Medicare Laws definition

Medicare Laws means any and all laws, rules, regulations, statutes, orders and standards, instructions and guidance applicable to the Medicare Advantage Program and Medicare Advantage Organizations, as the term is defined in 42 CFR § 422.4, including Health Plan in its capacity as the sponsor of Health Plan’s D-SNP(s).
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Medicare Laws means any and all Laws applicable to reimbursement by Medicare, Medicaid or any other governmental healthcare program for services or items rendered by the Company, including all federal and state laws relating to the referral of patients to the Company's business.
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Medicare Laws means the Social Security Act, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, any applicable regulations (including but not limited to those under 42 CFR Part 423), the CMS Medicare Prescription Drug Benefit Manual (the “Manual”), and any and all related guidance, instructions, or other requirements issued by CMS.
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Examples of Medicare Laws in a sentence

  • Health Plan shall comply with all applicable State and Medicare Laws relating to marketing of its D-SNP(s).

  • The Company may amend, revise or supplement this Agreement with written notice to Agent in order to maintain compliance with Medicare Laws and Regulations and any applicable state, federal or local statutes, ordinances, codes, rules, regulations, restrictions, orders, procedures, directives, guidelines, policies or requirements enacted, adopted, applied or imposed by any governmental authority or court.

  • Health Plan’s administration of Health Plan’s D- SNP(s), including, without limitation, plan benefit package design, provider network adequacy, provider credentialing, utilization management programs, quality improvement programs, and payment processes and procedures (collectively, “Administrative Services”), shall be subject to and in compliance with Medicare Laws.

  • Additionally, the Company or CMS shall have the right to institute corrective action plans or seek other remedies or curative measures respecting the unsatisfactory performance consistent with applicable Medicare Laws and Regulations.

  • Agent shall ensure that any such delegation or subcontract shall be performed by the subcontractor in accordance with the Company’s contractual obligations to CMS, Agent’s contractual obligation under this Agreement, and in compliance with all applicable Medicare Laws and Regulations and the requirements of this Addendum.

  • Subject to Medicare Laws and Regulations and applicable federal and state laws and regulations, the Company may, in its discretion, discontinue or modify any of the Products.

  • Agent agrees that Agent shall comply with all requirements imposed upon a First Tier Entity and a Downstream Entity by CMS or by Medicare Laws and Regulations.

  • Agent specifically acknowledges that marketing and enrollment materials must be approved by CMS and the Company and that the enrollment of Members into MA Plans and PDP Plans is governed by Medicare Laws and Regulations.

  • Agency agrees that any coordinated marketing to be carried out by Agency (and any agents working under Agency) must be done in compliance with all Medicare Laws, Medicare Guidelines and federal health care laws (including civil monetary penalty laws).

  • Maintain and make available for inspection complete books and records of all transactions pertaining to this Agreement, as required by Medicare Laws and Regulations and as set forth in the Medicare Regulatory Addendum attached to this Agreement as Exhibit C and incorporated herein, and as may otherwise be required under state insurance laws and regulations or by any governmental entity or regulatory agency.