Recoupment Rights. The following provision supplements the "Recoupments" section of the Agreement:
Recoupment Rights. PacifiCare shall have the right, but not the obligation, to pay claims which Medical Group fails to pay for Covered Services provided to PacifiCare Members if Medical Group fails to pay such claims following ten (10) days written notice from PacifiCare. Except as may otherwise be specifically provided in this Agreement, PacifiCare shall have the right to immediately recoup any and all amounts owed by Medical Group to PacifiCare against amounts, including Capitation Payments, owed by PacifiCare to Medical Group. This right shall include, without limitation, PacifiCare’s right to recoup the following amounts owed to PacifiCare by Medical Group: (i) amounts owed by Medical Group due to overpayments or payments made in error by PacifiCare; (ii) amounts owed by Medical Group as a result of claims for Medical Group Services that PacifiCare may pay on behalf of Medical Group; (iii) amounts owed by Medical Group for Covered Services provided outside the Medical Group Service Area; (iv) amounts owed by Medical Group as a result of the outcome of the Member appeals and grievance procedure; (v) amounts owed by Medical Group in connection with any other prior or existing agreement between Medical Group and PacifiCare or any PacifiCare Affiliate and (vi) amounts owed by Medical Group pursuant to Section 5.4.2 (Incentive Program Settlements) above. As a material condition to PacifiCare’s obligations under this Agreement, Medical Group agrees that all recoupment and any offset rights pursuant to this Agreement shall be deemed to be and to constitute rights of recoupment authorized in State or Federal law or in equity to the maximum extent possible under law or in equity and that such rights shall not be subject to any requirement of prior or other approval from any court or other government authority that may now or hereafter have jurisdiction over Medical Group.
Recoupment Rights. Nothing in this Agreement shall limit the Company’s right of recoupment of Options or any shares of Common Stock purchased by exercise of the Option, under the Plan or this Agreement as in effect on the Grant Date or any later date, including recoupment of payments pursuant to the Company’s compensation recovery, “clawback” or similar policy, as may be in effect from time to time, including any policy implemented after the Grant Date.
Recoupment Rights. Payor or MCNA shall have the right to immediately recoup any and all amounts owed by Provider to Payor, MCNA or any Affiliate against amounts owed by Payor, MCNA or Affiliate to Provider. Provider agrees that all recoupment and any offset rights under this Agreement shall constitute rights of recoupment authorized under State or federal law and that such rights shall not be subject to any requirement of prior or other approval from any court or other government authority that may now have or hereafter have jurisdiction over Provider.
Recoupment Rights. Subcontractor is required to reimburse Cenpatico for the following immediately upon demand: (i) the amount of any overpayment or erroneous payment made by Cenpatico to Subcontractor; (ii) any amounts that Cenpatico pays a third-party to provide Covered Services that Subcontractor is obligated to provide under the Agreement; (iii) amounts owed by Subcontractor in relation to under-delivery of services or failure to provide encounter value equal to payment; (iv) any amounts paid to Subcontractor for Covered Services delivered on dates on which Subcontractor did not have the credentials, license, certification, or accreditation required to be an AHCCCS registered provider; (v) amounts deemed by Cenpatico, ADHS, or the Arizona Auditor General not to have been disbursed in accordance with the terms of the applicable ADHS/DBHS – Cenpatico Contract (see Exhibit A); and (vi) any recoupment imposed by ADHS, AHCCCS, or the federal government for which Subcontractor is the responsible party.
Recoupment Rights. (h) The Publishing Names; and
Recoupment Rights. PacifiCare shall provide Medical Group with prior written notice of any proposed offset (i.e., recoupment) from PacifiCare’s payments to Medical Group, which notice shall contain supporting relevant documentation for such proposed offset (“Notice of Proposed Offset”). Medical Group shall review the proposed offset and advise PacifiCare in writing within thirty (30) days of Medical Group’s receipt of the Notice of Proposed Offset if Medical Group objects to the proposed offset, which objection must be reasonable and supported, as appropriate, by all relevant documentation. If (a) PacifiCare does not receive Medical Group’s approval to the proposed offset or if Medical Group objects to the proposed offset, and (b) PacifiCare continues to take the position that it is entitled to the offset, either party may submit such dispute for resolution pursuant to the Dispute Resolution Procedures set forth in Section 7.5 (Dispute Resolution Procedures) of this Agreement and, as set forth at Section 7.5.1, the Medical Group shall have the right to begin any Dispute Resolution Procedure with the Confidential Independent Review set forth at Section 7.5.2, regardless of whether Medical Group or PacifiCare initiates the Dispute Resolution Procedures. While any PacifiCare Provider Dispute Resolution Procedure pursuant to Section 7.5.1 or Confidential Independent Review pursuant to Section 7.5.2 of this Agreement is pending, PacifiCare shall not deduct the amounts to be offset from Medical Group’s Capitation Payments. As a material condition to PacifiCare’s obligations under this Agreement, Medical Group agrees that all recoupment and any offset rights pursuant to this Agreement shall be deemed to be and to constitute rights of recoupment authorized in State or Federal law or in equity to the maximum extent possible under law or in equity.
Recoupment Rights. Payor shall have the right to immediately recoup any and all amounts owed by Provider to Payor or any Affiliate against amounts owed by Payor or Affiliate to Provider. Provider agrees that all recoupment and any offset rights under this Agreement shall constitute rights of recoupment authorized under State or federal law and that such rights shall not be subject to any requirement of prior or other approval from any court or other government authority that may now have or hereafter have jurisdiction over Provider.
Recoupment Rights. PacifiCare shall have the right, but not the obligation, to pay claims which Medical Group fails to pay for Covered Services provided to PacifiCare Members if Medical Group fails to pay such claims following ten (10) days written notice from
Recoupment Rights. Except as may otherwise be specifically provided in this Agreement, PacifiCare shall have the right to immediately recoup any and all amounts owed by Medical Group to PacifiCare against amounts, including Capitation Payments, owed by PacifiCare to Medical Group. This right shall include, without limitation, PacifiCare’s right to recoup the following amounts owed to PacifiCare by Medical Group: (i) amounts owed by Medical Group due to overpayments or payments made in error by PacifiCare; (ii) amounts owed by Medical Group as a result of claims for Medical Group Services that PacifiCare may pay on behalf of Medical Group; (iii) amounts owed by Medical Group for Covered Services provided outside the Medical Group Service Area; (iv) amounts owed by Medical Group as a result of the outcome of the Member appeals and grievance procedure; (v) amounts owed by Medical Group in connection with any other prior, existing or future agreement between Medical Group and PacifiCare or any PacifiCare Affiliate. As a material condition to PacifiCare’s obligations under this Agreement, Medical Group agrees that all recoupment and any offset rights pursuant to this Agreement shall be deemed to be and to constitute rights of recoupment authorized in State or federal law or in equity to the maximum extent possible under law or in equity and that such rights shall not be subject to any requirement of prior or other approval from any court or other governmental authority that may now or hereafter have jurisdiction over Medical Group.
