Common use of Government Program Representations Clause in Contracts

Government Program Representations. Company has or may seek a contract to serve Medicare, Medicaid, CHIP, and/or Tricare beneficiaries (“Government Programs”). To the extent Company participates in such Government Programs, Group and Participating Group Providers agree, on behalf of themselves and any subcontractors of Group or Participating Group Providers, to be bound by all rules and regulations of, and all requirements applicable to, Government Programs. Group and Participating Group Providers acknowledges and agrees that all provisions of this Agreement shall apply equally to any employees, independent contractors and subcontractors of Group and Participating Group Providers who provide or may provide Covered Services to Members of Government Programs, and Group and Participating Group Providers represents and warrants that Group and Participating Group Providers shall take all steps necessary to cause such employees, independent contractors and subcontractors to comply with the Agreement and all applicable laws, rules and regulations and perform all requirements applicable to Government Programs. With respect to Members of Government Programs, Group and Participating Group Providers acknowledge that compensation under this Agreement for such Members constitutes receipt of Federal funds. Group and Participating Group Providers agree that all services and other activities performed by Group and Participating Group Providers under this Agreement will be consistent and comply with Company’s obligations under its contract(s) with the Centers for Medicare and Medicaid Services (“CMS”), and any applicable state regulatory agency, to offer Medicare/Medicaid Plans. Group and Participating Group Providers further agree to allow CMS, any applicable state regulatory agency, and Company to monitor Group and Participating Group Providers’ performance under this Agreement on an ongoing basis in accordance with Medicare/Medicaid laws, rules and regulations. Group and Participating Group Providers acknowledge and agree that Company may only delegate its activities and responsibilities under its contract(s) with CMS and any applicable regulatory agency, to offer Medicare/Medicaid Plans in a manner consistent with Medicare/Medicaid laws, rules and regulations, and that if any such activity or responsibility is delegated by Company to Group and Participating Group Providers, the activity or responsibility may be revoked if CMS or Company determine that Group and Participating Group Providers have not performed satisfactorily. If Company designates Group and Participating Group Providers to participate in a Government Program Pursuant to Section 2.10 below. Group and Participating Group Providers may opt out of participation of that Government Program. Group and Participating Group Providers shall have thirty (30) days from receipt of Company’s notice of designation, to notify Company in writing if Group and Participating Group Providers elects not to participate in that Government Program.

Government Program Representations. Company has or may shall seek a contract contracts to serve Medicare, Medicaid, CHIP, and/or Tricare beneficiaries (“of Government Programs”). To the extent Company participates in such a specific Government ProgramsProgram, Group and Participating Group Providers Physicians agree, on behalf of themselves and any subcontractors of Group or Participating Group ProvidersPhysicians, to be bound by all rules and regulations of, and all requirements applicable to, such Government Programs. Group and Participating Group Providers acknowledges Physicians acknowledge and agrees agree that all provisions of this Agreement shall apply equally to any employees, independent contractors and subcontractors of Group and Participating Group Providers Physicians who provide or may provide Covered Services to Members of Government Programs, and Group and Participating Group Providers represents Physicians represent and warrants warrant that Group and Participating Group Providers Physicians shall take all steps necessary to cause such employees, independent contractors and subcontractors to comply with this Agreement, the Agreement State Contract, and all applicable laws, rules and regulations and perform all requirements applicable to Government Programs. Any such subcontract or delegation shall be subject to prior written approval by Company. With respect to Members of Government Programs, Group and Participating Group Providers Physicians acknowledge that compensation under this Agreement for such Members constitutes receipt of Federal funds. Group and Participating Group Providers Physicians agree that all services and other activities performed by Group and Participating Group Providers Physicians under this Agreement will be consistent and comply with Company’s the obligations of Company and/or Government Sponsor under its contract(s) with the Centers for Medicare and Medicaid Services (“CMS”), and any applicable state regulatory agency, to offer Medicare/Medicaid PlansGovernment Programs. Group and Participating Group Providers Physicians further agree to allow Government Sponsor, CMS, any applicable state regulatory agency, and Company to monitor Group and Participating Group ProvidersPhysicians’ performance under this Agreement on an ongoing basis in accordance with Medicare/Medicaid applicable laws, rules and regulations. Group and Participating Group Providers Physicians acknowledge and agree that Company may only delegate its activities and responsibilities under its the State Contract or any Company contract(s) with Government Sponsor, CMS and any applicable regulatory agency, to offer Medicare/Medicaid Plans Government Programs in a manner consistent with Medicare/Medicaid applicable laws, rules and regulations, and that if any such activity or responsibility is delegated by Company to Group and Participating Group ProvidersPhysicians, the activity or responsibility may be revoked if Government Sponsor, CMS or Company determine that Group and Participating Group Providers Physicians have not performed satisfactorily. If Upon request, Group or Participating Group Provider shall immediately provide to Company designates any information that is required by Company to meet its reporting obligations to CMS, including without limitation, physician incentive plan information, if applicable. To the extent that Group or Participating Group Providers generates and/or compiles and provides any data to Company that Company, in turn, submits to CMS, Group and Participating Group Providers to participate in a Government Program Pursuant to Section 2.10 below. Group and Participating Group Providers may opt out of participation of that Government Program. Group and Participating Group Providers shall have thirty (30) days from receipt of Company’s notice of designationcertify, to notify Company in writing if Group the best of their knowledge and Participating Group Providers elects not to participate in belief, that Government Programsuch data is accurate, complete and truthful.

