Common use of Determination of Compliance Clause in Contracts

Determination of Compliance. Performance is monitored once every month. Compliance determination with the standard applies only to the month under consideration and does not include performance in previous quarters. Penalty for Noncompliance with the Data Quality Standard for measure 2: If the MCP is determined to be noncompliant for either standard, ODJFS will impose a monetary sanction of one percent of the MCP’s current month’s premium payment. The monetary sanction will be applied for each file type in the ODJFS-specified medium per format that is determined to be out of compliance. The monetary sanction will be applied only once per file type per compliance determination period and will not exceed a total of two percent of the MCP’s current month’s premium payment. Once the MCP is performing at standard levels and violations/deficiencies are resolved to the satisfaction of ODJFS, the money will be refunded. Special consideration will be made for MCPs with less than 1,000 members.

Appears in 3 contracts

Samples: Provider Agreement (Molina Healthcare Inc), CFC Provider Agreement (Wellcare Health Plans, Inc.), Wellcare Health Plans, Inc.

AutoNDA by SimpleDocs

Determination of Compliance. Performance is monitored once every month. Compliance determination with the standard applies only to the month under consideration and does not include performance in previous quarters. Penalty for Noncompliance with the Data Quality Qualify Standard for measure 2: If the MCP is determined to be noncompliant for either standard, . ODJFS will impose a monetary sanction of one percent of the MCP’s 's current month’s 's premium payment. The monetary sanction will be applied for each file type in the ODJFS-specified medium per format that is determined to be out of compliance. The monetary sanction will be applied only once per file type measure per compliance determination period and will not exceed a total of two percent of the MCP’s 's current month’s 's premium payment. Once the MCP is performing at standard levels and violations/deficiencies are resolved to the satisfaction of ODJFS, . the money will be refunded. Special consideration will be made for MCPs with less than 1,000 members.

Appears in 1 contract

Samples: Provider Agreement (Wellcare Health Plans, Inc.)

Determination of Compliance. Performance is monitored once every month. Compliance determination with the standard applies only to the month under consideration and does not include performance in previous quarters. Penalty for Noncompliance with the Data Quality Standard for Standardfor measure 2: If the MCP is determined to be noncompliant for either standard, ODJFS will impose a monetary sanction of one percent of the MCP’s current month’s premium payment. The monetary sanction will be applied for each file type in the ODJFS-specified medium per format that is determined to be out of compliance. The monetary sanction will be applied only once per file type per compliance determination period and will not exceed a total of two percent of the MCP’s current month’s premium payment. Once the MCP is performing at standard levels and violations/deficiencies are resolved to the satisfaction of ODJFS, the money will be refunded. Special consideration will be made for MCPs with less than 1,000 members.

Appears in 1 contract

Samples: Provider Agreement (Wellcare Health Plans, Inc.)

Determination of Compliance. Performance is monitored once every month. Compliance determination with the standard applies only to the month under consideration and does not include performance in previous quarters. Penalty for Noncompliance with the Data Quality Standard for measure 2: If the MCP is determined to be noncompliant for either standard, ODJFS will impose a monetary sanction of one Appendix L Aged, Blind or Disabled (ABD) population Page 7 percent of the MCP’s current month’s premium payment. The monetary sanction will be applied for each file type in the ODJFS-specified medium per format that is determined to be out of compliance. The monetary sanction will be applied only once per file type per compliance determination period and will not exceed a total of two percent of the MCP’s current month’s premium payment. Once the MCP is performing at standard levels and violations/deficiencies are resolved to the satisfaction of ODJFS, the money will be refunded. Special consideration will be made for MCPs with less than 1,000 members.

Appears in 1 contract

Samples: Provider Agreement (Molina Healthcare Inc)

AutoNDA by SimpleDocs

Determination of Compliance. Performance is monitored once every month. Compliance determination with the standard applies only to the month under consideration and does not include performance in previous quarters. Penalty for Noncompliance with the Data Quality Standard for measure 2: If the MCP is determined to be noncompliant for either standard, ODJFS will impose a monetary sanction of one Appendix L Aged, Blind or Disabled (ABD) population Page 8 percent of the MCP’s current month’s premium payment. The monetary sanction will be applied for each file type in the ODJFS-specified medium per format that is determined to be out of compliance. The monetary sanction will be applied only once per file type per compliance determination period and will not exceed a total of two percent of the MCP’s current month’s premium payment. Once the MCP is performing at standard levels and violations/deficiencies are resolved to the satisfaction of ODJFS, the money will be refunded. Special consideration will be made for MCPs with less than 1,000 members.

Appears in 1 contract

Samples: Assistance Provider Agreement (Molina Healthcare Inc)

Time is Money Join Law Insider Premium to draft better contracts faster.