VA will Sample Clauses
The "VA will" clause outlines specific actions or obligations that the Department of Veterans Affairs (VA) is required to perform under an agreement or contract. This may include providing certain services, making payments, or fulfilling administrative duties as stipulated in the document. For example, the VA might be responsible for delivering healthcare services to eligible individuals or ensuring timely reimbursement to contractors. The core function of this clause is to clearly define the VA's responsibilities, ensuring all parties understand what is expected from the VA and reducing the risk of misunderstandings or disputes.
VA will. 1) Maintain those components of the VA Compensation and Pension examination system necessary to ensure objective assessment of disabilities of Service Members identified by Military Health System (MHS) personnel as requiring a Medical Evaluation Board (MEB) as part of the DES.
2) Conduct C&P examinations as requested in the DES for both medical conditions to be considered as the basis of fitness for duty determination, and for those claimed by the Service Member.
3) Bill the MHS via the appropriate Regional TRICARE Managed Care Support Contractors (MCSC), for those services which are related to medical conditions to be considered as the basis of fitness for duty determination.
VA will. 1) Maintain those components of the VA Compensation and Pension examination system necessary to ensure objective assessment of disabilities of Service Members identified by Military Health System (MHS) personnel as requiring a Medical Evaluation Board (MEB) as part of the DES. 2) Conduct C&P examinations as requested in the DES for both medical conditions to be considered as the basis of fitness for duty determination, and for those claimed by the Service Member.
VA will. 1. Provide CMS with electronic file(s) in a format defined by CMS, on a timeframe agreed upon by VA and CMS, no more than quarterly. VA will provide CMS with VA’s electronic files via the CMS Acumen Portal, a secured transmission pathway that has been given an Authority to Operate (ATO) and that is to be used as a means to transition the file to and from CMS. The electronic file(s) will include the data fields identified in Section V.C. of this Agreement.
2. Review the electronic file(s) returned by CMS containing the matched enrollment- related data, perform additional validation, and if deemed appropriate, conduct further investigation or refer the cases to OIG for further investigation. Based on additional validation/investigation if VA determines VA program requirements have been violated, VA intends to take action, or refer to OIG for action, against the VA internal and external providers. Such action may be premised on activities that are found to endanger patients of VA and/or evidence improper or erroneous billing practices that may have also occurred with respect to claims for health care provided to VA beneficiaries. The electronic file returned to VA from CMS will be stored on a secure network drive which has been given an ATO. VA will grant access to a limited number of people who have a need for the data.
3. Perform independent reviews for matched VA external providers returned by CMS, for any match VA determines may warrant action and was not referred to the VA OIG, such as reviewing the following: licensing information to determine if the external provider license is valid in accordance with licensing requirements; List of Excluded Individuals/Entities (LEIE) database to determine if providers and suppliers are excluded; court docket information for felony convictions to determine the appropriateness of continued participation in VA programs; provider billing practices to identify anomalies in VA data; and prescription records/Drug Enforcement Administration (DEA) registration information to identify potential issues related to treating Veterans. Actions VA may take include: terminating or modifying existing contractual agreements with the provider; stopping referral of VA patients to the external providers; or performing pre-payment or post-payment reviews of claims paid or submitted.
4. Perform independent reviews for matched VA internal providers returned by CMS, for any match VA determines may warrant action and was not referred to the V...