Common use of Unallowable Cost Review Clause in Contracts

Unallowable Cost Review. If applicable, for the first Reporting Period, the IRO shall conduct a review of the Provider’s compliance with the unallowable cost provisions of the Settlement Agreement. The IRO shall determine whether the Provider has complied with its obligations not to charge to, or otherwise seek payment from, federal or state payors for unallowable costs (as defined in the Settlement Agreement) and its obligation to identify to applicable federal or state payors any unallowable costs included in payments previously sought from the United States, or any state Medicaid program. This unallowable costs analysis shall include, but not be limited to, payments sought in any cost reports, cost statements, information reports, or payment requests already submitted by the Provider or any affiliates. To the extent that such cost reports, cost statements, information reports, or payment requests, even if already settled, have been adjusted to account for the effect of the inclusion of the unallowable costs, the IRO shall determine if such adjustments were proper. In making this determination, the IRO may need to review cost reports and/or financial statements from the year in which the Settlement Agreement was executed, as well as from previous years.

Unallowable Cost Review. If applicable, for For the first Reporting Period, the Billing IRO shall conduct a review of the ProviderParkland’s compliance with the unallowable cost provisions of the Settlement Agreement. The Billing IRO shall determine whether the Provider Parkland has complied with its obligations not to charge to, or otherwise seek payment from, federal Federal or state State payors for unallowable costs (as defined in the Settlement Agreement) and its obligation to identify to applicable federal Federal or state State payors any unallowable costs included in payments previously sought from the United States, or any state Medicaid program. This unallowable costs analysis shall include, but not be limited to, payments sought in any cost reports, cost statements, information reports, or payment requests already submitted by the Provider Parkland or any affiliates. To the extent that such cost reports, cost statements, information reports, or payment requests, even if already settled, have been adjusted to account for the effect of the inclusion of the unallowable costs, the Billing IRO shall determine if such adjustments were proper. In making this determination, the Billing IRO may need to review cost reports and/or financial statements from the year in which the Settlement Agreement was executed, as well as from previous years.

Unallowable Cost Review. If applicable, for the first Reporting Period, the IRO shall conduct a review of the Provider’s All Smiles’ compliance with the unallowable cost provisions of the Settlement Agreement. The IRO shall determine whether the Provider All Smiles has complied with its obligations not to charge to, or otherwise seek payment from, federal or state payors for unallowable costs (as defined in the Settlement Agreement) and its obligation to identify to applicable federal or state payors any unallowable costs included in payments previously sought from the United States, or any state Medicaid program. This unallowable costs analysis shall include, but not be limited to, payments sought in any cost reports, cost statements, information reports, or payment requests already submitted by the Provider All Smiles or any affiliates. To the extent that such cost reports, cost statements, information reports, or payment requests, even if already settled, have been adjusted to account for the effect of the inclusion of the unallowable costs, the IRO shall determine if such adjustments were proper. In making this determination, the IRO may need to review cost reports and/or financial statements from the year in which the Settlement Agreement was executed, as well as from previous years.

Unallowable Cost Review. If applicable, for the first Reporting Period, the IRO shall conduct a review of the ProviderAmedisys’s compliance with the unallowable cost provisions of the Settlement Agreement. The IRO shall determine whether the Provider Amedisys has complied with its obligations not to charge to, or otherwise seek payment from, federal or state payors for unallowable costs (as defined in the Settlement Agreement) and its obligation to identify to applicable federal or state payors any unallowable costs included in payments previously sought from the United States, or any state Medicaid program. This unallowable costs analysis shall include, but not be limited to, payments sought in any cost reports, cost statements, information reports, or payment requests already submitted by the Provider Amedisys or any affiliates. To the extent that such cost reports, cost statements, information reports, or payment requests, even if already settled, have been adjusted to account for the effect of the inclusion of the unallowable costs, the IRO shall determine if such adjustments were proper. In making this determination, the IRO may need to review cost reports and/or financial statements from the year in which the Settlement Agreement was executed, as well as from previous years.

Unallowable Cost Review. If applicable, for the first Reporting Period, the IRO shall conduct a review of the Provider’s Xxxxxxxx’x compliance with the unallowable cost provisions of the Settlement Agreement. The IRO shall determine whether the Provider Xxxxxxxx has complied with its obligations not to charge to, or otherwise seek payment from, federal or state payors for unallowable costs (as defined in the Settlement Agreement) and its obligation to identify to applicable federal or state payors any unallowable costs included in payments previously sought from the United States, or any state Medicaid program. This unallowable costs cost analysis shall include, but not be limited to, payments sought in any cost reports, cost statements, information reports, or payment requests already submitted by the Provider Xxxxxxxx or any affiliates. To the extent that such cost reports, cost statements, information reports, or payment requests, even if already settled, have been adjusted to account for the effect of the inclusion of the unallowable costs, the IRO shall determine if such adjustments were proper. In making this determination, the IRO may need to review cost reports and/or financial statements from the year in which the Settlement Agreement was executed, as well as from previous years.

Unallowable Cost Review. If applicable, for the first Reporting Period, the IRO shall conduct a review of the ProviderLWCI’s compliance with the unallowable cost provisions of the Settlement Agreement. The IRO shall determine whether the Provider LWCI has complied with its obligations not to charge to, or otherwise seek payment from, federal or state payors for unallowable costs (as defined in the Settlement Agreement) and its obligation to identify to applicable federal or state payors any unallowable costs included in payments previously sought from the United States, or any state Medicaid program. This unallowable costs analysis shall include, but not be limited to, payments sought in any cost reports, cost statements, information reports, or payment requests already submitted by the Provider LWCI or any affiliates. To the extent that such cost reports, cost statements, information reports, or payment requests, even if already settled, have been adjusted to account for the effect of the inclusion of the unallowable costs, the IRO shall determine if such adjustments were proper. In making this determination, the IRO may need to review cost reports and/or financial statements from the year in which the Settlement Agreement was executed, as well as from previous years.

Unallowable Cost Review. If applicable, for For the first Reporting Period, the IRO shall conduct a review of the Provider’s CareAll Entities’ compliance with the unallowable cost provisions of the Settlement Agreement. The IRO shall determine whether the Provider has VIP, Professional, and University complied with its their obligations not to charge to, or otherwise seek payment from, federal or state payors for unallowable costs (as defined in the Settlement Agreement) and its their obligation to identify to applicable federal or state payors any unallowable costs included in payments previously sought from the United States, or any state Medicaid program. This unallowable costs analysis shall include, but not be limited to, payments sought in any cost reports, cost statements, information reports, or payment requests already submitted by the Provider or any affiliatesVIP, Professional, and University. To the extent that such cost reports, cost statements, information reports, or payment requests, even if already settled, have been adjusted to account for the effect of the inclusion of the unallowable costs, the IRO shall determine if such adjustments were proper. In making this determination, the IRO may need to review cost reports and/or financial statements from the year in which the Settlement Agreement was executed, as well as from previous years.