Common use of Subcontracting Requirements Clause in Contracts

Subcontracting Requirements. The Contractor remains fully responsible for meeting all of the terms and requirements of the Contract regardless of whether the Contractor subcontracts for performance of any Contract responsibility. No subcontract will operate to relieve the Contractor of its legal responsibilities under the Contract. The Contractor is responsible for the satisfactory performance and adequate oversight of its First Tier, Downstream, and Related Entities. First Tier, Downstream, and Related Entities are required to meet the same federal and State financial and program reporting requirements as the Contractor. The Contractor is required to evaluate any potential contractor prior to delegation, pursuant to 42 C.F.R. § 438.20. Additional information about subcontracting requirements is contained in Appendix D. The Contractor must: Establish contracts and other written agreements between the Contractor and First Tier, Downstream, and Related Entities for Covered Services not delivered directly by the Contractor or its employees; Contract only with qualified or licensed providers who continually meet federal and State requirements, as applicable, and the qualifications contained in Appendix D. Non‑Payment and Reporting of Serious Reportable Events The Contractor shall work collaboratively with EOHHS to develop and implement a process for ensuring non‑payment or recovery of payment for services when “Serious Reportable Events” (SREs) (a/k/a “Never Events”), as defined by this three‑way Contract, occur. The Contractor’s standards for non‑payment or recovery of payment shall be, to the extent feasible, consistent with the minimum standards for non‑payment for such events developed by EOHHS and provided to Contractors via regulation and administrative bulletins. The Contractor shall notify EOHHS and CMS of SREs, in accordance with guidelines issued by the Department of Public Health. The Contractor shall provide EOHHS an annual summary of SREs. Such summary shall include the resolution of each SRE, if any, and any next steps to be taken with respect to each SRE. Non‑Payment and Reporting of Provider Preventable Conditions The Contractor agrees to take such action as is necessary in order for EOHHS to comply with and implement all Federal and State laws, regulations, policy guidance, and MassHealth policies and procedures relating to the identification, reporting, and non‑payment of provider preventable conditions, including 42 U.S.C. 1396b‑1 and regulations promulgated thereunder. As a condition of payment, the Contractor shall develop and implement policies and procedures for the identification, reporting, and non‑payment of Provider Preventable Conditions. Such policies and procedures shall be consistent with federal law, including but not limited to 42 C.F.R. § 434.6(a)(12), 42 C.F.R. § 438.3(g), and 42 C.F.R. § 447.26, and guidance and be consistent with EOHHS policies, procedures, and guidance on Provider Preventable Conditions. The Contractor’s policies and procedures shall also be consistent with the following: The Contractor shall not pay a provider for a Provider Preventable Condition. The Contractor shall require, as a condition of payment from the Contractor, that all providers comply with reporting requirements on Provider Preventable Conditions as described at 42 C.F.R. § 447.26(d) and as may be specified by the Contractor and/or EOHHS. The Contractor shall not impose any reduction in payment for a Provider‑Preventable Condition when the condition defined as a Provider‑Preventable Condition for a particular Enrollee existed prior to the provider’s initiation of treatment for that Enrollee. A Contractor may limit reductions in provider payments to the extent that the following apply: The identified Provider‑Preventable Condition would otherwise result in an increase in payment. The Contractor can reasonably isolate for nonpayment the portion of the payment directly related to treatment for, and related to, the Provider‑Preventable Condition. The Contractor shall ensure that its non‑payment for Provider‑Preventable Conditions does not prevent Enrollee access to services.

Subcontracting Requirements. The Contractor remains fully responsible for meeting all of the terms and requirements of the Contract regardless of whether the Contractor subcontracts for performance of any Contract responsibility. No subcontract will operate to relieve the Contractor of its legal responsibilities under the Contract. The Contractor is responsible for the satisfactory performance and adequate oversight of its First Tier, Downstream, and Related Entities. First Tier, Downstream, and Related Entities are required to meet the same federal and State financial and program reporting requirements as the Contractor. The Contractor is required to evaluate any potential contractor prior to delegation, pursuant to 42 C.F.R. § 438.20. Additional information about subcontracting requirements is contained in Appendix D. The Contractor must: Establish contracts and other written agreements between the Contractor and First Tier, Downstream, and Related Entities for Covered Services not delivered directly by the Contractor or its employees; Contract only with qualified or licensed providers who continually meet federal and State requirements, as applicable, and the qualifications contained in Appendix D. Non‑Payment Non-Payment and Reporting of Serious Reportable Events The Contractor shall work collaboratively with EOHHS to develop and implement a process for ensuring non‑payment non-payment or recovery of payment for services when “Serious Reportable Events” " (SREs) (a/k/a “Never Events”"), as defined by this three‑way three-way Contract, occur. The Contractor’s Contractor‘s standards for non‑payment non-payment or recovery of payment shall be, to the extent feasible, consistent with the minimum standards for non‑payment non-payment for such events developed by EOHHS and provided to Contractors via regulation and administrative bulletins. The Contractor shall notify EOHHS and CMS of SREs, in accordance with guidelines issued by the Department of Public Health. The Contractor shall provide EOHHS an annual summary of SREs. Such summary shall include the resolution of each SRE, if any, and any next steps to be taken with respect to each SRE. Non‑Payment Non-Payment and Reporting of Provider Preventable Conditions The Contractor agrees to take such action as is necessary in order for EOHHS to comply with and implement all Federal and State laws, regulations, policy guidance, and MassHealth policies and procedures relating to the identification, reporting, and non‑payment non-payment of provider preventable conditions, including 42 U.S.C. 1396b‑1 1396b-1 and regulations promulgated thereunder. As a condition of payment, the Contractor shall develop and implement policies and procedures for the identification, reporting, and non‑payment non-payment of Provider Preventable Conditions. Such policies and procedures shall be consistent with federal law, including but not limited to 42 C.F.R. § 434.6(a)(12), 42 C.F.R. § 438.3(g), and 42 C.F.R. § 447.26, and guidance and be consistent with EOHHS policies, procedures, and guidance on Provider Preventable Conditions. The Contractor’s Contractor‘s policies and procedures shall also be consistent with the following: The Contractor shall not pay a provider for a Provider Preventable Condition. The Contractor shall require, as a condition of payment from the Contractor, that all providers comply with reporting requirements on Provider Preventable Conditions as described at 42 C.F.R. § 447.26(d) and as may be specified by the Contractor and/or EOHHS. The Contractor shall not impose any reduction in payment for a Provider‑Preventable Provider-Preventable Condition when the condition defined as a Provider‑Preventable Provider-Preventable Condition for a particular Enrollee existed prior to the provider’s provider‘s initiation of treatment for that Enrollee. A Contractor may limit reductions in provider payments to the extent that the following apply: The identified Provider‑Preventable Provider-Preventable Condition would otherwise result in an increase in payment. The Contractor can reasonably isolate for nonpayment the portion of the payment directly related to treatment for, and related to, the Provider‑Preventable Provider-Preventable Condition. The Contractor shall ensure that its non‑payment non-payment for Provider‑Preventable Provider-Preventable Conditions does not prevent Enrollee access to services.

