Delegated Function definition
Examples of Delegated Function in a sentence
The Delegation in respect of each Delegated Function has effect from the Effective Date of Delegation.
Each Party acknowledges and agrees that any rights acquired, or liabilities (including liabilities in tort) incurred, in respect of the exercise by the ICB of any Delegated Function are enforceable by or against the ICB only, in accordance with section 65Z5(6) of the NHS Act.
At a Member Company's request, AHERF shall provide the Delegated Function on behalf of a Member Company's other products, including self insured products, at the same consideration.
In the event that such failure is not corrected within fifteen (15) days of the date of AHERF's written plan, the Member Company may notify AHERF that the Member Company shall perform the affected Delegated Function and shall discontinue payment for the same effective a date certain to be chosen by the Member Company.
HealthAmerica or another Member Company shall not be required to delegate a Delegated Function hereunder unless and until AHERF has submitted to HealthAmerica or another Member Company and HealthAmerica or another Member Company has approved a work plan satisfactory to it setting forth in sufficient detail the tasks to be performed by AHERF in performing the Delegated Function.
PBM’s Delegated Function processes will comply with all applicable federal, state, and local laws, rules and regulations, and NCQA/URAC accreditation standards; including without limitation the applicable utilization review requirements in the states where the Covered Individual’s Coverage Document is issued or delivered.
HealthAmerica or another Member Company shall not be required to delegate a Delegated Function hereunder unless and until HealthAmerica has performed a pre-delegation audit and determined, in its sole discretion, that AHERF shall perform such Delegated Function in accordance with the standards set forth in this Section 4.2.1.
A Member Company shall not be required to delegate a Delegated Function hereunder unless and until the Member Company and AHERF mutually agree to the frequency and content of periodic reports to be provided by AHERF to the Member Company in order to assist HealthAmerica in performing its oversight duties hereunder.
The terms of this Clause 12 do not prevent the ICB from making arrangements for assistance and support in the exercise of the Delegated Functions with any person, where such arrangements reserve the consideration and making of any decision in respect of a Delegated Function to the ICB.
In the event that AHERF fails to perform a Delegated Function in accordance with this Agreement, a Member Company shall so notify AHERF, which notice shall set forth in detail the reasons for such failure.