WITHHOLDING OF CAPITATION PAYMENTS AND ORDERS TO PROVIDE SERVICES. Notwithstanding the provisions of this Contract, the Department may withhold portions of capitation payments or liquidated damages or otherwise recover damages from the County on the following grounds: 1. Whenever the Department determines that the County has failed to provide one or more of the BadgerCare Plus covered Contract services under Addendum VII or failed to comply with the provisions contained in this Contract, the Department may either order the County to provide such service, or withhold a portion of the County’s capitation payments for the following month or subsequent months, such portion withheld to be equal to the amount of money the Department must pay to provide such services. County shall be given at least seven days written notice prior to the County being required to comply with either: a) Department direction to the County to pay, or b) The withholding of any capitation payments, except that in case of an emergency, no such seven-day notice is required. If the Department orders the County to provide services under this section and the County fails to provide the services within the timeline specified by the Department, the Department may withhold from the County’s capitation payments an amount up to 150% of the fee-for- service amount for such services. When it withholds payments under this section, the Department must submit to the County a list of the members for whom payments are being withheld, the nature of the service(s) denied, and payments the Department must make to provide medically necessary services. If the Department acts under this section and subsequently determines that the services in question were non-covered services: a. If the Department withheld payments it shall restore to the County the full capitation payment; or b. If Department ordered the County to provide services under this section it shall pay the County the actual documented cost of providing the services. 2. If the County fails to submit required data and/or information to the Department or the Department’s authorized agents, or fails to submit such data or information in the required form or format, by the deadline specified by the Department, the Department may immediately impose liquidated damages in the amount of $1,500 per day for each day beyond the deadline that the County fails to submit the data or fails to submit the data in the required form or format, such liquidated damages to be deducted from the County’s capitation payments. 3. Whenever the Department determines that the County has failed to perform an administrative function required under this Contract, the Department may withhold a portion of future capitation payments. For the purposes of this section, “administrative function” is defined as any Contract obligation other than the actual provision of Contract services. The amount withheld by the Department under this section will be an amount that the Department determines in the reasonable exercise of its discretion to approximate the cost to the Department to perform the function. The Department may increase these amounts by 50% for each subsequent non-compliance. Whenever the Department determines that the County has failed to perform the administrative functions, the Department may withhold a portion of future capitation payments sufficient to directly compensate the Department for the BadgerCare Plus program’s costs of providing mental health care services and items to individuals insured by said insurers and/or the insurers/employers represented by said third party administrators. 4. In any case under this Contract where the Department has the authority to withhold capitation payments, the Department also has the authority to use all other legal processes for the recovery of damages. 5. Not withstanding the provisions of this subsection, in any case where the Department deducts a portion of capitation payments under Section
Appears in 1 contract
Samples: Contract for Services
WITHHOLDING OF CAPITATION PAYMENTS AND ORDERS TO PROVIDE SERVICES. Notwithstanding the provisions of this Contract, the Department may withhold portions of capitation payments or liquidated damages or otherwise recover damages from the County on the following grounds:
1. Whenever the Department determines that the County has failed to provide one or more of the BadgerCare Plus Medicaid covered Contract services under Addendum VII this Contract or failed to comply with the provisions contained in this Contract, the Department may either order the County to provide such service, or withhold a portion of the County’s capitation payments for the following month or subsequent months, such portion withheld to be equal to the amount of money the Department must pay to provide such services. County shall be given at least seven days written notice prior to the County being required to comply with either: a) Department direction to the County to pay, or b) The the withholding of any capitation payments, except that in case of an emergency, no such seven-seven day notice is required. If the Department orders the County to provide services under this section and the County fails to provide the services within the timeline specified by the Department, the Department may withhold from the County’s capitation payments an amount up to 150% of the fee-for- for-service amount for such services. When it withholds payments under this section, the Department must submit to the County a list of the members for whom payments are being withheld, the nature of the service(s) denied, and payments the Department must make to provide medically necessary services. If the Department acts under this section and subsequently determines that the services in question were non-not covered services:
a. If the Department withheld payments it shall restore to the County the full capitation payment; or
b. If the Department ordered the County to provide services under this section it shall pay the County the actual documented cost of providing the services.
