Unrestricted Status. Provider warrants and represents that it has not been and is not currently excluded from, and will immediately notify Health Plan in the event it becomes excluded from, participation in Medicare and/or state health care programs pursuant to Section 1128 of the Social Security Act (42 U.S.C. 1320a-7) (“Section 1128”) for any of the following: (i) conviction of a crime; (ii) assessment of a civil penalty; (iii) entered into a contractual relationship with an entity convicted of a crime, and/or (iv) taken any other action that would prohibit it from participation in Medicare and/or state health care programs, all as set forth under Section 1128.
Unrestricted Status. Provider warrants and represents that it has not been convicted of crimes as specified in Section 1128 of the Social Security Act (42 U.S.C. 1320a-7), excluded from participation in the Medicare or Medicaid program, assessed a civil penalty under the provisions of Section 1128, entered into a contractual relationship with an entity convicted of a crime specified in Section 1128, or taken any other action that would prohibit it from participation in Medicaid and/or state health care programs.
Unrestricted Status. Provider represents to its best knowledge, information, and belief, neither it, nor any of its employees, temporary employees, volunteers, consultants, members of its board of directors, officers, or contractors or any persons or entities with an ownership or control interest in Provider as defined and set forth in 42 CFR 455.101 and 455.104 (collectively, “Personnel”) have been excluded from participation in the Medicare Program, any state, commonwealth, or the District of Columbia’s Medicaid Program, or any other federal health care program (collectively “Federal Health Care Program”). Provider agrees that it must check the Department of Health and Human Services Office of Inspector General List of Excluded Individuals and Entities, the System for Award Management, any other list maintained by a state, commonwealth, or federal government, and every state, commonwealth, and the District of Columbia’s Medicaid exclusion lists (including criminal background and registry checks) to determine whether Provider or any of its Personnel have been excluded from participation in any Federal Health Care Program. These databases must be checked for any new Personnel and thereafter not less than monthly. Provider will notify Health Plan immediately in writing if Provider determines that Provider or any of its Personnel are suspended or excluded from any Federal Health Care Program. Provider agrees that it is subject to 2 CFR Part 376 and will require its Personnel to agree that they are subject to 2 CFR Part 376. If a governmental agency imposes a penalty, sanction, or other monetary adjustment or withhold due to Provider’s non-compliance with this provision or any payments were made to Provider while under non-compliance with this provision, Health Plan will issue a letter requesting payment of the amount imposed. If the Provider does not timely pay the amount, Health Plan may collect the amount by offsetting or recouping from any amounts due. If required, such offset or recoupment will be done in a manner that is compliant with Laws and Government Program Requirements. This section will survive any termination.
Unrestricted Status. Provider warrants and represents that it has not been convicted of crimes as specified in Section 1128 of the Social Security Act HSA — Hospital Services Agreement Molina ECMS ref# 729 Provider or authorized MHC v122706 / MHI v091707 representative’s initials: Pacific Hospital of Long Beach (42 U.S.C. 1320a-7), excluded from participation in the Medicare or Medicaid program, assessed a civil penalty under the provisions of Section 1128, entered into a contractual relationship with an entity convicted of a crime specified in Section 1128, or taken any other action that would prohibit it from participation in Medicaid and/or state health care programs.