Government Program Representations. Company has or may shall seek a contract contracts to serve Medicare, Medicaid, CHIP, and/or Tricare beneficiaries (“of Government Programs”). To the extent Company participates in such Government Programs, Group and Participating Group Providers agreeHospital agrees, on behalf of themselves itself and any subcontractors of Group or Participating Group ProvidersHospital acting on behalf of Hospital, to be bound by all rules and regulations of, and all requirements applicable to, such Government Programs. Group and Participating Group Providers Hospital acknowledges and agrees that all provisions of this Agreement shall apply equally to any employees, independent contractors and subcontractors of Group and Participating Group Providers Hospital who provide or may provide Covered Services to Members of Government Programs, and Group and Participating Group Providers Hospital represents and warrants that Group and Participating Group Providers Hospital shall take all steps necessary to cause such employees, independent contractors and subcontractors to comply with this Agreement, the Agreement State Contract, and all applicable laws, rules and regulations and perform all requirements applicable to Government Programs. Any such subcontract or delegation shall be subject to prior written approval by Company. With respect to Members of Government Programs, Group and Participating Group Providers acknowledge Hospital acknowledges that compensation under this Agreement for such Members constitutes receipt of Federal funds. Group and Participating Group Providers agree Hospital agrees that all services and other activities performed by Group and Participating Group Providers Hospital under this Agreement will be consistent and comply with Company’s the obligations of Company and/or Government Sponsor under its contract(s) with the Centers for Medicare and Medicaid Services (“CMS”), and any applicable state regulatory agency, to offer Medicare/Medicaid PlansGovernment Program. Group and Participating Group Providers Hospital further agree agrees to allow Government Sponsor, CMS, any applicable state regulatory agency, and Company to monitor Group and Participating Group Providers’ Hospital’s performance under this Agreement on an ongoing basis in accordance with Medicare/Medicaid laws, rules and regulations. Group Hospital acknowledges and Participating Group Providers acknowledge and agree agrees that Company may only delegate its activities and responsibilities under its the State Contract or any Company contract(s) with Government Sponsor, CMS and any applicable regulatory agency, to offer Medicare/Medicaid Plans Government Program in a manner consistent with Medicare/Medicaid applicable laws, rules and regulations, and that if any such activity or responsibility is delegated by Company to Group and Participating Group ProvidersHospital, the activity or responsibility may be revoked if Government Sponsor, CMS or Company determine that Group and Participating Group Providers have Hospital has not performed satisfactorily. If Upon request, Hospital shall immediately provide to Company designates Group any information that is required by Company to meet its reporting obligations to CMS, including without limitation, physician incentive plan information, if applicable. To the extent that Hospital generates and/or compiles and Participating Group Providers provides any data to participate Company that Company, in a Government Program Pursuant turn, submits to Section 2.10 below. Group and Participating Group Providers may opt out of participation of that Government Program. Group and Participating Group Providers shall have thirty (30) days from receipt of Company’s notice of designationCMS, Hospital certifies, to notify Company in writing if Group the best of its knowledge and Participating Group Providers elects not to participate in belief, that Government Programsuch data is accurate, complete and truthful.