2. If the County fails to submit required data and/or information to the Department or the Department’s authorized agents, agents or fails to submit such data or information in the required form or format, by the deadline specified by the Department, the Department may immediately impose liquidated damages in the amount of $1,500 per day for each day beyond the deadline that the County fails to submit the data or fails to submit the data in the required form or format, such liquidated damages to be deducted from the County’s capitation payments.
3. Whenever the Department determines that the County has failed to perform an administrative function required under this Contract, the Department may withhold a portion of future capitation payments. For the purposes of this section, “administrative functionAdministrative Function” is defined as any Contract obligation other than the actual provision of Contract services. The amount withheld by the Department under this section will be an amount that the Department determines in the reasonable exercise of its discretion to approximate the cost to the Department to perform the function. The Department may increase these amounts by 50% for each subsequent non-compliance. Whenever the Department determines that the County has failed to perform the administrative functions, the Department may withhold a portion of future capitation payments sufficient to directly compensate the Department for the BadgerCare Plus program’s costs of providing mental health care services and items to individuals insured by said insurers and/or the insurers/employers represented by said third party administrators.
4. In any case under this Contract where the Department has the authority to withhold capitation payments, the Department also has the authority to use all other legal processes for the recovery of damages.
5. Not withstanding the provisions of this subsection, in any case where the Department deducts a portion of capitation payments under SectionSection 2 above, the following procedures shall be used:
a. The Department will notify the County Contract administrator no later than the second business day after the Department’s deadline that the County has failed to submit the required data or the required data cannot be processed. Beginning on the second business day after the Department’s deadline, the County will be subject without further notification to liquidated damages per data file or report. If the County submits encounter data late but submits it within five business days from the deadline, the Department will rescind liquidated damages if the data can be processed according to the criteria published in the Wisconsin BadgerCare Plus and Medicaid SSI HMO Encounter Data User Manual. The Department will not edit the data until the process period in the subsequent month.
Appears in 1 contract
Samples: Contract for Services
WITHHOLDING OF CAPITATION PAYMENTS AND ORDERS TO PROVIDE SERVICES. Notwithstanding the provisions of this Contract, the Department may withhold portions of capitation payments or liquidated damages or otherwise recover damages from the County on the following grounds:
1. Whenever the Department determines that the County has failed to provide one or more of the BadgerCare Plus Medicaid covered Contract services under Addendum VII this Contract or failed to comply with the provisions contained in this Contract, the Department may either order the County to provide such service, or withhold a portion of the County’s capitation payments for the following month or subsequent months, such portion withheld to be equal to the amount of money the Department must pay to provide such services. County shall be given at least seven days written notice prior to the County being required to comply with either: a) Department direction to the County to pay, or b) The the withholding of any capitation payments, except that in case of an emergency, no such seven-seven day notice is required. If the Department orders the County to provide services under this section and the County fails to provide the services within the timeline specified by the Department, the Department may withhold from the County’s capitation payments an amount up to 150% of the fee-for- for-service amount for such services. When it withholds payments under this section, the Department must submit to the County a list of the members for whom payments are being withheld, the nature of the service(s) denied, and payments the Department must make to provide medically necessary services. If the Department acts under this section and subsequently determines that the services in question were non-not covered services:
a. If the Department withheld payments it shall restore to the County the full capitation payment; or
b. If the Department ordered the County to provide services under this section it shall pay the County the actual documented cost of providing the services.
2. If the County fails to submit required data and/or information to the Department or the Department’s authorized agents, agents or fails to submit such data or information in the required form or format, by the deadline specified by the Department, the Department may immediately impose liquidated damages in the amount of $1,500 per day for each day beyond the deadline that the County fails to submit the data or fails to submit the data in the required form or format, such liquidated damages to be deducted from the County’s capitation payments.
3. Whenever the Department determines that the County has failed to perform an administrative function required under this Contract, the Department may withhold a portion of future capitation payments. For the purposes of this section, “administrative functionAdministrative Function” is defined as any Contract obligation other than the actual provision of Contract services. The amount withheld by the Department under this section will be an amount that the Department determines in the reasonable exercise of its discretion to approximate the cost to the Department to perform the function. The Department may increase these amounts by 50% for each subsequent non-compliance. Whenever the Department determines that the County has failed to perform the administrative functions, the Department may withhold a portion of future capitation payments sufficient to directly compensate the Department for the BadgerCare Plus program’s costs of providing mental health care services and items to individuals insured by said insurers and/or the insurers/employers represented by said third party administrators.
