Medicare Certification. In addition to the eligibility requirements outlined above, in order to receive payment under Medicaid, hospitals must meet the requirements for participation as a hospital in Medicare (except in the case of medical supervision of nurse-midwife services). Therefore, for purposes of DSH, the facility must be Medicare-certified during the state plan rate year for which the initial DSH payment is made. If a facility is Medicare-certified for the full state plan rate year for which the initial DSH payment is made, but subsequently loses that certification, the facility remains eligible to receive the payment (together with any payment adjustments). If a hospital is only Medicare-certified for part of the state plan rate year for which the initial DSH payment is made, the eligibility and the payment will be calculated based on the period for which the hospital was Medicare- certified. Data on a State Plan Year Basis DSH payments are made based on the State Plan Year. The State Plan Year (or State Plan Rate Year or SPY) is equivalent to the Federal Fiscal Year and runs from October 1 to September 30 of each year. The calculations to determine eligibility for, and the amount of, DSH payments, will be made on the basis of the State Plan Year. This requirement will impact the information collected and submitted by all hospitals that do not have a fiscal year and/or CMS 2552 Report year that runs from 10/1 to 9/30. In order to make the necessary calculations to determine eligibility and payments on a State Plan Year basis, hospitals that do not have a fiscal/CMS Report year that runs from 10/1 to 9/30 will have to submit cost reports and other data elements for each of the fiscal/CMS Report years that encompass the State Plan Year. For example, for SPY 2008 (10/1/07 to 9/30/08), for a hospital that has a CMS 2552 Report year that runs from 7/1 to 6/30, the hospital will have to submit the CMS 2552 Report and other data elements for the fiscal/CMS Report year that ends on 6/30/08 and the same information for the fiscal/CMS Report year that ends 6/30/09.1 As discussed later in this Attachment, AHCCCS will extract all Title XIX (Medicaid) claims and encounters from the PMMIS system on the basis of each hospital’s CMS 2552 Report year and these data will serve as the basis for all Medicaid days, charges and payments. Similarly, AHCCCS will collect all Medicaid and Non-Title XIX payments (for the Comprehensive Medical and Dental Program, behavioral health services and pa...
Medicare Certification certification by CMS or a state agency or entity under contract with CMS that the health care operation is in compliance with all the conditions of participation set forth in the Medicare Regulations.
Medicare Certification. Provider must be certified by Medicare as an Ambulatory Surgery Center, or determined by Medicare to be an extension or part of a Medicare certified hospital.
Medicare Certification. The Facility is certified under the conditions of coverage and participates in the federal Medicare program as an ESRD facility providing ESRD services indicated on the Patient List. Seller has delivered to Buyer complete and correct copies of all surveys, reports or deficiency notices concerning the Facility by the Medicare program, the state survey agency, the Medicaid program or the Alabama Kidney Disease Program. The Medicare certification of the Facility is in full force and effect and, to the best of Seller's knowledge, no violation of the conditions and standards of coverage, participation or certification exists and, to the best of Seller's knowledge, no event or circumstances exist which, with the giving of notice or passage of time, or both, would constitute a violation thereof.
Medicare Certification. Plaintiffs represent and warrant that they are not Medicare recipients and/or Medicare eligible, have never been on Medicare or Social Security Disability Insurance (“SSDI”), that no conditional payments have been made on their behalf by Medicare, and further that they do not expect to be Medicare eligible and/or a recipient within the next thirty (30) months following the date of this Settlement Agreement. Plaintiffs agree to each deliver a fully executed and notarized Affidavit of Medicare Eligibility Status in the form annexed hereto as Exhibit B (“Medicare Affidavit”) to the Office of the Attorney General. Plaintiffs acknowledge and understand that receipt of this document by the Office of the Attorney General is a prerequisite to payment of the settlement amounts referenced in Paragraph 3, and that this document falls within the category of “other documentation” and “required documentation” described in Paragraphs 4 and 5 of this Settlement Agreement.
Medicare Certification. Each of the Properties is certified for participation in the Medicare program, and is a party to a current and valid Medicare provider agreement. Neither Seller nor MI have received notice of and, to the Seller's and MI's knowledge, there is no pending, threatened or possible investigation by, or loss of participation in, the Medicare program with respect to either of the Properties.
Medicare Certification. Employee warrants that Employee is not a Medicare beneficiary as of the date of this release, and no conditional payments have been made to Employee by Medicare.
Medicare Certification. The Centers are certified under the conditions of coverage and participation in the federal Medicare program as an end stage renal disease facility. For all dates on or after January 1, 2004 and prior to the Effective Date, Sellers have provided (and, for the period after the Effective Date and prior to the Closing Date, the Sellers will, prior to the Closing Date, provide) the copies of all surveys, reports or deficiency notices concerning the Centers by the Medicare program, any state survey agency, and the applicable state Medicaid programs prior to the Closing Date. Except as set forth in Schedule 4.14 attached hereto, and except as has not had, or would not reasonably be expected to have a, Material Adverse Effect, the Medicare certification of each of the Centers is in full force and effect, the applicable Seller is under no suspension or plan of correction, no violation of the Medicare conditions of participation exists and no event or circumstances exists that with the giving of notice or passage of time would constitute a violation.
Medicare Certification. All directors, officers or employees of the Contractor must be eligible for participation in any government health care program, including but not limited to, Medicare, Medicaid, CHAMPUS, or Tricare. The Contractor must provide any certification or licensure necessary to meet this requirement prior to contract execution.
