Common use of Types of Remedial Action Clause in Contracts

Types of Remedial Action. (a) If CMS determines that remedial action is warranted pursuant to sections 3.4(g), 3.12, or 15.1(a), one or more of the actions set forth in the following paragraphs (i) – (xii) may be taken by CMS or a State Party, and CMS may take either or both of the actions set forth in the following paragraphs (xiii) and (xiv). (i) Notify the Hospital and, if appropriate, its Care Partner and its Downstream Care Partners, of the violation; (ii) Require the Hospital to provide additional information to CMS, the State or their designees; (iii) Conduct on-site visits, interview the Hospital’s and Care Partner’s personnel and staff, or interview beneficiaries and patients to gather information; (iv) Subject the Hospital to additional monitoring, auditing, or both; (v) Remove one or more individuals or entities from the Hospital’s Care Partner List; (vi) Require the Hospital to terminate one or more of its Care Partner Arrangements; (vii) Prohibit or suspend the Hospital’s distribution of Incentive Payments or Intervention Resources to any of its Care Partners; (viii) Require the Hospital to recalculate an Incentive Payment based on a prohibition or suspension of a PGP Care Partner’s distribution of a Downstream Incentive Payment to any of its Downstream Care Partners; (ix) Require the Hospital to amend one or more of its Approved Track Implementation Protocols; (x) Terminate the Hospital’s participation in one or more CRP Tracks; (xi) Require the Hospital to enter into a PIP, in accordance with section 15.6; (xii) Require the Hospital to comply with any applicable requirements under a Corrective Action Plan that CMS imposes upon the State, under the terms of the State Agreement; (xiii) Amend this Agreement without the consent of the Hospital to limit or deny the applicability of any or all waivers of existing law made pursuant to section 1115A(d)(1) of the Act; or (xiv) Discontinue the provision of data sharing and reports to the Hospital, under section 10.2. (b) If CMS determines that remedial action is warranted pursuant to section 15.1(b), CMS may take one or more of the following actions: (i) Remove the Care Partner or Downstream Care Partner from the Hospital’s Care Partner List; (ii) Require the Hospital to terminate its Care Partner Arrangements with the Care Partner; (iii) If the Care Partner remains on the Care Partner List, prohibit or suspend the Hospital’s distribution of Incentive Payments or Intervention Resources to that Care Partner; or (iv) Require the Hospital to recalculate an Incentive Payment based on a prohibition or suspension of a PGP Care Partner’s distribution of a Downstream Incentive Payment to the Downstream Care Partner.

Types of Remedial Action. (a) If CMS determines that remedial action is warranted pursuant to sections 3.4(g), 3.123.4,3.13, or 15.1(a)15.1, one or more of the actions set forth in the following paragraphs (i) – (xii) may be taken by CMS or a State Party, and CMS may take either or both of the actions set forth in the following paragraphs (xiii) and (xiv). (i) Notify the Hospital and, if appropriate, its Care Partner and its Downstream Care Partners, of the violation; (ii) Require the Hospital to provide additional information to CMS, the State or their designees; (iii) Conduct on-site visits, interview the Hospital’s and Care Partner’s personnel and staff, or interview beneficiaries and patients to gather information; (iv) Subject the Hospital to additional monitoring, auditing, or both; (v) Remove one or more individuals or entities from the Hospital’s Care Partner List; (vi) Require the Hospital to terminate one or more of its Care Partner Arrangements; (vii) Prohibit or suspend the Hospital’s distribution of Incentive Payments or Intervention Resources to any of its Care Partners; (viii) Require the Hospital to recalculate an Incentive Payment based on a prohibition or suspension of a PGP Care Partner’s distribution of a Downstream Incentive Payment to any of its Downstream Care Partners; (ix) Require the Hospital to amend one or more of its Approved Track Implementation Protocols; (x) Terminate the Hospital’s participation in one or more CRP Tracks; (xi) Require the Hospital to enter into a PIP, in accordance with section 15.6; (xii) Require the Hospital to comply with any applicable requirements under a Corrective Action Plan that CMS imposes upon the State, under the terms of the State Model Agreement; (xiii) Amend this Agreement without the consent of the Hospital to limit or deny the applicability of any or all waivers of existing law made pursuant to section 1115A(d)(1) of the Act; or (xiv) Discontinue the provision of data sharing and reports to the Hospital, under section 10.2. (b) If CMS determines that remedial action is warranted pursuant to section 15.1(b), CMS may take one or more of the following actions: (i) Remove the Care Partner or Downstream Care Partner from the Hospital’s Care Partner List; (ii) Require the Hospital to terminate its Care Partner Arrangements with the Care Partner; (iii) If the Care Partner remains on the Care Partner List, prohibit or suspend the Hospital’s distribution of Incentive Payments or Intervention Resources to that Care Partner; or (iv) Require the Hospital to recalculate an Incentive Payment based on a prohibition or suspension of a PGP Care Partner’s distribution of a Downstream Incentive Payment to the Downstream Care Partner.

