OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Xxxxx in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Xxxxx shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by Xxxxx regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Xxxxx in writing that Xxxxx shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Xxxxx must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require Xxxxx to engage a new IRO shall be made at the sole discretion of OIG.
OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and/or objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG may, at its sole discretion, require GSK to engage a new IRO in accordance with Paragraph A of this Appendix. GSK must engage a new IRO within 60 days of termination of the IRO. Prior to requiring GSK to engage a new IRO, OIG shall notify GSK of its intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, GSK may present additional information regarding the IRO’s qualifications, independence or performance of its responsibilities. OIG will attempt in good faith to resolve any differences regarding the IRO with GSK prior to requiring GSK to terminate the IRO. However, the final determination as to whether or not to require GSK to engage a new IRO shall be made at the sole discretion of OIG. Appendix B to CIA for GlaxoSmithKline LLC Independent Review Organization Reviews I. Covered Functions Review, General Description As specified more fully below, GlaxoSmithKline (GSK) shall retain an Independent Review Organization (IRO) (or IROs) to perform reviews (IRO Reviews) to assist GSK in assessing and evaluating its systems, processes, policies, procedures, and practices related to certain of GSK's Covered Functions (collectively, “IRO Covered Functions”). The IRO Review shall consist of two components - a systems review (Systems Review) and a transactions review (Transactions Review) as described more fully below. GSK may engage, at its discretion, a single IRO to perform both components of the IRO Review provided that the entity has the necessary expertise and capabilities to perform both. If there are no material changes in GSK’s systems, processes, policies, and procedures relating to the Covered IRO Functions, the IRO shall perform the Systems Review for the second and fifth IRO Reporting Periods. If GSK materially changes its systems, processes, policies, and procedures relating to the Covered IRO Functions, the IRO shall perform a Systems Review for the IRO Reporting Period(s) in which such changes were made in addition to conducting the Review for the second and fifth IRO Reporting Periods. The additional Systems Review(s) shall consist of: 1) an identification of the material changes; 2) an assessment of whether other sys...
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify Practitioner in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Practitioner shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by Practitioner regarding its IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Practitioner in writing that Practitioner shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. Practitioner must engage a new IRO within 60 days of receipt of OIG’s written notice. The final determination as to whether or not to require Practitioner to engage a new IRO shall be made at the sole discretion of OIG.
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify CCH in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CCH shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CCH regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CCH in writing that CCH shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. CCH must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require CCH to engage a new IRO shall be made at the sole discretion of OIG.
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG may, at its sole discretion, require the Provider to engage Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement - Appendix A a new IRO in accordance with Paragraph A of this Appendix. The Provider must engage a new IRO within 60 days of termination of the IRO. Prior to requiring a Provider to engage a new IRO, OIG shall notify the Provider of its intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, the Provider may present additional information regarding the IRO’s qualifications, independence or performance of its responsibilities. OIG will attempt in good faith to resolve any differences regarding the IRO with the Provider prior to requiring the Provider to terminate the IRO. However, the final determination as to whether or not to require the Provider to engage a new IRO shall be made at the sole discretion of OIG. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement- Appendix B APPENDIX B CLAIMS REVIEW
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG may, at its sole discretion, require Amedisys to engage a new IRO in accordance with Paragraph A of this Appendix. Amedisys must engage a new IRO within 60 days of termination of the IRO. Prior to requiring Amedisys to engage a new IRO, OIG shall notify Amedisys of its intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, Amedisys may present additional information regarding the IRO’s qualifications, independence or performance of its responsibilities. OIG will attempt in good faith to resolve any differences regarding the IRO with Amedisys prior to requiring Amedisys to terminate the IRO. However, the final determination as to whether or not to require Amedisys to engage a new IRO shall be made at the sole discretion of OIG. Amedisys, Inc. and Amedisys Holding, LLC Corporate Integrity Agreement Appendix A APPENDIX B
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG may, at its sole discretion, require CHSI to engage a new IRO in accordance with Paragraph A of this Appendix. CHSI must engage a new IRO within 60 days of termination of the IRO. Prior to requiring CHSI to engage a new IRO, OIG shall notify CHSI of its intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, CHSI may present additional information regarding the IRO’s qualifications, independence or performance of its responsibilities. OIG will attempt in good faith to resolve any differences regarding the IRO with CHSI prior to requiring CHSI to terminate the IRO. However, the final determination as to whether or not to require CHSI to engage a new IRO shall be made at the sole discretion of OIG. Community Health Systems, Inc. 3 Corporate Integrity Agreement - Appendix A APPENDIX B INPATIENT MEDICAL NECESSITY AND APPROPRIATENESS REVIEW
OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG may, at its sole discretion, require TCH to engage a new IRO in accordance with Paragraph A of this Appendix. TCH must engage a new IRO within 60 days of termination of the prior IRO or at least 60 days prior to the end of the current Reporting Period, whichever is earlier. Prior to requiring TCH to engage a new IRO, OIG shall notify TCH of its intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, TCH may present additional information regarding the IRO’s qualifications, independence or performance of its responsibilities. OIG will attempt in good faith to resolve any differences regarding the IRO with TCH prior to requiring TCH to terminate the IRO. However, the final determination as to whether or not to require TCH to engage a new IRO shall be made at the sole discretion of OIG. APPENDIX B ARRANGEMENTS REVIEW The Arrangements Review shall consist of two components: a systems review and a transactions review. The IRO shall perform all components of each Arrangements Review. If there are no material changes to TCH’s systems, processes, policies, and procedures relating to Arrangements, the Arrangements Systems Review shall be performed for the first and fourth Reporting Periods. If TCH materially changes the Arrangements systems, processes, policies and procedures, the IRO shall perform an Arrangements Systems Review for the Reporting Period in which such changes were made in addition to conducting the systems review for the first and fourth Reporting Periods. The Arrangements Transactions Review shall be performed annually and shall cover each of the five Reporting Periods.
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG may, at its sole discretion, require Good Shepherd to engage a new IRO in accordance with Paragraph A of this Appendix. Good Shepherd must engage a new IRO within 60 days of termination of the IRO. Prior to requiring Good Shepherd to engage a new IRO, OIG shall notify Good Shepherd of its intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, Good Shepherd may present additional information regarding the IRO’s qualifications, independence or performance of its responsibilities. OIG will attempt in good faith to resolve any differences regarding the IRO with Good Shepherd prior to requiring Good Shepherd to terminate the IRO. However, the final determination as to whether or not to require Good Shepherd to engage a new IRO shall be made at the sole discretion of OIG.
OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG may, at its sole discretion, require Orbit to engage a new IRO in accordance with Paragraph A of this Appendix. Orbit must engage a new IRO within 60 days of termination of the IRO. Prior to requiring Orbit to engage a new IRO, OIG shall notify Orbit of its intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, Orbit may present additional information regarding the IRO’s qualifications, independence or performance of its responsibilities. OIG will attempt in good faith to resolve any differences regarding the IRO with Orbit prior to requiring Orbit to terminate the IRO. However, the final determination as to whether or not to require Orbit to engage a new IRO shall be made at the sole discretion of OIG.
