Two Year Limit to Assert Claim. (A) The STATE shall not assert any claim for or seek the payment of or make any adjustment for any alleged overpayment made by the STATE to the MCO pursuant to section 4.1 of this Contract, more than two years after the date such payment was actually received by the MCO from the STATE. (B) The MCO shall not assert any claim for or seek the payment of or make any adjustment for any alleged underpayment made by the STATE to the MCO pursuant to section 4.1 of this Contract, more than two years after the date such payment was actually received by the MCO from the STATE. The MCO must have filed a timely appeal of risk factors under section 4.1.9 in order to assert any claims regarding risk adjusted payments.
Appears in 2 contracts
Samples: Contract for Medical Assistance and Minnesotacare Medical Care Services, Contract for Medical Assistance and Minnesotacare Medical Care Services
Two Year Limit to Assert Claim. (A1) The STATE shall not assert any claim for or for, seek the payment of reimbursement of, or make any adjustment for any alleged overpayment made by the STATE to the MCO pursuant to under section 4.1 of this Contract, Contract more than two (2) years after the date such payment was actually received by the MCO from the STATE.STATE.
(B2) The MCO shall not assert any claim for or for, seek the payment of of, or make any adjustment for any alleged underpayment made by the STATE to the MCO pursuant to section 4.1 under Article 4 of this Contract, Contract more than two (2) years after the date such payment was actually received by the MCO from the STATE. The MCO must have filed a timely appeal of risk factors under section 4.1.9 4.13 in order to assert any claims regarding risk adjusted payments.payments.
Appears in 2 contracts
Samples: Contract for Special Needs Basiccare Program Services, Contract for Special Needs Basiccare Program Services
Two Year Limit to Assert Claim. (A) The STATE shall not assert any claim for or seek the payment of or make any adjustment for any alleged overpayment made by the STATE to the MCO pursuant to section 4.1 of this Contract, more than two years after the date such payment was actually received by the MCO from the STATE.
(B) The MCO shall not assert any claim for or seek the payment of or make any adjustment for any alleged underpayment made by the STATE to the MCO pursuant to section 4.1 of this Contract, more than two years after the date such payment was actually received by the MCO from the STATE. The MCO must have filed a timely appeal of risk factors under section 4.1.9 4.1.8 in order to assert any claims regarding risk adjusted payments.
Appears in 1 contract
Samples: Contract for Medical Assistance, General Assistance and Minnesotacare Medical Care Services