Types of Remedial Action. (a) If CMS determines that remedial action is warranted pursuant to sections 3.4(g), 3.12, or 15.1(a), one or more of the actions set forth in the following paragraphs (i) – (xii) may be taken by CMS or a State Party, and CMS may take either or both of the actions set forth in the following paragraphs (xiii) and (xiv). (i) . Notify the Hospital and, if appropriate, its Care Partner and its Downstream Care Partners, of the violation; (ii) ; Require the Hospital to provide additional information to CMS, the State or their designees; (iii) ; Conduct on-site visits, interview the Hospital’s and Care Partner’s personnel and staff, or interview beneficiaries and patients to gather information; (iv) ; Subject the Hospital to additional monitoring, auditing, or both; (v) ; Remove one or more individuals or entities from the Hospital’s Care Partner List; (vi) ; Require the Hospital to terminate one or more of its Care Partner Arrangements; (vii) ; Prohibit or suspend the Hospital’s distribution of Incentive Payments or Intervention Resources to any of its Care Partners; (viii) ; Require the Hospital to recalculate an Incentive Payment based on a prohibition or suspension of a PGP Care Partner’s distribution of a Downstream Incentive Payment to any of its Downstream Care Partners; (ix) ; Require the Hospital to amend one or more of its Approved Track Implementation Protocols; (x) ; Terminate the Hospital’s participation in one or more CRP Tracks; (xi) ; Require the Hospital to enter into a PIP, in accordance with section 15.6; (xii) ; Require the Hospital to comply with any applicable requirements under a Corrective Action Plan that CMS imposes upon the State, under the terms of the State Agreement; (xiii) ; Amend this Agreement without the consent of the Hospital to limit or deny the applicability of any or all waivers of existing law made pursuant to section 1115A(d)(1) of the Act; or (xiv) or Discontinue the provision of data sharing and reports to the Hospital, under section 10.2. (b) . If CMS determines that remedial action is warranted pursuant to section 15.1(b), CMS may take one or more of the following actions: (i) : Remove the Care Partner or Downstream Care Partner from the Hospital’s Care Partner List; (ii) ; Require the Hospital to terminate its Care Partner Arrangements with the Care Partner; (iii) ; If the Care Partner remains on the Care Partner List, prohibit or suspend the Hospital’s distribution of Incentive Payments or Intervention Resources to that Care Partner; or (iv) or Require the Hospital to recalculate an Incentive Payment based on a prohibition or suspension of a PGP Care Partner’s distribution of a Downstream Incentive Payment to the Downstream Care Partner.

