Agency Audits definition

Agency Audits means any audits and all other state or federal audits, recoupments and overpayment, false claim, fine or penalty actions, in each case including any threatened or preliminary reports, audits, recoupments and overpayment, false claim, fine or penalty actions, (i) covering any of the following, or any matter similar to any of the following: Medicare/Medicaid dual HMO enrollment, newborn eligibility payments, downward substitution of (nursing home) care, death audits (payments for deceased members), recipients enrolled in counties with no certificates of authority, recipients ineligible for HMO coverage, coordination of benefits, patient responsibility, deductible, dual payments to another provider, and non-compliance with the Medicaid or Medicare HMO/managed care contract or applicable Laws, including but not limited to non-compliance with quality assurance requirements, reporting requirements, emergency room and other claim payment requirements, marketing practices requirements, employee compensation requirements, member grievance requirements or similar matters, or (ii) conducted or threatened to be conducted by the CMS, the NY DOI, the CT DOI, the NY DOH or the CT DSS.
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Agency Audits means any audits and all other state or federal audits, recoupments and overpayment, false claim, fine or penalty actions, in each case including any threatened or preliminary reports, audits, recoupments and overpayment, false claim, fine or penalty actions, (i) covering any of the following, or any matter similar to any of the following: Medicare/Medicaid dual HMO enrollment, newborn eligibility payments, downward substitution of (nursing home) care, death audits (payments for deceased members), recipients enrolled in counties with no certificates of authority, recipients ineligible for HMO coverage, coordination of benefits, patient responsibility, deductible, dual payments to another provider, and non-compliance with the Medicaid or Medicare HMO/managed care contract or applicable Laws, including but not limited to non-compliance with quality assurance requirements, reporting requirements, emergency room and other claim payment requirements, marketing practices requirements, employee compensation requirements, member grievance requirements or similar matters, or (ii) conducted or threatened to be conducted by the CMS, the DOI or AHCA.
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Agency Audits means any audits and all other state, state or federal audits, recoupments and overpayments, false claims, fine or penalty actions, in each case including any threatened or preliminary reports, audits, recoupments and overpayments, false claims, fine or penalty actions (i) covering any of the following: HMO enrollment, newborn eligibility payments, downward substitution of (lower) acuity care providers, death audits (payments for deceased Members), recipients enrolled in counties with no certificates of authority, recipients ineligible for HMO coverage, coordination of benefits, patient responsibility, deductibles, dual payments to another provider, and non-compliance with the Medicare HMO/managed care contract or applicable Laws, including but not limited to non-compliance with quality assurance requirements, reporting requirements, emergency room and other claim payment requirements, marketing practices requirements, employee compensation requirements, member grievance requirements or similar matters, or (ii) conducted or threatened to be conducted by the CMS.
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Examples of Agency Audits in a sentence

  • Seller shall at all times maintain copies of relevant portions of all Agency Audits in which there are material adverse findings, including without limitation notices of defaults, notices of termination of approved status, notices of imposition of supervisory agreements or interim servicing agreements, and notices of probation, suspension, or non-renewal.

  • Single Agency Audits shall comply with the procedures specified by MFA.

  • Under 2.2.2.12A(1), NMAC, Due Dates for Agency Audits, agency audit reports under the oversight of DFA FCD are due to OSA in accordance with the requirements of 12-6-3.

  • Users shall be suspicious of e-mail messages containing links to unknown web sites.

  • Government Agency Audits Government agencies often require CoreCivic to apply their preferred set of operational standards.

  • Guarantor shall (i) at all times maintain copies of relevant portions of all final written Agency Audits in which there are material adverse findings, including without limitation notices of defaults, notices of termination of approved status, notices of imposition of supervisory agreements or interim servicing agreements, and notices of probation, suspension, or non-renewal, and all necessary approvals from each Agency and (ii) take all actions necessary to maintain its respective Approvals.

  • Additionally, Agency Audits, Reviews and Monitoring is included via a PowerPoint presentation, which relates to reviews and audits conducted by third parties and/or internally.

  • A trust agreement submitted to the governing body of the charter holder is confidential information excepted from the requirements of Government Code, §552.021, but must be disclosed to the Texas Education Agency under §100.1029 (relating to Agency Audits, Monitoring, and Investigations).

  • Schedule 2.28 sets forth a true, accurate and complete list of all reports and correspondence regarding all Agency Audits, and all other audit reports prepared by the CMS, the NY DOI, the CT DOI, the NY DOH, the CT DSS or any other Governmental or Regulatory Authority relating to the operations or business of the Company or either Company Subsidiary, from each year (or part thereof) since January 1, 2000.

  • Internal Agency Audits Agency or university policy should require their internal Property Officer annually perform a physical inventory within each department.

Related to Agency Audits

  • Agency(ies) means any government regulatory authority or authorities in the world responsible for granting approval(s), clearance(s), qualification(s), license(s), or permit(s) for any aspect of the research, Development, manufacture, marketing, distribution, or sale of a Product. The term “Agency” includes, without limitation, the United States Food and Drug Administration (“FDA”).

  • Agencies means the Department, the Agency for International Develop- ment (AID), the International Commu- nication Agency (USICA), the Foreign Agricultural Service (FAS), and the Foreign Commercial Service (FCS).

