provide written notification of RCP status to such members and their assigned primary physicians, pharmacies and/or hospitals;  Intervene in the care provided to RCP members by providing, at minimum, enhanced education, case management and/or care coordination with the goal of modifying member behavior;  Provide appropriate customer service to providers and members;  Evaluate and monitor the member’s compliance with his or her treatment plan to determine if the RCP restrictions should terminate or continue—the State shall make available utilization data about the Contractor’s RCP members to assist the Contractor in its monitoring duties;  Notify OMPP of members that are being reported to the OMPP Bureau of Investigation for suspected or alleged fraudulent activities;  Complete periodic reports about RCP to OMPP  Cooperate with OMPP in evaluation activities of the program by providing data and/or feedback when requested by OMPP;  Meet with OMPP about RCP program implementation as requested by OMPP; and  Develop, obtain OMPP approval of and implement internal policies and procedures regarding the Contractor’s RCP program administration and use of any subcontractors with the RCP members. OMPP shall monitor...
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Related to The Right Choices Program (RCP)

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  • Purchase Order Flip via Ariba Network (AN) The online process allows suppliers to submit invoices via the AN for catalog and non- catalog goods and services. Contractors have the ability to create an invoice directly from their Inbox in their AN account by simply “flipping” the purchase order into an invoice. This option does not require any special software or technical capabilities. For the purposes of this section, the Contractor warrants and represents that it is authorized and empowered to and hereby grants the State and the third-party provider of MFMP the right and license to use, reproduce, transmit, distribute, and publicly display within the system the information outlined above. In addition, the Contractor warrants and represents that it is authorized and empowered to and hereby grants the State and the third-party provider the right and license to reproduce and display within the system the Contractor’s trademarks, system marks, logos, trade dress, or other branding designation that identifies the products made available by the Contractor under the Contract.

  • Your Billing Rights: Keep This Document For Future Use This notice tells you about your rights and our responsibilities under the Fair Credit Billing Act.

  • BUY AMERICA ACT (National School Lunch Program and Breakfast Program With respect to products purchased by Customers for use in the National School Lunch Program and/or National School Breakfast Program, Contractor shall comply with all federal procurement laws and regulations with respect to such programs, including the Buy American provisions set forth in 7 C.F.R. Part 210.21(d), to the extent applicable. Contractor agrees to provide all certifications required by Customer regarding such programs. In the event Contractor or Contractor’s supplier(s) are unable or unwilling to certify compliance with the Buy American Provision, or the applicability of an exception to the Buy American provision, H-GAC Customers may decide not to purchase from Contractor. Additionally, H-GAC Customers may require country of origin on all products and invoices submitted for payment by Contractor, and Contractor agrees to comply with any such requirement.

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  • Deliverables for an Authorized User Agreement (Transaction Deliverables must be identified, as a measure of progress in the Authorized User Agreement. A Deliverable as a bulk number of hours is not permissible under the OGS Centralized Contract. Retainage As part of the Mini-Bid, the Authorized User may elect to retain a percentage of each individual Deliverable payment of no more than 20% until the acceptance of the complete Deliverable or project. This retainage may be reduced as described in the Mini-Bid, when the Contractor substantially reduces the time required from the timeframes negotiated between the Authorized User and the Contractor for the completion and acceptance of a Deliverable.

  • COMMERCIAL REUSE OF SERVICES The member or user herein agrees not to replicate, duplicate, copy, trade, sell, resell nor exploit for any commercial reason any part, use of, or access to 's sites.

  • Processing of Grievance It is recognized and accepted by the Union and the County that the processing of grievances as hereinafter provided is limited by the job duties and responsibilities of the employees and shall therefore be accomplished during normal working hours only when consistent with such employee duties and responsibilities. The aggrieved employee's representative, if an employee, shall be allowed a reasonable amount of time without loss in pay, to investigate a grievance, and present grievances to the County during normal working hours provided the employee and the employee representative have notified the designated supervisor.

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