Preclusion List definition

Preclusion List means the CMS-compiled list of providers and prescribers who are precluded from receiving payment for Medicare Advantage (MA) items and services or Part D drugs furnished or prescribed to Medicare beneficiaries.
Sample 1Sample 2Sample 3
Preclusion List. The list maintained by CMS under42 C.F.R. § 422.222 and defined in 42 C.F.R. § 422.2.
Sample 1Sample 2Sample 3
Preclusion List means the CMS Preclusion List and/or the OIG exclusion list.
Sample 1Sample 2

Examples of Preclusion List in a sentence

  • IEHP does notcontract with prospective Hospitals and entities for the IEHP Medicare line of business if the Provider is on the CMS Preclusion List or has opted-out of the Medicare Program.

  • A monthly review of the Department of Health Care Services Medi-Cal Suspended and Ineligible list and Centers for Medicare and Medicaid Services Preclusion List.

  • A Grievance is a complaint by a Teacher or by the Association in its behalf, concerning any alleged violation, misinterpretation or misapplication of this Agreement or any disciplinary action administered to a Teacher.

  • CMS Preclusion List Ancillary ProvidersYou must send Clover a completed Facility/Ancillary Provider Credentialing Application that is signed and dated (application is valid for 180 days).

  • Thus, a plan may provide a beneficiary with more than 60 days’ notice, and if a plan does so, the plan should not deny payments/reject claims earlier than 90 days after publication of the associated Preclusion List.

  • Have been convicted of a felony under federal or state law within the previous ten years that CMS determines is detrimental to the best interests of the Medicare program.[13]Of note, the second criteria listed above allows for a provider not currently enrolled in Medicare to be placed on the CMS Preclusion List.

  • On April 1, 2019, the Center for Medicare and Medicaid Services (“CMS”) announced a new exclusion sanction: the CMS Preclusion List.

  • A monthly review of the Department of Health Care Services Medi-Cal Suspended and Ineligible list and the Centers for Medicare and Medicaid Services Preclusion List.

  • All prescribers who write prescriptions for PACE Participants will be checked against the OIG List of Excluded Individuals/Entities, the GSA Excluded Parties Listing System, the CMS Preclusion List, and/or any state exclusion lists maintained by state Medicaid programs on an annual basis.

  • The rate of suicide in the CDCR was 18.6 suicides per 100,000 inmates in 2015 and 17.0 per 100,000 in 2014.


More Definitions of Preclusion List

Preclusion List shall be added to the Contract as follows:
Sample 1
Preclusion List means the CMS-compiled list of individuals and entities that -
Sample 1

Related to Preclusion List

  • DQ List has the meaning specified in Section 10.06(g).

  • Update means a modification to a Component System necessary to maintain the operation of the Component System in compliance with the Documentation in effect as of the Component System’s applicable License Effective Date and includes without limitation modifications correcting any design or operational errors in the Component System and modifications enabling the Component System to be operated in any revised operating environment issued by BNYM and excludes Upgrades.

  • Material safety data sheet or "MSDS" means the chemical, physical, technical, and safety information document supplied by the manufacturer of the coating, solvent, or other chemical product, usually through the distribution network or retailers.

  • Endpoint means any Federal Reserve Bank, financial institution, local clearing house, courier or other entity or location for the delivery of cash letters or other presentment of Imaged Items or Substitute Checks.

  • Debarment means an action taken by a Federal agency or official to exclude a person or business entity from participating in transactions involving certain federal funds.

  • Safety Data Sheet means a safety data sheet within the meaning of regulation 5 of the CHIP Regulations;

  • Regulatory Action means an administrative, regulatory, or judicial enforcement action, proceeding, investigation or inspection, FDA Form 483 notice of inspectional observation, warning letter, untitled letter, other notice of violation letter, recall, seizure, Section 305 notice or other similar written communication, injunction or consent decree, issued by the FDA or a federal or state court.

  • Complaint Investigation means an investigation of any complaint that has been made to a proper authority that is not covered by an abuse investigation.

  • Policy Grievance shall be signed by a xxxxxxx or a Union representative or, in the case of an Employer's policy grievance, by the Employer or its representative.