Program Establishment and Eligibility Clause Samples

The Program Establishment and Eligibility clause defines the criteria and procedures for creating a program and determining who is eligible to participate. It typically outlines the requirements that individuals or entities must meet to qualify, such as age, residency, or other specific qualifications, and may describe the process for applying or enrolling in the program. This clause ensures that participation is limited to those who meet predetermined standards, thereby maintaining the integrity and intended scope of the program.
Program Establishment and Eligibility. FSSA has established a pay for outcomes program under which Contractor may receive additional compensation if certain conditions are met. The state encourages plans to share earned incentive payments with members and providers. The compensation under the pay for outcomes program is subject to Contractor’s complete and timely satisfaction of its obligations under the Contract. This includes but is not limited to timely submission of the Contractor’s HEDIS Report for the measurement year and the Certified HEDIS Compliance Auditor’s attestation, as well as timely submission of the Priority Reports listed in Section A.5 of this Exhibit. In furtherance of the foregoing and not by limitation, the Contractor may, in FSSA’s discretion, lose eligibility for its compensation under the pay for outcomes program if: a. FSSA has suspended, in whole or in part, capitation payments or enrollment to the Contractor; b. FSSA has assigned, in whole or in part, the membership and responsibilities of Contractor to another participating managed care plan contractor; c. FSSA has assumed or appointed temporary management with respect to the Contractor; d. The Contract has been terminated; e. The Contractor has, in the determination of the Director of the Office of Medicaid Policy and Planning, failed to execute a smooth transition at the end of the Contract term, including failure to comply with the MCE responsibilities set forth in the Scope of Work; or f. Pursuant to the Contract, including without limitation this Exhibit, FSSA has required a corrective action plan or assessed liquidated damages against Contractor in relation to its performance under the Contract during the measurement year. FSSA may, at its option, reinstate Contractor’s eligibility for participation in the pay for outcomes program once Contractor has properly cured all prior instances of non-compliance of its obligations under the Contract, and FSSA has satisfactory assurances of acceptable future performance.
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Program Establishment and Eligibility. FSSA has established a pay for outcomes program under which Contractor may receive additional compensation if certain conditions are met. The state encourages plans to share earned incentive payments with members and providers. The compensation under the pay for outcomes program is subject to Contractor’s complete and timely satisfaction of its obligations under the Contract. This includes but is not limited to timely submission of the Contractor’s CAHPS and HEDIS Reports for the measurement year and the Certified HEDIS Compliance Auditor’s attestation, as well as timely submission of the Priority Reports listed in Section A.5 of this Exhibit. In furtherance of the foregoing and not by limitation, the Contractor may, in FSSA’s discretion, lose eligibility for its compensation under the pay for outcomes program if:
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Program Establishment and Eligibility. The Office has established a pay for performance program under which Contractor may receive additional compensation if certain conditions are met. Participation in the pay for performance program by Contractor is subject to Contractor's complete and timely satisfaction of its obligations under the Contract, including but not limited to all data reporting obligations. In furtherance of the foregoing and not by limitation, in the event Contractor has been subject to any of the following corrective actions (administered pursuant to the Contract) as a result of its failure to perform or non-compliance under the Contract, Contractor shall lose eligibility for participation in the program: a. The Office has suspended, in whole or in part, capitation payments or enrollment to the Contractor; b. The Office has assigned, in whole or in part, the membership and responsibilities of Contractor to another participating managed care plan contractor; c. The Office has assumed or appointed temporary management with respect to the Contractor; d. The Contract has been terminated; or e. Pursuant to the Contract including without limitation this Attachment, the Office has assessed liquidated damages against Contractor, in relation to its performance under the Contract more than four times during the measurement year. The Office may, at its option, reinstate Contractor's eligibility for participation in the pay for performance program once Contractor has properly cured all prior instances of non-compliance of its obligations under the Contract, and the Office has satisfactory assurances of acceptable future performance.
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Program Establishment and Eligibility. FSSA has established a pay for outcomes program under which Contractor may receive additional compensation if certain conditions are met. The state encourages plans to share earned incentive payments with members and providers. The compensation under the pay for outcomes program is subject to Contractor’s complete and timely satisfaction of its obligations under the Contract. This includes but is not limited to timely submission of the Contractor’s HEDIS Report for the measurement year and the Certified HEDIS Compliance Auditor’s attestation, as well as timely submission of the Priority Reports listed in Section A.5 of this Exhibit. In furtherance of the foregoing and not by limitation, the Contractor may, in FSSA’s discretion, lose eligibility for its compensation under the pay for outcomes program if:
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Related to Program Establishment and Eligibility

  • Program Eligibility The COUNTY shall provide eligibility determination for those persons applying for home repair under this Agreement by using the following factors: 1. The applicant is a resident of the CITY; and 2. The total income for all members of the applicant’s household does not exceed 80% of the median income of the Kansas City metropolitan area, as determined by the Secretary of Housing and Urban Development; and 3. The applicant is the homeowner and must have occupied the property as a primary residence for at least six (6) months; 4. The property to be repaired is within the corporate limits of the CITY; and 5. When required, medical need will be substantiated and documented.

