IRO Qualifications The IRO shall Sample Clauses

IRO Qualifications The IRO shall. 1. assign individuals to conduct the Claims Review who have expertise in the Medicare and state Medicaid program requirements applicable to the claims being reviewed;
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IRO Qualifications The IRO shall. 1. assign individuals to conduct the Arrangements Review who are knowledgeable in the requirements of the Anti-Kickback Statute and the Xxxxx Law and the regulations and other guidance documents related to these statutes;
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IRO Qualifications The IRO shall. 1. assign individuals to conduct the IRO Reviews who have expertise in the pharmaceutical industry and in all applicable Federal health care program and FDA requirements relating to the Covered Functions, including but not limited to expertise relating to marketing and promotional activities associated with pharmaceutical products and the Federal Anti-Kickback Statute and False Claims Act and relating to the collection, calculation, verification and reporting of information for such products for purposes of the Medicaid Drug Rebate Program, the Medicare Program and the 340B Drug Pricing Program;
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IRO Qualifications The IRO shall. 1. assign individuals to conduct the Claims Review and Surgical Procedures Quality Review who have expertise in the billing, coding, reporting, and other requirements governing the surgical procedures subject to review during the applicable Reporting Period, and in the general requirements of the Federal health care program(s) from which Xxx Xxxxxx seeks reimbursement;
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IRO Qualifications The IRO shall. 1. assign individuals to conduct the MDS Review who have expertise in the billing, coding, reporting, and other requirements of the Medicare Prospective Payment System for skilled nursing facilities and in the general requirements of the Federal health care program(s) from which Extendicare seeks reimbursement;
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IRO Qualifications The IRO shall. 1. assign individuals to conduct the Claims Review who have expertise in the billing, coding, reporting, and other requirements of dental and orthodontic claims and in the general requirements of the Federal health care program(s) from which All Smiles seeks reimbursement;
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IRO Qualifications The IRO shall. 1. assign individuals to conduct the Rehabilitation Therapy Services Medical Necessity and Appropriateness Review (Rehab Medical Review) who have expertise in the Medicare requirements relating to rehabilitation therapy in skilled nursing facilities and in the general requirements of the Federal health care program(s) from which RehabCare’s customers seeks reimbursement
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IRO Qualifications The IRO shall 
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Related to IRO Qualifications The IRO shall

  • IRO Qualifications The IRO shall:

  • Personnel Qualifications Contractor shall assign properly qualified and experienced personnel to the program contemplated under this Agreement, and Contractor shall use reasonable efforts to retain such personnel on Customer’s program for the duration of such program.

  • Staff Qualifications a) CONTRACTOR shall ensure that all individuals employed, contracted, and/or otherwise hired by CONTRACTOR to provide classroom and/or individualized instruction or related services hold a license, certificate, permit, or other document equivalent to that which staff in a public school are required to hold in the service rendered consistent with Education Code section 56366.1(n)(1) and are qualified pursuant to Title 5 of the California Code of Regulations sections 3064 and 3065.

  • Professional Qualifications It shall be a condition of continued professional employment that employees must apply for enrolment in their appropriate professional licensing body by the thirtieth day of continuous service.

  • Employee Qualifications When a layoff is necessary, the Employer will lay off employees so that the reduction will be made in such a manner that the remaining employees possess the necessary qualifications to perform the required duties.

  • Required Qualifications At all times during the term of the Contract, Vendor shall have available, under direct employment and supervision and/or subcontract agreement fully incorporating the terms and conditions of the Contract Documents, the required qualified and properly licensed (as applicable) personnel to properly fulfill all the terms and conditions of the Contract.

  • General Qualifications General qualifications commonly required of all candidates for, appointees to, and employees in the classified service such as integrity, honesty, sobriety, dependability, industry, thoroughness, accuracy, good judgment, initiative, resourcefulness, courtesy, ability to work cooperatively with others, good health, and freedom from disabling defects, shall be deemed to be a part of the personal characteristics of the minimum qualifications of each class specification and need not be specifically set forth therein. The Commission may prescribe alternative or additional qualifications for individual classes and such qualifications also shall be deemed to be a part of the specifications for such classes.

  • Foreign Qualification Prior to the Company’s conducting business in any jurisdiction other than Delaware, the Majority Members shall cause the Company to comply, to the extent procedures are available and those matters are reasonably within the control of the Majority Members, with all requirements necessary to qualify the Company as a foreign limited liability company in that jurisdiction.

  • Minimum Qualifications If applicable pursuant to Article 3, I acknowledge that the Bidder meets the minimum qualification requirements established for this solicitation.

  • Vendor Qualifications Minimum Qualifications Based on the Contractor’s submission, OGS has determined that Contractor met the minimum qualifications for the lot(s) as identified in Appendix G, Contractor and OGS Information. If Contractor is awarded Lot 1 as a New York State Certified Minority- or Women- Owned Business Enterprise or as a New York State Small Business, Contractor agrees that it must retain at least one of such statuses to retain its Lot 1 award. Should a Contractor no longer retain at least one of such statuses, OGS shall suspend its Lot 1 award and the Contractor shall not be able to respond to Authorized User’s requests. If the Contractor fails to regain at least one of the statuses within 90 calendar days and provide OGS with documentation of such status, then its Lot 1 award shall be terminated. Any transaction awarded prior to Contractor’s loss of such statuses may continue until completion, unless otherwise terminated in accordance with this Contract. Lot 1– For projects up to $200,000 total Eligibility for this Lot is limited to the following:  Contractor is a New York State Certified Minority- or Women-Owned Business Enterprise; or  Contractor meets the definition of a New York State Small Business which is as follows: o A business which is resident in New York State, independently owned and operated, not dominant in its field and employs one hundred or less persons (see State Finance Law section 160(8)).

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