Written Agreements, Specific Requirements Sample Clauses

Written Agreements, Specific Requirements. (A) Each of the Contractor’s Subcontracts shall contain the following: (1) A specific description of the activities, service or responsibility being delegated to the Subcontractor; (2) A provision outlining Contractor’s ability to revoke delegation or impose other sanctions if the Subcontractor’s performance is inadequate; (3) A provision stating that if the Subcontractor becomes insolvent or bankrupt Enrollees shall not be liable for the debt of the Subcontractor; (4) A provision stating that the Subcontractor, acting within the lawful scope of his or her practice, shall not be prohibited from advising or advocating on behalf of an Enrollee who is his or her patient for the following: (i) The Enrollee’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered; (ii) Any information the Enrollee needs in order to decide among all relevant treatment options; (iii) The risks, benefits, and consequences of treatment or non-treatment; and (iv) The Enrollee’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions; and (5) Adequate information about the Grievance, Appeal, and State fair hearing procedures and timelines so that the Provider can comply with the Grievance and Appeals Systems requirements including: (i) The Enrollee’s right to a State Fair Hearing, how to obtain a hearing, and representation rules at a hearing; (ii) The Enrollee’s right to file Grievances and Appeals; (iii) The requirements and timeframes for filing a Grievance or Appeal; (iv) The availability of assistance in the filling process; (v) The toll-free numbers that the Enrollee can use to file a Grievance or Appeal by phone; (vi) The fact that, when requested by the Enrollee, disputed services will continue if the Enrollee files an Appeal or request a State fair hearing within the timeframes specified for filing, and the Enrollee may be required to pay the cost of disputed services furnished while the Appeal is pending if the final decision is adverse to the Enrollee; and (vii) Any State-determined Provider Appeal rights to challenge the failure of the Contractor to cover a service. (6) a requirement that the Subcontractor comply with the requirements of 42 CFR Part 438, to the extent they apply.
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Written Agreements, Specific Requirements. (A) Each of the Contractor’s Subcontracts shall contain the following: (1) Adequate information about the Grievance, Appeal, and State fair hearing procedures and timelines so that the Provider can comply with the Grievance and Appeals Systems requirements including: (i) The Enrollee’s right to a State Fair Hearing, how to obtain a hearing, and representation rules at a hearing; (ii) The Enrollee’s right to file Grievances and Appeals; (iii) The requirements and timeframes for filing a Grievance or Appeal; (iv) The availability of assistance in the filling process; (v) The toll-free numbers that the Enrollee can use to file a Grievance or Appeal by phone; (vi) The fact that, when requested by the Enrollee, disputed services will continue if the Enrollee files an Appeal or request a State fair hearing within the timeframes specified for filing, and the Enrollee may be required to pay the cost of disputed services furnished while the Appeal is pending if the final decision is adverse to the Enrollee; and (vii) Any State-determined Provider Appeal rights to challenge the failure of the Contractor to cover a service.
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Written Agreements, Specific Requirements. (A) The Contractor shall ensure that each of the Subcontracts with Participating Providers entered into by either the Contractor or a Contractor Affiliate contains the following:
Sample 1
Written Agreements, Specific Requirements. (A) The Contractor shall ensure that each of the Subcontracts with Participating Providers entered into by either the Contractor or a Contractor Affiliate contains the following: (1) Adequate information about the Grievance, Appeal, and State fair hearing procedures and timelines so that the Provider can comply with the Grievance and Appeals Systems requirements including: (i) The Enrollee’s right to a State Fair Hearing, how to obtain a hearing, and representation rules at a hearing; (ii) The Enrollee’s right to file Grievances and Appeals; (iii) The requirements and timeframes for filing a Grievance or Appeal; (iv) The availability of assistance in the filling process; (v) The toll-free numbers that the Enrollee can use to file a Grievance or Appeal by phone; (vi) The fact that, when requested by the Enrollee, disputed services will continue if the Enrollee files an Appeal or request a State fair hearing within the timeframes specified for filing, and the Enrollee may be required to pay the cost of disputed services furnished while the Appeal is pending if the final decision is adverse to the Enrollee; and (vii) Any State-determined Provider Appeal rights to challenge the failure of the Contractor to cover a service.
Sample 1

Related to Written Agreements, Specific Requirements

  • WRITTEN AGREEMENT All insurance policies required by this Contract shall waive all rights of subrogation against the County of Orange, its elected and appointed officials, officers, employees and agents when acting within the scope of their appointment or employment.