  • General Eligibility i. Except as provided in paragraph 2 (a)(ii) below, a teacher who received an evaluation rating of needs improvement or ineffective in the prior school year is not eligible for any salary increase and remains at their prior year salary. ii. A teacher who is in the first two full school years of instructing students who receives an evaluation rating of improvement necessary is eligible for salary increase.

  • Special Eligibility The following employees also receive an Employer Contribution:

  • Funding Eligibility Contractor understands, acknowledges, and agrees that, pursuant to Chapter 2272 (eff. Sept. 1, 2021, Ch. 2273) of the Texas Government Code, except as exempted under that Chapter, HHSC cannot contract with an abortion provider or an affiliate of an abortion provider. Contractor certifies that it is not ineligible to contract with HHSC under the terms of Chapter 2272 (eff. Sept. 1, 2021, Ch. 2273) of the Texas Government Code.

  • Establishment of Service 6.1 After receiving certification as a local exchange company from the appropriate regulatory agency, <<customer_name>> will provide the appropriate BellSouth service center the necessary documentation to enable BellSouth to establish a master account for <<customer_name>>’s resold services. Such documentation shall include the Application for Master Account, proof of authority to provide telecommunications services, an Operating Company Number ("OCN") assigned by the National Exchange Carriers Association ("NECA") and a tax exemption certificate, if applicable. When necessary deposit requirements are met, as described in Section 6.6 below, BellSouth will begin taking orders for the resale of service. 6.2 Service orders will be in a standard format designated by BellSouth. 6.3 <<customer_name>> shall provide to BellSouth a blanket letter of authorization ("LOA") certifying that <<customer_name>> will have End User authorization prior to viewing the End User's customer service record or switching the End User's service. BellSouth will not require End User confirmation prior to establishing service for <<customer_name>>’s End User customer. <<customer_name>> must, however, be able to demonstrate End User authorization upon request. 6.4 BellSouth will accept a request directly from the End User for conversion of the End User's service from <<customer_name>> to BellSouth or will accept a request from another CLEC for conversion of the End User's service from <<customer_name>> to such other CLEC. Upon completion of the conversion BellSouth will notify <<customer_name>> that such conversion has been completed. 6.5 If BellSouth is informed that an unauthorized change in local service to <<customer_name>> has occurred, BellSouth will reestablish service with the appropriate local service provider and will assess <<customer_name>> as the CLEC initiating the alleged unauthorized change, the unauthorized change charge described in FCC Tariff No. 1, Section 13 or applicable state tariff. Appropriate nonrecurring charges, as set forth in Section A4 of the General Subscriber Service Tariff, will also be assessed to <<customer_name>>. In accordance with FCC Slamming Liability Rules, the relevant governmental agency will determine if an unauthorized change has occurred. Resolution of all relevant issues shall be handled directly with the authorized CLEC and <<customer_name>>. 6.6 BellSouth reserves the right to secure the account with a suitable form of security deposit, unless satisfactory credit has already been established. 6.6.1 Such security deposit shall take the form of cash for cash equivalent, an irrevocable Letter of Credit or other forms of security acceptable to BellSouth. Any such security deposit may be held during the continuance of the service as security for the payment of any and all amounts accruing for the service. 6.6.2 If a security deposit is required, such security deposit shall be made prior to the inauguration of service. 6.6.3 Such security deposit shall be two months' estimated billing. 6.6.4 The fact that a security deposit has been made in no way relieves <<customer_name>> from complying with BellSouth's regulations as to advance payments and the prompt payment of bills on presentation nor does it constitute a waiver or modification of the regular practices of BellSouth providing for the discontinuance of service for non-payment of any sums due BellSouth. 6.6.5 BellSouth reserves the right to increase the security deposit requirements when, in its reasonable judgment, changes in <<customer_name>>'s financial status so warrant and/or gross monthly billing has increased beyond the level initially used to determine the security deposit. 6.6.6 In the event service to <<customer_name>> is terminated due to <<customer_name>>'s default on its account, any security deposits held will be applied to <<customer_name>>'s account. 6.6.7 Interest on a cash or cash equivalent security deposit shall accrue and be paid in accordance with the terms in the appropriate BellSouth tariff.