Types of Remedial Action. (a) If CMS determines that remedial action is warranted pursuant to sections 3.4(g)Article 20.1, 3.12, or 15.1(a), CMS may take one or more of the actions set forth in the following paragraphs (i) – (xii) may be taken by CMS or a State Party, and CMS may take either or both of the actions set forth in the following paragraphs (xiii) and (xiv).actions:‌ (ia) Notify require the Hospital and, if appropriate, its Care Partner and its Downstream Care Partners, of the violation; (ii) Require the Hospital Participant to provide additional information to CMS, the State CMS or their its designees; (iiib) Conduct on-conduct site visits, interview the Hospital’s and Care Partner’s personnel and staffBeneficiaries, or interview beneficiaries and patients take other actions to gather information; (ivc) Subject subject the Hospital Participant to additional monitoring, auditing, or both; (vd) Remove one or more individuals or entities remove a Downstream Episode Initiator from the Hospital’s Care Partner Participant Profile; (e) remove an NPRA Sharing Partner, an NPRA Sharing Group Practice Practitioner, or a BPCI Advanced Entity from the Initial Financial Arrangement List or the Updated Financial Arrangement List; (vif) Require require the Hospital Participant to terminate its relationship with any other individual or entity with respect to the individual’s or entity’s performance of functions or services related to BPCI Advanced Activities; (g) deny, suspend, or recoup NPRA payments; (h) require the Participant to amend its Participant Profile to terminate or modify any election to pursue Financial Arrangements, offer Beneficiary Engagement Incentives, or furnish services to BPCI Advanced Beneficiaries pursuant to one or more of its Care Partner ArrangementsPayment Policy Waivers; (viii) Prohibit or suspend prohibit the Hospital’s distribution of Incentive Payments or Intervention Resources Participant from making payments from the BPCI Advanced Savings Pool, to include any of its Care PartnersNPRA Shared Payment to an NPRA Sharing Partner and any payment for Administrative Services to a BPCI Advanced Entity; (viiij) Require suspend or terminate the Hospital Participant’s ability to recalculate an Incentive Payment based on a prohibition or suspension of a PGP Care Partner’s distribution of a Downstream Incentive Payment to any of its Downstream Care Partnersinitiate new Clinical Episodes under BPCI Advanced; (ixk) Require require the Hospital Participant to amend one or more of its Approved Track Implementation Protocolssubmit to CMS a proposed corrective action plan (“CAP”) in accordance with Article 20.3, and to implement that CAP once approved by CMS; (xl) Terminate the Hospital’s participation in one or more CRP Tracks; (xi) Require the Hospital to enter into a PIP, in accordance with section 15.6; (xii) Require the Hospital to comply with any applicable requirements under a Corrective Action Plan that CMS imposes upon the State, under the terms of the State Agreement; (xiii) Amend amend this Agreement without the consent of the Hospital Participant to limit or deny the applicability of any or all waivers of existing law made pursuant to section Section 1115A(d)(1) of the Act; or; (xivm) Discontinue discontinue the provision of data sharing and reports to the Hospital, Participant under section 10.2.Article 12; (bn) If CMS determines that remedial action is warranted pursuant suspend or terminate the Participant’s ability to section 15.1(b), CMS may take utilize one or more of the following actions: (i) Remove the Care Partner or Downstream Care Partner from the Hospital’s Care Partner List; (ii) Require the Hospital to terminate its Care Partner Arrangements with the Care Partner; (iii) If the Care Partner remains on the Care Partner List, prohibit or suspend the Hospital’s distribution of Incentive Payments or Intervention Resources to that Care PartnerPayment Policy Waivers; or (ivo) Require Impose additional remedial actions, including termination of this Agreement pursuant to Article 21, if CMS determines that remedial actions were insufficient to correct noncompliance with the Hospital to recalculate an Incentive Payment based on a prohibition or suspension terms of a PGP Care Partner’s distribution of a Downstream Incentive Payment to the Downstream Care Partnerthis Agreement.

Types of Remedial Action. (a) If CMS determines that remedial action is warranted pursuant to sections 3.4(g), 3.12, or 15.1(a), one or more of the actions set forth in the following paragraphs (i) – (xii) may be taken by CMS or a State Party, and CMS may take either or both of the actions set forth in the following paragraphs (xiii) and (xiv). (i) Notify the Hospital and, if appropriate, its Care Partner and its Downstream Care Partners, of the violation; (ii) Require the Hospital to provide additional information to CMS, the State or their designees; (iii) Conduct on-site visits, interview the Hospital’s and Care Partner’s personnel and staff, or interview beneficiaries and patients to gather information; (iv) Subject the Hospital to additional monitoring, auditing, or both; (v) Remove one or more individuals or entities from the Hospital’s Care Partner List; (vi) Require the Hospital to terminate one or more of its Care Partner Arrangements; (vii) Prohibit or suspend the Hospital’s distribution of Incentive Payments or Intervention Resources to any of its Care Partners; (viii) Require the Hospital to recalculate an Incentive Payment based on a prohibition or suspension of a PGP Care Partner’s distribution of a Downstream Incentive Payment to any of its Downstream Care Partners; (ix) Require the Hospital to amend one or more of its Approved Track Implementation Protocols; (x) Terminate the Hospital’s participation in one or more CRP Tracks; (xi) Require the Hospital to enter into a PIP, in accordance with section 15.6; (xii) Require the Hospital to comply with any applicable requirements under a Corrective Action Plan that CMS imposes upon the State, under the terms of the State Model Agreement; (xiii) Amend this Agreement without the consent of the Hospital to limit or deny the applicability of any or all waivers of existing law made pursuant to section 1115A(d)(1) of the Act; or (xiv) Discontinue the provision of data sharing and reports to the Hospital, under section 10.2. (b) If CMS determines that remedial action is warranted pursuant to section 15.1(b), CMS may take one or more of the following actions: (i) Remove the Care Partner or Downstream Care Partner from the Hospital’s Care Partner List; (ii) Require the Hospital to terminate its Care Partner Arrangements with the Care Partner; (iii) If the Care Partner remains on the Care Partner List, prohibit or suspend the Hospital’s distribution of Incentive Payments or Intervention Resources to that Care Partner; or (iv) Require the Hospital to recalculate an Incentive Payment based on a prohibition or suspension of a PGP Care Partner’s distribution of a Downstream Incentive Payment to the Downstream Care Partner.