Common use of Conditional Status Clause in Contracts

Conditional Status. Monitoring of agencies on Conditional Status may include but is not limited to site visits and requests for documentation/records review and/or interviews of the DSP, Participant or Service Recipient or their parent, guardian or caretaker. For agencies on Conditional Status, the following conditions may apply solely or in combination: 1. Restriction in the number of new referrals the Provider may receive; 2. Restriction or reduction in the number of currently approved Covered Services the Provider is allowed to provide; 3. Suspension of currently approved Covered Services the Provider is providing; 4. Suspension of current services, including removal of Service Recipients. 5. Withholding payment to Provider for Covered Services pending receipt and satisfactory review of requested information and/or documentation. 1. New Providers 2. Current Providers (providers with Agreements in effect with Purchaser) a. Previous or current suspension, which may or may not include compliance with a corrective action plan. b. Critical incident/complaint, which may or may not include compliance with a corrective action plan. c. Addition of new service(s), for the newly added service(s) only. d. Findings resulting from a Site Review/audit by Purchaser representatives, the Milwaukee County Department of Audit and/or representatives of appropriate federal, state or local agencies that document quality and/or fiscal concerns related to applicable Policies and Procedures.

Conditional Status. Monitoring of agencies on Conditional Status may include but is not limited to site visits and requests for documentation/records review and/or interviews of the DSPDirect Service Provider, Participant or Service Recipient or their parent, guardian or caretaker. For agencies on Conditional Status, the following conditions may apply solely or in combination: 1. Restriction in the number of new referrals the Provider may receive; 2. Restriction or reduction in the number of currently approved Covered Services the Provider is allowed to provide; 3. Suspension of currently approved Covered Services the Provider is providing; 4. Suspension of current services, including removal of Service Recipients. 5. Withholding payment to Provider for Covered Services pending receipt and satisfactory review of requested information and/or documentation. 1. New Providers 2. Current Providers (providers with Agreements in effect with Purchaser) a. Previous or current suspension, which may or may not include compliance with a corrective action plan. b. Critical incident/complaint, which may or may not include compliance with a corrective action plan. c. Addition of new service(s), for the newly added service(s) only. d. Findings resulting from a Site Review/audit by Purchaser representatives, the Milwaukee County Department of Audit and/or representatives of appropriate federal, state or local agencies that document quality and/or fiscal concerns related to applicable Policies and Procedures.