PROVIDER AGREEMENT - APPENDIX EProvider Agreement • April 6th, 2018
This policy and its accompanying procedures are based on the following: (1) DHSS’s obligations under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) (42 U.S.C. 1320d – 3120d- 8), the Health Information Technology for Economic and Clinical Health Act of 2009 (P.L. 111-5) (the “HITECH Act”) and their implementing regulations at 45 C.F.R. 160 and 45 C.F.R. 164 (the “Privacy and Security Rule”) to protect the privacy and security of protected health information (2) where applicable, the obligations of Providers under HIPAA, HITECH Act and the Privacy and Security Rule;
Provider Agreement Number: 13Provider Agreement • September 6th, 2023
This Agreement is entered into by and between the State of Connecticut Department of Children and Families, with a primary business location of 505 Hudson Street / Hartford, CT 06106 (hereinafter “the Department” or "the Agency") and
DATE: 11/28/2008 2:46 PMProvider Agreement • March 18th, 2024
OHIO MEDICAL ASSISTANCE PROVIDER AGREEMENT FOR MANAGED CARE PLANProvider Agreement • June 23rd, 2022
This Provider Agreement (hereinafter “Agreement”) is entered into this first day of July, 2022, at Columbus, Franklin County, Ohio, between the State of Ohio, the Ohio Department of Medicaid, (hereinafter referred to as ODM) whose principal office is located in the City of Columbus, County of Franklin, State of Ohio, and
Provider AgreementProvider Agreement • May 4th, 2023
Appendix 1: Application to be included in the Sunderland Directory of Providers of Free Early Education Entitlement for Two, Three and Four Year
OHIO MEDICAL ASSISTANCE PROVIDER AGREEMENT FOR MANAGED CARE PLANProvider Agreement • October 2nd, 2024
This Provider Agreement (hereinafter “Agreement”) is entered into this first day of July, 2022, at Columbus, Franklin County, Ohio, between the State of Ohio, the Ohio Department of Medicaid, (hereinafter referred to as ODM) whose principal office is located in the City of Columbus, County of Franklin, State of Ohio, and
WITNESSETH:Provider Agreement • December 21st, 2004 • Safe Auto Group, Inc. • Fire, marine & casualty insurance
Provider Agreement 2023-24Provider Agreement • February 23rd, 2023
Nottingham City Council values the partnership with all childcare and early years providers and we acknowledge this year may continue to be challenging in relation to the continued recovery from the pandemic, additional concerns over energy costs and recruitment of quality staff, which we know are significant to the sector. Please be reassured that we will keep you updated on any national changes to the funding of free early years entitlement places, as well as any other funding opportunities from central government, that may become available over the course of the year.
THE OHIO DEPARTMENT OF MEDICAID MYCARE OHIO PROVIDER AGREEMENT FOR MYCARE OHIO PLANProvider Agreement • June 15th, 2022
This Provider Agreement (hereinafter “Agreement”) is entered into this first day of July, 2022, between the State of Ohio, the Ohio Department of Medicaid, (hereinafter referred to as ODM) whose principal office is located in the City of Columbus, County of Franklin, State of Ohio, and , MyCare Ohio Plan (hereinafter referred to as MCOP), an Ohio corporation, whose principal office is located in the city of , County of , State of Ohio.
Suffolk Agreement for List of Provider MembersProvider Agreement • July 24th, 2024
Provider AgreementProvider Agreement • June 5th, 2023
ContractProvider Agreement • February 28th, 2024
THE OHIO DEPARTMENT OF MEDICAID MYCARE OHIO PROVIDER AGREEMENT FOR MYCARE OHIO PLANProvider Agreement • October 2nd, 2024
This Provider Agreement (hereinafter “Agreement”) is entered into this first day of July, 2023, between the State of Ohio, the Ohio Department of Medicaid, (hereinafter referred to as ODM) whose principal office is located in the City of Columbus, County of Franklin, State of Ohio, and , MyCare Ohio Plan (hereinafter referred to as MCOP), an Ohio corporation, whose principal office is located in the city of , County of , State of Ohio.
