Government Sponsored Programs definition

Government Sponsored Programs means those government sponsored programs, as designated by Highmark, for which the Provider has been designated to participate, at Highmark’s sole discretion , which includes but is not limited those qualified benefit plans offered by Highmark or Health Plan, in its discretion, to individuals and/or families and/or small groups, as determined by Highmark on or off an American Health Benefit Exchange as defined in the Patient Protection and Affordable Care Act (P.L. 111-148) as amended from time to time.
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Government Sponsored Programs means those government sponsored programs, as designated by Highmark, for which the Provider has been designated to participate, at Highmark’s sole discretion, which includes but is not limited those qualified benefit plans offered by Highmark or Health Plan, in its discretion, to individuals and/or families and/or small groups, as determined by Highmark on or off an American Health Benefit Exchange as defined in the Patient Protection and Affordable Care Act (P.L. 111-148) as amended from time to time.
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Examples of Government Sponsored Programs in a sentence

  • Government Sponsored Programs Provider acknowledges and agrees that Health Plan may terminate this Agreement to furnish services under a QHP in instances where CMS or Health Plan determines that Government Sponsored Programs Provider has not performed satisfactorily.

  • Government Sponsored Programs Providers shall permit access to such records, books, contracts, computer or other electronic systems until ten (10) years from the final date of the Agreement period.

  • Government Sponsored Programs Provider acknowledges and agrees that to the extent CMS directs such revocation, Highmark shall provide immediate written notice of such to Government Sponsored Programs Provider, and such revocation shall become effective as directed by CMS.

  • In furtherance of that right, Government Sponsored Programs Providers shall permit access by the HHS Secretary, OIG and their designees to any books, contracts, computer or other electronic systems, including medical records and documentation related to any services provided under benefit plans offered by Health Plan through an Exchange under a Qualified Health Plan Issuer Agreement.

  • Government Sponsored Programs Providers shall maintain timely and accurate medical, financial and administrative records related to services rendered by Government Sponsored Programs Providers.

  • Unless a longer time period is required by applicable statutes or regulations, Government Sponsored Programs Provider shall maintain such records and any related contracts for ten (10) years.

  • The provisions in Sections 2.3 of the Participating Provider Agreement, the Preferred Provider Agreement, and/or the Government Sponsored Programs Provider Agreement as applicable; Sections 4.3, 4.4, 4.5, 5, 6, 9, and 12 of Part I of these Regulations; and Section 2 of Part II of these Regulations; and Section 6 of Part III of these Regulations; and Section 2 of Part IV of these Regulations shall survive the termination of this Agreement, regardless of the cause giving rise to such termination.

  • If Government Sponsored Programs Providers has any arrangements, in accordance with the terms of the Agreement, with affiliates, subsidiaries, or Downstream Entities, directly or through another person or entity, to perform any health care or administrative services under a QHP, Government Sponsored Programs Providers shall ensure that all such arrangements are in writing, duly executed, and include all the terms contained in this Section 1.5.

  • In addition, to the extent applicable to the activities under this Agreement, Government Sponsored Programs Providers shall comply with the standard rules of conduct set forth in Section II of Highmark or a Health Plan’s Qualified Health Plan Issuer Agreement, to be furnished by Highmark to Government Sponsored Programs Providers in the Administrative Requirements.

  • Payment for Covered Services provided to Members under the Government Sponsored Programs Provider Agreement may be derived in whole or in part from federal funds.

Related to Government Sponsored Programs

  • Government Programs means (i) the Medicare and Medicaid Programs, (ii) the United States Department of Defense Civilian Health Program for Uniformed Services and (iii) other similar foreign or domestic federal, state or local reimbursement or governmental health care programs.

  • Government Apprenticeship Programme “ means training which is funded by the Government via the National Apprenticeship Service.

  • Dependent care assistance program or "DCAP" means a benefit plan whereby school employees may pay for certain employment related dependent care with pretax dollars as provided in the salary reduction plan under chapter 41.05 RCW pursuant to 26 U.S.C. Sec. 129 or other sections of the Internal Revenue Code.

  • Managed Care Program means the process that determines Medical Necessity and directs care to the most appropriate setting to provide quality care in a cost-effective manner, including Prior Authorization of certain services.

  • Government assistance means a grant, loan, or tax increment financing that result in a financial benefit from an agency, commission, instrumentality, or other entity of the District government.

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • Government energy aggregation program means a program and

  • Government Lists means, collectively, (i) the Specially Designated Nationals and Blocked Persons Lists maintained by OFAC, (ii) any other list of terrorists, terrorist organizations or narcotics traffickers maintained pursuant to any of the Rules and Regulations of OFAC, and (iii) any similar lists maintained by the United States Department of State, the United States Department of Commerce or any other governmental authority or pursuant to any Executive Order.

  • OFAC Sanctions Programs means all laws, regulations, and Executive Orders administered by OFAC, including without limitation, the Bank Secrecy Act, anti-money laundering laws (including, without limitation, the Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism Act of 2001, Pub. L. 107-56 (a/k/a the USA Patriot Act)), and all economic and trade sanction programs administered by OFAC, any and all similar United States federal laws, regulations or Executive Orders, and any similar laws, regulators or orders adopted by any State within the United States.

  • Government school means a school established under section 5 of the Act, for the purpose of providing courses of instruction in pre-school, primary or secondary education.

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Covered Program means an education program or activity over which the College exercised substantial control over both the Respondent and the context in which the sexual harassment occurred.

  • Government data means any information, document, media, or machine readable material regardless of physical form or characteristics, that is created or obtained by the Government in the course of official Government business.

  • Sanctions Programs means any OFAC economic sanction program (including, without limitation, programs related to Crimea, Cuba, Iran, North Korea, Sudan and Syria).

  • Government List means any of (i) the two lists maintained by the United States Department of Commerce (Denied Persons and Entities), (ii) the list maintained by the United States Department of Treasury (Specially Designated Nationals and Blocked Persons), and (iii) the two lists maintained by the United States Department of State (Terrorist Organizations and Debarred Parties).

  • Covered Government support contractor means a contractor (other than a litigation support contractor covered by 252.204-7014) under a contract, the primary purpose of which is to furnish independent and impartial advice or technical assistance directly to the Government in support of the Government’s management and oversight of a program or effort (rather than to directly furnish an end item or service to accomplish a program or effort), provided that the contractor—

  • Developed exclusively with government funds means development was not accomplished exclusively or partially at private expense.

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Child Care Program means a person or business that offers child care.

  • Government Accounts means Accounts on which any federal or state governmental unit or any intermediary for any federal or state governmental unit is the Account Debtor.

  • Available government assistance means any governmental rental or housing payment benefits available to the individual or any household member.

  • Participating Retail Health Clinic means a Retail Health Clinic which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Participating Clinical Laboratory means a Clinical Laboratory which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Government Subcontract means each contract between the Issuer or any of its Subsidiaries and any prime contractor or upper-tier subcontractor relating to a contract between such Person and any governmental entity, and each Bid with respect to Government Subcontracts.