Subcontracting Requirements. The Contractor remains fully responsible for meeting all of the terms and requirements of the Contract regardless of whether the Contractor subcontracts for performance of any Contract responsibility. No subcontract will operate to relieve the Contractor of its legal responsibilities under the Contract. The Contractor is responsible for the satisfactory performance and adequate oversight of its First Tier, Downstream, and Related Entities. First Tier, Downstream, and Related Entities are required to meet the same federal and State financial and program reporting requirements as the Contractor. The Contractor is required to evaluate any potential contractor prior to delegation, pursuant to 42 C.F.R. § 438.20. Additional information about subcontracting requirements is contained in Appendix D. The Contractor must: Establish contracts and other written agreements between the Contractor and First Tier, Downstream, and Related Entities for Covered Services not delivered directly by the Contractor or its employees; Contract only with qualified or licensed providers who continually meet federal and State requirements, as applicable, and the qualifications contained in Appendix D. Non‑Payment Non-Payment and Reporting of Serious Reportable Events The Contractor shall work collaboratively with EOHHS to develop and implement a process for ensuring non‑payment non-payment or recovery of payment for services when “Serious Reportable Events” (SREs) (a/k/a “Never Events”), as defined by this three‑way three-way Contract, occur. The Contractor’s standards for non‑payment non-payment or recovery of payment shall be, to the extent feasible, consistent with the minimum standards for non‑payment non-payment for such events developed by EOHHS and provided to Contractors via regulation and administrative bulletins. The Contractor shall notify EOHHS and CMS of SREs, in accordance with guidelines issued by the Department of Public Health. The Contractor shall provide EOHHS an annual summary of SREs. Such summary shall include the resolution of each SRE, if any, and any next steps to be taken with respect to each SRE. Non‑Payment Non-Payment and Reporting of Provider Preventable Conditions The Contractor agrees to take such action as is necessary in order for EOHHS to comply with and implement all Federal and State laws, regulations, policy guidance, and MassHealth policies and procedures relating to the identification, reporting, and non‑payment non-payment of provider preventable conditions, including 42 U.S.C. 1396b‑1 1396b-1 and regulations promulgated thereunder. As a condition of payment, the Contractor shall develop and implement policies and procedures for the identification, reporting, and non‑payment non-payment of Provider Preventable Conditions. Such policies and procedures shall be consistent with federal law, including but not limited to 42 C.F.R. § 434.6(a)(12), 42 C.F.R. § 438.3(g), and 42 C.F.R. § 447.26, and guidance and be consistent with EOHHS policies, procedures, and guidance on Provider Preventable Conditions. The Contractor’s policies and procedures shall also be consistent with the following: The Contractor shall not pay a provider for a Provider Preventable Condition. The Contractor shall require, as a condition of payment from the Contractor, that all providers comply with reporting requirements on Provider Preventable Conditions as described at 42 C.F.R. § 447.26(d) and as may be specified by the Contractor and/or EOHHS. The Contractor shall not impose any reduction in payment for a Provider‑Preventable Provider-Preventable Condition when the condition defined as a Provider‑Preventable Provider-Preventable Condition for a particular Enrollee existed prior to the provider’s initiation of treatment for that Enrollee. A Contractor may limit reductions in provider payments to the extent that the following apply: The identified Provider‑Preventable Provider-Preventable Condition would otherwise result in an increase in payment. The Contractor can reasonably isolate for nonpayment the portion of the payment directly related to treatment for, and related to, the Provider‑Preventable Provider-Preventable Condition. The Contractor shall ensure that its non‑payment non-payment for Provider‑Preventable Provider-Preventable Conditions does not prevent Enrollee access to services.