THE OHIO DEPARTMENT OF MEDICAID MYCARE OHIO PROVIDER AGREEMENT FOR MYCARE OHIO PLANProvider Agreement • June 10th, 2024
This Provider Agreement (hereinafter “Agreement”) is entered into this first day of July, 2024, between the State of Ohio, the Ohio Department of Medicaid, (hereinafter referred to as ODM) whose principal office is located in the City of Columbus, County of Franklin, State of Ohio, and , MyCare Ohio Plan (hereinafter referred to as MCOP), an Ohio corporation, whose principal office is located in the city of , County of , State of Ohio.
Bury Provider Agreement for the funding of:Provider Agreement • April 5th, 2023
ContractProvider Agreement • October 11th, 2022 • New Mexico
This Provider Agreement is entered into by and between the DEPARTMENT OF HEALTH, hereinafter referred to as the "DEPARTMENT", and Name of Provider, hereinafter referred to as the "PROVIDER".
Independent Living Systems, LLC Standard Provider Agreement Homemaker Companion AgencyProvider Agreement • January 31st, 2017 • Florida
NEW JERSEY PROVIDER AGREEMENTProvider Agreement • March 3rd, 2021 • New Jersey
This Agreement is made by and between Conduent State & Local Solutions, Inc. a New Jersey Corporation, (hereinafter “CONDUENT”) and , a corporation, individual(s), partnership, Limited Liability Company (LLC), other ; organized and existing under the Laws of the state of , and having a business, residence at (hereinafter “Provider”).
Division of TennCare Required Language - Provider Agreements) DOWNSTREAM PROVIDERProvider Agreement • December 23rd, 2020 • Tennessee
This Appendix applies with respect to the provision of health care services that Provider provides directly to Covered Persons through Health Plan’s (as defined herein) products or benefit plans under the TennCare program (“TennCare”) as governed by the State’s designated regulatory agencies. Effective January 1, 2021, the requirements of this Appendix (unless otherwise specified below) shall also apply to CoverKids. In the event of a conflict between this Appendix and other appendices or any provision of the Agreement, the provisions of this Appendix shall control except with regard to benefit plans outside the scope of this Appendix or unless otherwise required by law. In the event Subcontractor is required to amend or supplement this Appendix as required or requested by the State and as requested by Health Plan, Provider agrees that Subcontractor shall be permitted to unilaterally initiate such additions, deletions or modifications through an amendment to the Provider’s Agreement.
PROVIDER AGREEMENT TO ELECTRONICALLY FILE AND MAINTAIN WAREHOUSE RECEIPTS AND UNITED STATES WAREHOUSE ACT DOCUMENTSProvider Agreement • September 13th, 2024
(Provider), and the Agricultural Marketing Service (AMS), authorizes the Provider to establish and maintain a database and a system, referred to as a central filing system (CFS), for electronic warehouse receipts (EWRs) and electronic documents issued under the authority of the United States Warehouse Act (USWA). By entering into this Agreement, the Provider agrees to the terms and conditions set forth in this Agreement, its Addenda, and the regulations found at 7 CFR Part 869. This Agreement and its Addenda will become effective upon execution by AMS and shall remain in effect until terminated as provided for in Section V of this Agreement.
KENTUCKY STATE PROGRAM REGULATORY REQUIREMENTS APPENDIX DOWNSTREAM PROVIDERProvider Agreement • May 11th, 2022
This Appendix applies with respect to the provision of health care services that Provider provides directly to Covered Persons through Health Plan’s (as defined herein) products or benefit plans under the Commonwealth of Kentucky’s Medicaid program, CHIP program and, as applicable, benefit plans for other state-based healthcare programs for low income individuals (the “State Program”), as governed by the State’s designated regulatory agencies. Provider has agreed to provide Covered Services to Covered Persons who receive their coverage pursuant to a contract between the State and Health Plan (the “State Contract” as defined herein). The State Contract and applicable State and federal law require that the provisions contained in this Appendix be part of the Agreement. In the event of a conflict between this Appendix and other appendices or any provision of the Agreement, the provisions of this Appendix shall control except with regard to benefit plans outside the scope of this Appendix
Provider Agreement for funded early education and childcare (FEE) for 9 month – 4 year olds Effective from: April 2024Provider Agreement • February 26th, 2024
Provider Agreement BetweenProvider Agreement • January 19th, 2021 • North Carolina
This Provider Agreement (hereinafter “Agreement” or “Contract” (used interchangeably)) establishes the relationship between the Department of Health and Human Services, Division of Public Health, Women’s and Children’s Health Section, Early Intervention Branch, Children’s Developmental Services Agency (hereinafter “CDSA”) and a Service Provider (hereinafter “Service Provider” or “Contractor” (used interchangeably)). This executed Agreement certifies that the Service Provider accepts the terms and conditions of the Agreement, which includes the Contract Documents listed below. The Service Provider is then eligible to provide authorized services under the Individualized Family Service Plan.