4. In any case under this Contract where the Department has the authority to withhold capitation payments, the Department also has the authority to use all other legal processes for the recovery of damages.
5. Not withstanding the provisions of this subsection, in any case where the Department deducts a portion of capitation payments under SectionSection 2 above, the following procedures shall be used:
a. The Department will notify the County Contract administrator no later than the second business day after the Department’s deadline that the County has failed to submit the required data or the required data cannot be processed.
b. Beginning on the second business day after the Department’s deadline, the County will be subject without further notification to liquidated damages per data file or report.
c. If the County submits encounter data late but submits it within five business days from the deadline, the Department will rescind liquidated damages if the data can be processed according to the criteria published in the Wisconsin BadgerCare Plus HMO Encounter Data User Manual. The Department will not edit the data until the process period in the subsequent month.
d. If the County submits any other required data or report but in the required format within five business days from the deadline, the Department will rescind liquidated damages and immediately process the data or report.
e. If the County repeatedly fails to submit required data or reports, or data that cannot be processed, the Department will require the County to develop an action plan to comply with the Contract requirements that must meet Department approval.
f. After a corrective action plan has been implemented, if the County continues to submit data beyond the deadline, or continues to submit data that cannot be processed, the Department will invoke the remedies under SUSPENSION OF NEW ENROLLMENT, or WITHHOLDING OF CAPITATION PAYMENTS AND ORDERS TO PROVIDE SERVICES sections, or both, in addition to liquidated damages that may have been imposed for a current violation.
g. If the County notifies the Department that it will discontinue contracting with the Department at the end of a Contract period, but reports or data are due for a Contract period, the Department retains the right to withhold up to two months of capitation payments otherwise due the County which will not be released to the County until all required reports or data are submitted and accepted after expiration of the Contract. Upon determination by the Department that the reports and data are accepted, the Department will release the monies withheld.
Appears in 1 contract
Samples: Contract for Services
WITHHOLDING OF CAPITATION PAYMENTS AND ORDERS TO PROVIDE SERVICES. Notwithstanding the provisions of this Contract, the Department may withhold portions of capitation payments or liquidated damages or otherwise recover damages from the County on the following grounds:
1. Whenever the Department determines that the County has failed to provide one or more of the BadgerCare Plus covered Contract services under Addendum VII or failed to comply with the provisions contained in this Contract, the Department may either order the County to provide such service, or withhold a portion of the County’s capitation payments for the following month or subsequent months, such portion withheld to be equal to the amount of money the Department must pay to provide such services. County shall be given at least seven days written notice prior to the County being required to comply with either: a) Department direction to the County to pay, or b) The withholding of any capitation payments, except that in case of an emergency, no such seven-day notice is required. If the Department orders the County to provide services under this section and the County fails to provide the services within the timeline specified by the Department, the Department may withhold from the County’s capitation payments an amount up to 150% of the fee-for- service amount for such services. When it withholds payments under this section, the Department must submit to the County a list of the members for whom payments are being withheld, the nature of the service(s) denied, and payments the Department must make to provide medically necessary services. If the Department acts under this section and subsequently determines that the services in question were non-covered services:
a. If the Department withheld payments it shall restore to the County the full capitation payment; or
b. If Department ordered the County to provide services under this section it shall pay the County the actual documented cost of providing the services.
2. If the County fails to submit required data and/or information to the Department or the Department’s authorized agents, or fails to submit such data or information in the required form or format, by the deadline specified by the Department, the Department may immediately impose liquidated damages in the amount of $1,500 per day for each day beyond the deadline that the County fails to submit the data or fails to submit the data in the required form or format, such liquidated damages to be deducted from the County’s capitation payments.
3. Whenever the Department determines that the County has failed to perform an administrative function required under this Contract, the Department may withhold a portion of future capitation payments. For the purposes of this section, “administrative function” is defined as any Contract obligation other than the actual provision of Contract services. The amount withheld by the Department under this section will be an amount that the Department determines in the reasonable exercise of its discretion to approximate the cost to the Department to perform the function. The Department may increase these amounts by 50% for each subsequent non-compliance. Whenever the Department determines that the County has failed to perform the administrative functions, the Department may withhold a portion of future capitation payments sufficient to directly compensate the Department for the BadgerCare Plus program’s costs of providing mental health care services and items to individuals insured by said insurers and/or the insurers/employers represented by said third party administrators.
