Affiliated Provider Enrollment Sample Clauses

Affiliated Provider Enrollment. Contractor shall assure that all Affiliated Providers, including out-of-State Affiliated Providers, are enrolled in the HFS Medical Program, if such enrollment is required by the Department’s rules or policy in order to submit claims for reimbursement or otherwise participate in the HFS Medical Program. Contractor shall make a good faith effort to give written notice of termination of a Provider as soon as practicable, but in no event later than fifteen (15) days following such termination, to each Enrollee who received his or her primary care from, or was seen on a regular basis by, the terminated Provider.
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Affiliated Provider Enrollment. Contractor shall assure that all Affiliated Providers that provide Medicare Covered Services are enrolled as Medicare providers in order to submit claims for reimbursement or otherwise participate in the Medicare Program. Contractor shall assure that all Affiliated Providers, including out-of-State Affiliated Providers that provide Medicaid Covered Services are enrolled in the HFS Medical Program, if such enrollment is required by the Department’s rules or policy in order to submit claims for reimbursement or otherwise participate in the HFS Medical Program.
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Affiliated Provider Enrollment. Contractor shall assure that all Affiliated Providers that provide Medicare Covered Services do not appear on the CMS preclusion list in order to submit claims for reimbursement or otherwise participate in the Medicare Program. Contractor shall assure that all Affiliated Providers, including out-of-State Affiliated Providers that provide Medicaid Covered Services are screened and enrolled in the HFS Medical Program, in compliance with 42 C.F.R. § 438.602(b). Payment of a portion of a Medicare Covered Service by a Contractor does not constitute a Medicaid Covered Service for the purposes of this section.
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Related to Affiliated Provider Enrollment

  • How Are Distributions from a Xxxxxxxxx Education Savings Account Taxed For Federal Income Tax Purposes? Amounts distributed are generally excludable from gross income if they do not exceed the beneficiary’s “qualified higher education expenses” for the year or are rolled over to another Xxxxxxxxx Education Savings Account according to the requirements of Section (4). “Qualified higher education expenses” generally include the cost of tuition, fees, books, supplies, and equipment for enrollment at (i) accredited post-secondary educational institutions offering credit toward a bachelor’s degree, an associate’s degree, a graduate-level or professional degree or another recognized post-secondary credential and (ii) certain vocational schools. In addition, room and board may be covered if the beneficiary is at least a “half-time” student. This amount may be reduced or eliminated by certain scholarships, qualified state tuition programs, HOPE, Lifetime Learning tax credits, proceeds of certain savings bonds, and other amounts paid on the beneficiary’s behalf as well as by any other deductions or credits taken for the same expenses. The definition of “qualified education expenses” includes expenses more frequently and directly related to elementary and secondary school education, including the purchase of computer technology or equipment or Internet access and related services. To the extent payments during the year exceed such amounts, they are partially taxable and partially non-taxable similar to payments received from an annuity. Any taxable portion of a distribution is generally subject to a 10% penalty tax in addition to income tax unless the distribution is (i) due to the death or disability of the beneficiary, (ii) made on account of a scholarship received by the beneficiary, or (iii) is made in a year in which the beneficiary elects the HOPE or Lifetime Learning credit and waives the exclusion from income of the Xxxxxxxxx Education Savings Account distribution. You may be allowed to take both the HOPE or Lifetime Learning credits while simultaneously taking distributions from Xxxxxxxxx Education Savings Accounts. However, you cannot claim a credit for the same educational expenses paid for through Xxxxxxxxx Education Savings Account distributions. To the extent a distribution is taxable, capital gains treatment does not apply to amounts distributed from the account. Similarly, the special five- and ten-year averaging rules for lump-sum distributions do not apply to distributions from a Xxxxxxxxx Education Savings Account. The taxable portion of any distribution is taxed as ordinary income. The IRS does not require withholding on distributions from Xxxxxxxxx Education Savings Accounts.

  • Re-enrollment Any eligible employees who wish to join the Sick Leave Bank after their first year of eligibility will contribute two (2) days upon joining. Such membership may only be made during the month of October using the appropriate forms. The two (2) required days of leave shall be donated from their account upon enrollment in the Classified Employee Council (CEC).

  • Provider Selection To the extent applicable to Provider in performance of the Agreement, Provider shall comply with 42 CFR 438.214, as may be amended from time to time, which includes, but is not limited to the selection and retention of providers, credentialing and recredentialing requirements and nondiscrimination. If Subcontractor and/or Health Plan delegate credentialing to Provider, Subcontractor and/or Health Plan will provide monitoring and oversight and Provider shall ensure that all licensed medical professionals are credentialed in accordance with Health Plan’s and the State Contract’s credentialing requirements.

  • Medicaid Enrollment Treatment Grantees shall enroll as a provider with Texas Medicaid and Healthcare Partnership (TMHP) and all Medicaid Managed Care organizations in Grantee’s service region within the first quarter of this procurement term and maintain through the procurement term.

  • Special Enrollment Under the circumstances described below, referred to as “qualifying events”, eligible employees and/or eligible dependents may request to enroll in the Plan outside of the initial and annual open enrollment periods, during a special enrollment period.

  • Disenrollment Adverse Benefit Determination taken by the Division, or its Agent, to remove a Member's name from the monthly Member Listing report following the Division's receipt and approval of a request for Disenrollment or a determination that the Member is no longer eligible for Enrollment in the Contractor.

  • Initial Enrollment Upon retirement, each new retiree who is eligible to enroll in plans under the Health Benefits Program shall receive uninterrupted coverage under the plan in which he or she was enrolled as an active employee, provided the employee submits all necessary applications and other required documentation in a timely fashion.

  • Open Enrollment There shall be an open enrollment period each enrollment year during which eligible employees may change plans. The District shall establish and announce the dates of such open enrollment period, and shall mail open enrollment materials to employees fourteen or more days before the beginning of the open enrollment period. If an eligible employee requests a change of plan, he or she shall continue to be covered under his or her existing plan until coverage under the new plan can be instituted.

  • Certification for Federal-Aid Contracts Lobbying Activities A. The CONSULTANT certifies, by signing and submitting this Contract, to the best of its knowledge and belief after diligent inquiry, and other than as disclosed in writing to the LPA prior to or contemporaneously with the execution and delivery of this Contract by the CONSULTANT, the CONSULTANT has complied with Section 1352, Title 31, U.S. Code, and specifically, that:

  • Medical Benefits - Prescription Drugs Administered by a Provider (other than a pharmacist) This plan covers prescription drugs as a medical benefit, referred to as “medical prescription drugs”, when the prescription drug requires administration (or the FDA approved recommendation is administration) by a licensed healthcare provider (other than a pharmacist). Please note: Specialty prescription drugs meeting these requirements or recommendations are covered as a pharmacy benefit and not a medical benefit. These medical prescription drugs include, but are not limited to, medications administered by infusion, injection, or inhalation, as well as nasal, topical or transdermal administered medications. For some of these medical prescription drugs, the cost of the prescription drug is included in the allowance for the medical service being provided, and is not separately reimbursed.

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