  • Additional Agreements and Covenants The parties further agree and covenant as follows:

  • Final Agreement This Agreement terminates and supersedes all prior understandings or agreements on the subject matter hereof. This Agreement may be modified only by a further writing that is duly executed by both parties.

  • Complete and Final Agreement This Guaranty and the other Loan Documents represent the final agreement between the parties and may not be contradicted by evidence of prior, contemporaneous or subsequent oral agreements. There are no unwritten oral agreements between the parties. All prior or contemporaneous agreements, understandings, representations, and statements, oral or written, are merged into this Guaranty and the other Loan Documents. Guarantor acknowledges that Guarantor has received a copy of the Note and all other Loan Documents. Neither this Guaranty nor any of its provisions may be waived, modified, amended, discharged, or terminated except by a writing signed by the party against which the enforcement of the waiver, modification, amendment, discharge, or termination is sought, and then only to the extent set forth in that writing.

  • Entire Agreement; Written Amendments Required This Agreement, including the Exhibits attached hereto, the Common Stock certificates, the Warrants, the Registration Rights Agreement, and the other documents delivered pursuant hereto constitute the full and entire understanding and agreement between the parties with regard to the subjects hereof and thereof, and no party shall be liable or bound to any other party in any manner by any warranties, representations or covenants, whether oral, written, or otherwise except as specifically set forth herein or therein. Except as expressly provided herein, neither this Agreement nor any term hereof may be amended, waived, discharged or terminated other than by a written instrument signed by the party against whom enforcement of any such amendment, waiver, discharge or termination is sought.

  • Conclusiveness of Statements; Survival of Provisions Determinations and statements of any Lender pursuant to Sections 8.1, 8.2, 8.3 or 8.4 shall be conclusive absent demonstrable error. Lenders may use reasonable averaging and attribution methods in determining compensation under Sections 8.1 and 8.4, and the provisions of such Sections shall survive repayment of the Obligations, cancellation of any Notes, expiration or termination of the Letters of Credit and termination of this Agreement.

  • Representations Relating to Documents and Legal Compliance Borrower represents and warrants to Silicon as follows: All statements made and all unpaid balances appearing in all invoices, instruments and other documents evidencing the Receivables are and shall be true and correct and all such invoices, instruments and other documents and all of Borrower's books and records are and shall be genuine and in all respects what they purport to be, and all signatories and endorsers have the capacity to contract. All sales and other transactions underlying or giving rise to each Receivable shall fully comply with all applicable laws and governmental rules and regulations. All signatures and endorsements on all documents, instruments, and agreements relating to all Receivables are and shall be genuine, and all such documents, instruments and agreements are and shall be legally enforceable in accordance with their terms.

  • Compliance with Laws and Agreements; No Default Except where the failure to do so, individually or in the aggregate, could not reasonably be expected to result in a Material Adverse Effect, each Loan Party and each Subsidiary is in compliance with (i) all Requirements of Law applicable to it or its property and (ii) all indentures, agreements and other instruments binding upon it or its property. No Default has occurred and is continuing.

  • Inconsistencies with Other Documents; Independent Effect of Covenants (a) In the event there is a conflict or inconsistency between this Agreement and any other Loan Document, the terms of this Agreement shall control; provided that, other than for purposes of Article XI, any provision of the other Loan Documents which imposes additional burdens on any Borrower or its Subsidiaries or further restricts the rights of such Borrower or its Subsidiaries or gives the Administrative Agent or any Lender additional rights shall not be deemed to be in conflict or inconsistent with this Agreement and shall be given full force and effect. (b) Each Borrower expressly acknowledges and agrees that each covenant contained in Article VIII, IX, or X hereof shall be given independent effect. Accordingly, no Borrower shall engage in any transaction or other act otherwise permitted under any covenant contained in Article VIII, IX, or X if, before or after giving effect to such transaction or act, such Borrower shall or would be in breach of any other covenant contained in Article VIII, IX, or X.

  • Duration and Scope of Covenants If any court or other decision-maker of competent jurisdiction determines that any of the Executive’s covenants contained in this Agreement, including, without limitation, any of the Restrictive Covenants, or any part thereof, is unenforceable because of the duration or geographical scope of such provision, then, after such determination has become final and unappealable, the duration or scope of such provision, as the case may be, shall be reduced so that such provision becomes enforceable and, in its reduced form, such provision shall then be enforceable and shall be enforced.

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