APPOINTMENT OF TEMPORARY MANAGEMENT Sample Clauses

APPOINTMENT OF TEMPORARY MANAGEMENT. 18.5.1 TDH may appoint temporary management to oversee the operation of HMO upon a finding that there is continued egregious behavior by HMO or there is a substantial risk to the health of the Members.

APPOINTMENT OF TEMPORARY MANAGEMENT. 142 18.6 TDH-INITIATED DISENROLLMENT OF A MEMBER OR MEMBERS WITHOUT CAUSE..............143 18.7 RECOMMENDATION TO HCFA THAT SANCTIONS BE TAKEN AGAINST HMO....................143 18.8 CIVIL MONETARY PENALTIES......................................................143 18.9 FORFEITURE OF ALL OR PART OF THE TDI PERFORMANCE BOND.........................144 18.10 REVIEW OF REMEDY OR REMEDIES TO BE IMPOSED....................................144 ARTICLE XIX TERM...............................................................144 1999 Renewal Contract Harrxx Xxxvice Area 5 August 9, 1999 APPENDIX A Standards For Quality Improvement Programs APPENDIX B HUB Progress Assessment Reports APPENDIX C Value-added Services APPENDIX D Required Critical Elements APPENDIX E Transplant Facilities APPENDIX F Trauma Facilities APPENDIX G Hemophilia Treatment Centers And Programs APPENDIX H APPENDIX I Managed Care Financial-Statistical Report APPENDIX J Utilization Management Report - Physical Health APPENDIX K Preventive Health Performance Objectives APPENDIX L Cost Principles For Administrative Expenses APPENDIX M Arbitration/Litigation Report 1999 Renewal Contract Harrxx Xxxvice Area 6 August 9, 1999 1999 CONTRACT FOR SERVICES Between THE TEXAS DEPARTMENT OF HEALTH And HMO This contract is entered into between the Texas Department of Health (TDH) and AMERICAID Texas, Inc., dba Americaid Community Care (HMO). The purpose of this contract is to set forth the terms and conditions for HMO's participation as a managed care organization in the TDH STAR Program (STAR or STAR Program). Under the terms of this contract HMO will provide comprehensive health care services to qualified and Medicaid-eligible recipients through a managed care delivery system. This is a risk-based contract. HMO was selected to provide services under this contract under Health and Safety Code, Title 2, Section 12.011 and Section 12.021, and Texas Government Code Section 533.001 et seq. HMO's selection for this contract was based upon HMO's Application submitted in response to TDH's Request for Application (RFA) in the service area. Representations and responses contained in HMO's Application are incorporated into and are enforceable provisions of this contract, except where changed by this contract.

APPOINTMENT OF TEMPORARY MANAGEMENT. 116 18.6 TDHS-INITIATED DISENROLLMENT OF A MEMBER OR MEMBERS WITHOUT CAUSE.......................................116 18.7 RECOMMENDATION TO HCFA THAT SANCTIONS BE TAKEN AGAINST HMO.........................................117 18.8 CIVIL MONETARY PENALTIES............................117 18.9 FORFEITURE OF ALL OR A PART OF THE TDI PERFORMANCE BOND................................................117 18.10 REVIEW OF REMEDY OR REMEDIES TO BE IMPOSED..........117 ARTICLE XIX TERM....................................118 TDHS/HMO CONTRACT August 11, 1999 iv ATTACHMENTS ATTACHMENT A Value Added Services ATTACHMENT B HUB Reporting Requirements and Forms ATTACHMENT C Behavioral Health Value-added Services ATTACHMENT D Required Critical Elements ATTACHMENT E Cost Principles for Administrative Expenses TDHS/HMO CONTRACT August 11, 1999 v 7 1999 CONTRACT FOR SERVICES BETWEEN THE TEXAS DEPARTMENT OF HUMAN SERVICES AND HMO This Contract is entered into between the Texas Department of Human Services ("TDHS") and AMERICIAD TEXAS, INC. ("HMO"). The purpose of this Contract is to set forth the terms and conditions for HMO participation as a managed care organization in the TDHS STAR+PLUS Program ("STAR+PLUS"). Under the terms of this Contract HMO will provide comprehensive health care services to qualified and eligible Medicaid recipients through a managed care delivery system. This is a risk-based Contract. HMO was selected to provide services under this Contract pursuant to Human Resources Code Section 22.002(f). The HMO's original selection for this Contract was based on HMOs Application to TDH/TDHS Request for Application (RFA). Representation and responses contained in HMO's Application are incorporated into and are enforceable provisions of this Contract, except where changed by this Contract.