4. In any case under this Contract where the Department has the authority to withhold capitation payments, the Department also has the authority to use all other legal processes for the recovery of damages.
5. Not withstanding the provisions of this subsection, in any case where the Department deducts a portion of capitation payments under Section
Appears in 1 contract
Samples: Contract for Services
WITHHOLDING OF CAPITATION PAYMENTS AND ORDERS TO PROVIDE SERVICES. Notwithstanding the provisions of this Contract, the Department may withhold portions of capitation payments or liquidated damages or otherwise recover damages from the County on the following grounds:
1. Whenever the Department determines that the County has failed to provide one or more of the BadgerCare Plus Medicaid covered Contract services under Addendum VII this Contract or failed to comply with the provisions contained in this Contract, the Department may either order the County to provide such service, or withhold a portion of the County’s capitation payments for the following month or subsequent months, such portion withheld to be equal to the amount of money the Department must pay to provide such services. County shall be given at least seven days written notice prior to the County being required to comply with either: a) Department direction to the County to pay, or b) The the withholding of any capitation payments, except that in case of an emergency, no such seven-seven day notice is required. If Whenever the Department orders determines that the County has failed to provide one or more of the Medicaid covered Contract services under this Contract or failed to comply with the provisions contained in this Contract, the Department may either order the County to provide services under this section and the County fails to provide the services within the timeline specified by the Departmentsuch service, the Department may or withhold from a portion of the County’s capitation payments an for the following month or subsequent months, such portion withheld to be equal to the amount up of money the Department must pay to 150% of the fee-for- service amount for provide such services. County shall be given at least seven days written notice prior to the County being required to comply with either: a) Department direction to the County to pay, or b) the withholding of any capitation payments, except that in case of an emergency, no such seven day notice is required. When it withholds payments under this section, the Department must submit to the County a list of the members for whom payments are being withheld, the nature of the service(s) denied, and payments the Department must make to provide medically necessary services. If the Department acts under this section and subsequently determines that the services in question were non-not covered services:
a. If the Department withheld payments it shall restore to the County the full capitation payment; or
b. If the Department ordered the County to provide services under this section it shall pay the County the actual documented cost of providing the services.
2. If the County fails to submit required data and/or information to the Department or the Department’s authorized agents, agents or fails to submit such data or information in the required form or format, by the deadline specified by the Department, the Department may immediately impose liquidated damages in the amount of $1,500 per day for each day beyond the deadline that the County fails to submit the data or fails to submit the data in the required form or format, such liquidated damages to be deducted from the County’s capitation payments.
3. Whenever the Department determines that the County has failed to perform an administrative function required under this Contract, the Department may withhold a portion of future capitation payments. For the purposes of this section, “administrative functionAdministrative Function” is defined as any Contract obligation other than the actual provision of Contract services. The amount withheld by the Department under this section will be an amount that the Department determines in the reasonable exercise of its discretion to approximate the cost to the Department to perform the function. The Department may increase these amounts by 50% for each subsequent non-compliance. Whenever the Department determines that the County has failed to perform the administrative functions, the Department may withhold a portion of future capitation payments sufficient to directly compensate the Department for the BadgerCare Plus program’s costs of providing mental health care services and items to individuals insured by said insurers and/or the insurers/employers represented by said third party administrators.
4. In any case under this Contract where the Department has the authority to withhold capitation payments, the Department also has the authority to use all other legal processes for the recovery of damages.
5. Not withstanding the provisions of this subsection, in any case where the Department deducts a portion of capitation payments under SectionSection 2 above, the following procedures shall be used:
a. The Department will notify the County Contract administrator no later than the second business day after the Department’s deadline that the County has failed to submit the required data or the required data cannot be processed.
b. Beginning on the second business day after the Department’s deadline, the County will be subject without further notification to liquidated damages per data file or report.
c. If the County submits encounter data late but submits it within five business days from the deadline, the Department will rescind liquidated damages if the data can be processed according to the criteria published in the Wisconsin BadgerCare Plus and Medicaid SSI HMO Encounter Data User Manual. The Department will not edit the data until the process period in the subsequent month.
d. If the County submits any other required data or report but in the required format within five business days from the deadline, the Department will rescind liquidated damages and immediately process the data or report.
e. If the County repeatedly fails to submit required data or reports, or data that cannot be processed, the Department will require the County to develop an action plan to comply with the Contract requirements that must meet Department approval.
