Common use of Unallowable Cost Review Clause in Contracts

Unallowable Cost Review. If applicable, the IRO shall conduct a review of Pediatrix’s compliance with the unallowable cost provisions of the Settlement Agreement. The IRO shall determine whether Pediatrix 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 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 Pediatrix 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, the The IRO shall conduct a an internal review of Pediatrix’s its compliance with the unallowable cost Unallowable Cost provisions of the Settlement Agreement. The IRO shall determine whether Pediatrix Allegiance has complied with its obligations not to charge to, or otherwise seek payment from, federal or state payors for unallowable costs Unallowable Costs (as defined in the Settlement Agreement) and its obligation to identify to applicable federal or state payors any unallowable costs Unallowable Costs included in payments previously sought from the United States, or any state Medicaid program. This unallowable cost Unallowable 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 Pediatrix Allegiance 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 costsUnallowable 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, the The IRO shall conduct a review of PediatrixVanguard’s compliance with the unallowable cost provisions of the Settlement Agreement. The IRO shall determine whether Pediatrix Vanguard 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 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 Pediatrix Vanguard 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, the IRO shall conduct a review of PediatrixRotech’s compliance with the unallowable cost provisions of the Settlement Agreement. The IRO shall determine whether Pediatrix Rotech 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 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 Pediatrix Rotech 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.