ATTACHMENT J. Add new Section 16.5(e) as follows: 16.5
ATTACHMENT J. 2, the SLP, contains fixed unit prices, fixed unit fees, and cost-reimbursement elements, which may vary from person to person based on each ISP. Negotiated prices, agreed upon by the District and Contractor, shall be incorporated in the terms and conditions of the established HCA and shall continue under the terms of the HCA unless there is a change to a specific ISP or other condition, approved by the District that warrants a change, to include, but not be limited to, changes in rental rate of an individual lease agreement.
ATTACHMENT J. Program Pricing CFM and Airline both recognize that it is desirable that Airline maintains a spare-to-installed engine ratio of CFM56-5B engines that will be sufficient to assure optimal stability in Airline’s A320 family flight operations. In order to induce Airline to purchase sufficient CFM56-5B engines to achieve this objective, CFM is offering a Spare Engine purchase price credit to Airline, in accordance with the following terms.
ATTACHMENT J. Fourth Revised and Restated Reporting Requirements is revised and restated in its entirety to incorporate reports associated with the Healthy Opportunities Pilot as set forth in Attachment 5: Attachment J. Fifth Revised and Restated Reporting Requirements to this Amendment.
ATTACHMENT J. HIPAA PRIVACY BUSINESS ASSOCIATE AGREEMENT This Contract is entered into this day of , 200_, between the County of Orange (the “County”) acting on behalf of the County Group Health Plans and the Management and Attorney Dental Plan (the “Plan(s)”), and . (“Business Associate”). The parties intend to use this Amendment to satisfy the Business Associate contract requirements in the regulations at 45 CFR 164.502(e) and 164.504(e), issued under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).
ATTACHMENT J. Please provide the results of the GeoAccess analysis requested in Section II, Part 3, Section E. Summary results should be provided in hard copy. Full results should be provided on CD-ROM. While we understand eligibility for each product will differ, please use the total census population for all GeoAccess reports GeoAccess Summary – As appropriate Include the number of providers who meet the access criteria outlined in the table for each plan you are providing a response for: Medicare advantage HMO (medicare risk/medicare choice) California only Medicare Advantage PPO/PFFS (private fee-for- service) NATIONAL commercial non-medicare Narrow Network HMO California only commercial non-medicare HMO California only 1 PCP 5 MILES 2 PCPS 8 MILES 2 OB/GYNS 10 MILES 1 Hospital 15 MILES 1 Hospital 20 MILES Please provide a total count for the number of providers for each plan from the GeoAccess analysis: Medicare Medicare COMMERCIAL ADVANTAGE HMO Advantage NON-MEDICARE COMMERCIAL (MEDICARE PPO/PFFS Narrow NON-MEDICARE RISK/MEDICARE (PRIVATE FEE-FOR- Network HMO HMO CHOICE) SERVICE) California only PCP’S OB/GYNS SPECIALISTS Hospital Attachment K
ATTACHMENT J. 1 – CONTRACTOR INFORMATION SPREADSHEET
ATTACHMENT J. 2 – SYSTEM FOR AWARD MANAGEMENT CERTIFICATION
ATTACHMENT J. How the state must calculate the impact of the transformation. The attachment will outline all of the costs that should be captured in the pre and post transformation implementation. This will assist the state and CMS in tracking whether transformation is being accomplished.
ATTACHMENT J. Acknowledgement of Receipt of Provider Manual Provider hereby acknowledges receipt of Health Plan’s Provider Manual. Date of receipt: ________________________ Initials of authorized representative of Provider: _________________________ ATTACHMENT K BUSINESS ASSOCIATE AGREEMENT This BUSINESS ASSOCIATE AGREEMENT (“BAA”) is entered into effective the _____ day of __________, 20____ (the “Effective Date”) by and between Ventura County Medi-Cal Managed Care Commission doing business as Gold Coast Health Plan (“Health Plan”) and _______________________________________________________, (“Business Associate”), each a “Party” and collectively the “Parties”.