f. After a corrective action plan has been implemented, if the County continues to submit data beyond the deadline, or continues to submit data that cannot be processed, the Department will invoke the remedies under SUSPENSION OF NEW ENROLLMENT, or WITHHOLDING OF CAPITATION PAYMENTS AND ORDERS TO PROVIDE SERVICES sections, or both, in addition to liquidated damages that may have been imposed for a current violation.
g. If the County notifies the Department that it will discontinue contracting with the Department at the end of a Contract period, but reports or data are due for a Contract period, the Department retains the right to withhold up to two months of capitation payments otherwise due the County which will not be released to the County until all required reports or data are submitted and accepted after expiration of the Contract. Upon determination by the Department that the reports and data are accepted, the Department will release the monies withheld.
6. Payments provided for under the contract will be denied for new members when, and for so long as, payment for those membersis denied by CMS in accordance with the requirements in 42 CFR 438.730.
Appears in 1 contract
Samples: Contract for Services
WITHHOLDING OF CAPITATION PAYMENTS AND ORDERS TO PROVIDE SERVICES. Notwithstanding the provisions of this Contract, the Department may withhold portions of capitation payments or liquidated damages or otherwise recover damages from the County on the following grounds:
1. Whenever the Department determines that the County has failed to provide one or more of the BadgerCare Plus Medicaid covered Contract services under Addendum VII VIII or failed to comply with the provisions contained in this Contract, the Department may either order the County to provide such service, or withhold a portion of the County’s capitation payments for the following month or subsequent months, such portion withheld to be equal to the amount of money the Department must pay to provide such services. County shall be given at least seven days written notice prior to the County being required to comply with either: a) Department direction to the County to pay, or b) The withholding of any capitation payments, except that in case of an emergency, no such seven-day notice is required. If the Department orders the County to provide services under this section and the County fails to provide the services within the timeline specified by the Department, the Department may withhold from the County’s capitation payments an amount up to 150% of the fee-for- for-service amount for such services. When it withholds payments under this section, the Department must submit to the County a list of the members for whom payments are being withheld, the nature of the service(s) denied, and payments the Department must make to provide medically necessary services. If the Department acts under this section and subsequently determines that the services in question were non-covered services:
a. If the Department withheld payments it shall restore to the County the full capitation payment; or
b. If Department ordered the County to provide services under this section it shall pay the County the actual documented cost of providing the services.
2. If the County fails to submit required data and/or information to the Department or the Department’s authorized agents, or fails to submit such data or information in the required form or format, by the deadline specified by the Department, the Department may immediately impose liquidated damages in the amount of $1,500 per day for each day beyond the deadline that the County fails to submit the data or fails to submit the data in the required form or format, such liquidated damages to be deducted from the County’s capitation payments.
3. Whenever the Department determines that the County has failed to perform an administrative function required under this Contract, the Department may withhold a portion of future capitation payments. For the purposes of this section, “administrative function” is defined as any Contract obligation other than the actual provision of Contract services. The amount withheld by the Department under this section will be an amount that the Department determines in the reasonable exercise of its discretion to approximate the cost to the Department to perform the function. The Department may increase these amounts by 50% for each subsequent non-compliance. Whenever the Department determines that the County has failed to perform the administrative functions, the Department may withhold a portion of future capitation payments sufficient to directly compensate the Department for the BadgerCare Plus program’s costs of providing mental health care services and items to individuals insured by said insurers and/or the insurers/employers represented by said third party administrators.
4. In any case under this Contract where the Department has the authority to withhold capitation payments, the Department also has the authority to use all other legal processes for the recovery of damages.
5. Not withstanding the provisions of this subsection, in any case where the Department deducts a portion of capitation payments under SectionSection 2. above, the following procedures shall be used:
a. The Department will notify the County Contract administrator no later than the second business day after the Department’s deadline that the County has failed to submit the required data or the required data cannot be processed.
b. Beginning on the second business day after the Department’s deadline, the special managed care program will be subject without further notification to liquidated damages per data file or report..
c. If the County submits encounter data late but submits it within five business days from the deadline, the Department will rescind liquidated damages if the data can be processed according to the criteria published in the Wisconsin BadgerCare Plus HMO Encounter Data User Manual. The Department will not edit the data until the process period in the subsequent month.