PROVIDER AGREEMENT – REQUIREMENTSProvider Agreement • December 16th, 2020
This Provider Agreement Requirements (hereinafter “Agreement”) is entered into this day of , 20 , (hereinafter effective date) by and between Beyond Med Plans of New York Inc. and its affiliates (hereinafter collectively “BMP”) and (hereinafter “Provider). BMP and Provider may be referred to herein individually as a “Party” and collectively as the “Parties.” Now, therefore the Parties do mutually covenant and agree as follows:
DATE: 03/31/2010 9:53 AMProvider Agreement • February 16th, 2024
Provider Agreement Attachment AProvider Agreement • February 16th, 2024
❑ TRANSLATION/INTERPRETING SERVICES are provided by skilled individuals in order to communicate with and provide services to a consumer.
Provider Agreement Number 11: After School Services: YouthProvider Agreement • September 12th, 2011
IRIS PROVIDER AGREEMENTProvider Agreement • February 10th, 2022 • Wisconsin
THIS INDIANA STATE PROGRAM REGULATORY REQUIREMENTS APPENDIX (thisProvider Agreement • November 30th, 2023
The requirements of this Appendix apply to benefit plans sponsored, issued or administered by UnitedHealthcare Insurance Company or one of its Affiliates (referred to in this Appendix as “United”) under the State’s Medicaid program, CHIP program and, as applicable, benefit plans for other state-based healthcare programs for low-income individuals (the “State Program”) as governed by the State’s designated regulatory agencies. In the event of a conflict between this Appendix and other appendices or any provision of the Agreement, the provisions of this Appendix shall control except with regard to benefit plans outside the scope of this Appendix or unless otherwise required by law. In the event United is required to amend or supplement this Appendix as required by law or requested by the State to comply with federal or State regulations, United will unilaterally initiate such additions, deletions or modifications.
Palm Beach, Martin, St. Lucie, Indian River and Okeechobee CountiesProvider Agreement • September 10th, 2015
This 2014-17 Provider Agreement, for the Implementation of and Participation in the local Early Steps System of Care provided under the Individuals with Disabilities Education Act (IDEA), Part C, is entered into by and between Easter Seals Florida, Inc. (“Treasure Coast Early Steps System of Care” or “TCES”) and (“Early Steps Provider Agency” or “Provider”).
EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES PROVIDER AGREEMENT FORMProvider Agreement • July 8th, 2022
I, the Provider acknowledge and understand that participation in the Rhode Island Executive Office of Health and Human Services Medicaid Program hereafter, “EOHHS” or “RI Medicaid” is voluntary, and I agree to the following:
DATE: 07/17/2009 11:30 AMProvider Agreement • July 19th, 2023
Provider Agreement For the Provision of Chaplaincy Services in Victorian Government Schools The State of Victoria through the Department of Education and Training (the Department) and Chaplaincy Services Provider (Provider)Provider Agreement • December 4th, 2020
Provider Agreement Attachment AProvider Agreement • January 11th, 2021
Supportive Day Programs provide support services in a group setting to help participants recover and rehabilitate from an acute illness or injury, or to manage a chronic illness, or for participants who have an assessed need for increased social integration and/or structured day activities. The services include assessments and care planning, health-related services, social services, therapeutic activities, nutrition, and transportation. These services focus on the participant’s strengths and abilities, while maintaining their connection to the community and helping them to retain their daily skills.
Provider Agreement for the delivery of funded early education and childcare provisionProvider Agreement • March 2nd, 2023
This document details the requirements and expectations for Providers delivering the Funded Entitlement (FE), in combination with DfE Early education and childcare statutory guidance for local authorities.