  • Agency Fees On each order accepted by us for a Fund with a sales charge, we understand that you will charge your customer an agency commission or agency transaction fee ("agency fee") as set forth in the schedule of sales concessions and agency fees set forth in that Fund's Prospectus, as it may be amended from time to time. This fee shall be subject to the provisions of all terms set forth in the Prospectus for volume purchases and special plans and accounts (e.g. retirement plans, letter of intent, etc.). You will not receive from us a dealer's concession or similar allowance out of the sales charge. The agency fee will not exceed the maximum limits on sales charges specified in Rule 2830 of the Conduct Rules of the National Association of Securities Dealers, Inc. (the "NASD") regardless of whether you are a member of the NASD or not. You will not accept or withhold any fee otherwise allowed under the terms of this Agreement, for any shares purchased under this Agreement, if prohibited by the Employee Retirement Income Security Act or trust or similar laws to which you are subject, in the case of purchases or redemptions of Fund shares involving retirement plans, trusts or similar accounts. You may elect to make payments for Fund shares in either of two ways: (a) you may send us the public offering price for the Fund shares purchased less the amount of the agency fee due you, or (b) you or your customer may send us the entire public offering price for the Fund shares and we will, on a periodic basis, remit to you the agency fee due. You will specify in writing the method of payment you elect (See NOTICES AND COMMUNICATIONS Section below). If any shares sold to your customer under the terms of this Agreement are repurchased by the Fund or by us, or are tendered to a Fund for redemption or repurchase, within seven (7) business days after the date of the confirmation of the original purchase order, you will promptly refund to us the full agency fee paid or allowed to you on such shares. This Section shall not apply to the extent that you or your customer is qualified to buy, and is buying, shares at net asset value.

  • County Auditor means the Greenville County Auditor, or the person holding any successor office of the County.

  • Agency action Not later than 30 days after receiving an inspector general report of an alleged reprisal, the head of the agency shall determine whether there is sufficient basis to conclude that the non-Federal employer has subjected the employee to a prohibited reprisal. The agency shall either issue an order denying relief in whole or in part or shall take one or more of the following actions: - Order the employer to take affirmative action to xxxxx the reprisal. - Order the employer to reinstate the person to the position that the person held before the reprisal, together with compensation including back pay, compensatory damages, employment benefits, and other terms and conditions of employment that would apply to the person in that position if the reprisal had not been taken. - Order the employer to pay the employee an amount equal to the aggregate amount of all costs and expenses (including attorneys' fees and expert witnesses' fees) that were reasonably incurred by the employee for or in connection with, bringing the complaint regarding the reprisal, as determined by the head of a court of competent jurisdiction.

  • Agency Fee means the fee payable by the Partner to Bolt per every event of sale of the Partner’s Goods through the Bolt Food Platform for the provision of agency services to the Partner. Agreed Percentage is the percentage agreed in the Special Terms that serves as the basis for the calculation of the Agency Fee.

  • Agency Period means the period commencing on the date of this Agreement and expiring on the earliest to occur of (x) the date on which the Agent shall have placed the Maximum Program Amount pursuant to this Agreement and (y) the date this Agreement is terminated pursuant to Section 7.

  • Agency Worker means the individual who is Introduced by the Employment Business to provide services to the Hirer;

  • Agency Representative A person assigned by a primary, assisting, or cooperating federal, state, local, or tribal government agency or private entity that has been delegated authority to make decisions affecting that agency’s or organization’s participation in incident management activities following appropriate consultation with the leadership of that agency. Area: The lands in a described geographic area that are managed and/or protected by the Parties within this Agreement.

  • Rating Agency Inquiry As defined in Section 4.5(d).

  • Reporting Accountants means an accounting firm of international repute as agreed by the Seller and the Purchaser or, if that firm is unable or unwilling to act in any matter referred to them under this Agreement, such other firm of accountants to be agreed by the Seller and the Purchaser within seven (7) days of a notice by one to the other requiring such agreement or failing such agreement to be nominated on the application of either of them by or on behalf of the Institute of Chartered Accountants in England and Wales;

  • Collection agency means a person that is directly engaged in collecting or attempting to collect a claim owed or due or asserted to be owed or due another, or repossessing or attempting to repossess a thing of value owed or due or asserted to be owed or due another person, arising out of an expressed or implied agreement. Collection agency includes an individual who, in the course of collecting, repossessing, or attempting to collect or repossess, represents himself or herself as a collection or repossession agency, or a person that performs collection activities that are regulated under article 9 of the occupational code, 1980 PA 299, MCL 339.901 to 339.920. Collection agency includes a person that furnishes or attempts to furnish a form or a written demand service that is represented to be a collection or repossession technique, device, or system to be used to collect or repossess claims, if the form contains the name of a person other than the creditor in a manner that indicates that a request or demand for payment is being made by a person other than the creditor even though the form directs the debtor to make payment directly to the creditor rather than to the other person whose name appears on the form. Collection agency includes a person that uses a fictitious name or the name of another in the collection or repossession of claims to convey to the debtor that a third person is collecting or repossessing or has been employed to collect or repossess the claim.

  • Auction Agency Agreement means the agreement between the Fund and the Auction Agent which provides, among other things, that the Auction Agent will follow the Auction Procedures for purposes of determining the Applicable Rate for shares of a series of MuniPreferred so long as the Applicable Rate for shares of such series is to be based on the results of an Auction.

  • Agency Office The office of the Issuing Entity maintained pursuant to Section 3.2 of the Indenture.

  • Agency Fee Letter means the administrative agency fee letter, dated as of the March 29, 2012, between the Company and the Administrative Agent.