d. If the County submits any other required data or report but in the required format within five business days from the deadline, the Department will rescind liquidated damages and immediately process the data or report.
e. If the County repeatedly fails to submit required data or reports, or data that cannot be processed, the Department will require the County to develop an action plan to comply with the Contract requirements that must meet Department approval.
f. After a corrective action plan has been implemented, if the County continues to submit data beyond the deadline, or continues to submit data that cannot be processed, the Department will invoke the remedies under SUSPENSION OF NEW ENROLLMENT, or WITHHOLDING OF CAPITATION PAYMENTS AND ORDERS TO PROVIDE SERVICES sections, or both, in addition to liquidated damages that may have been imposed for a current violation.
g. If the County notifies the Department that it will discontinue contracting with the Department at the end of a Contract period, but reports or data are due for a Contract period, the Department retains the right to withhold up to two months of capitation payments otherwise due the County which will not be released to the County until all required reports or data are submitted and accepted after expiration of the Contract. Upon determination by the Department that the reports and data are accepted, the Department will release the monies withheld.
Appears in 1 contract
Samples: Contract for Services
WITHHOLDING OF CAPITATION PAYMENTS AND ORDERS TO PROVIDE SERVICES. Notwithstanding the provisions of this Contract, the Department may withhold portions of capitation payments or liquidated damages or otherwise recover damages from the County on the following grounds:
1. Whenever the Department determines that the County has failed to provide one or more of the BadgerCare Plus Medicaid covered Contract services under Addendum VII this Contract or failed to comply with the provisions contained in this Contract, the Department may either order the County to provide such service, or withhold a portion of the County’s capitation payments for the following month or subsequent months, such portion withheld to be equal to the amount of money the Department must pay to provide such services. County shall be given at least seven days written notice prior to the County being required to comply with either: a) Department direction to the County to pay, or b) The the withholding of any capitation payments, except that in case of an emergency, no such seven-seven day notice is required. If Whenever the Department orders determines that the County has failed to provide one or more of the Medicaid covered Contract services under this Contract or failed to comply with the provisions contained in this Contract, the Department may either order the County to provide services under this section and the County fails to provide the services within the timeline specified by the Departmentsuch service, the Department may or withhold from a portion of the County’s capitation payments an for the following month or subsequent months, such portion withheld to be equal to the amount up of money the Department must pay to 150% of the fee-for- service amount for provide such services. County shall be given at least seven days written notice prior to the County being required to comply with either: a) Department direction to the County to pay, or b) the withholding of any capitation payments, except that in case of an emergency, no such seven day notice is required. When it withholds payments under this section, the Department must submit to the County a list of the members for whom payments are being withheld, the nature of the service(s) denied, and payments the Department must make to provide medically necessary services. If the Department acts under this section and subsequently determines that the services in question were non-not covered services:
a. If the Department withheld payments it shall restore to the County the full capitation payment; or
b. If the Department ordered the County to provide services under this section it shall pay the County the actual documented cost of providing the services.
2. If the County fails to submit required data and/or information to the Department or the Department’s authorized agents, agents or fails to submit such data or information in the required form or format, by the deadline specified by the Department, the Department may immediately impose liquidated damages in the amount of $1,500 per day for each day beyond the deadline that the County fails to submit the data or fails to submit the data in the required form or format, such liquidated damages to be deducted from the County’s capitation payments.
3. Whenever the Department determines that the County has failed to perform an administrative function required under this Contract, the Department may withhold a portion of future capitation payments. For the purposes of this section, “administrative function” is defined as any Contract obligation other than the actual provision of Contract services. The amount withheld by the Department under this section will be an amount that the Department determines in the reasonable exercise of its discretion to approximate the cost to the Department to perform the function. The Department may increase these amounts by 50% for each subsequent non-compliance. Whenever the Department determines that the County has failed to perform the administrative functions, the Department may withhold a portion of future capitation payments sufficient to directly compensate the Department for the BadgerCare Plus program’s costs of providing mental health care services and items to individuals insured by said insurers and/or the insurers/employers represented by said third party administrators.
4. In any case under this Contract where the Department has the authority to withhold capitation payments, the Department also has the authority to use all other legal processes for the recovery of damages.
5. Not withstanding the provisions of this subsection, in any case where the Department deducts a portion of capitation payments under Section
Appears in 1 contract
Samples: Contract for Services
