Excluded Provider definition

Excluded Provider means an individual or entity who or that is excluded from participating in any state or federal health care program pursuant to 42 U.S.C. § 1320a-7.
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Excluded Provider means a provider of services falling within paragraphs 2(k)(i) to (iii), (l) or (o) of Schedule 1 (limited network, electronic communications and cash withdrawal exclusions);
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Excluded Provider means each entity entering into this Agreement and each entity's parent, principals, shareholders, directors, and officers (including subcontractors and employees).
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Examples of Excluded Provider in a sentence

  • The Lead Inspector, who conducted the final clearance inspection, shall complete a Conditional Lead-Safe Certificate (Form PBLC- 15) or Full Lead-Safe Certificate (Form PBLC-21), as applicable, when the child care center, single-family house, or dwelling unit and common areas, as applicable, meet the lead-safe standards in § 5.8 of 216-RICR-50-15-5.

  • If the Contractor employs or contracts with an Excluded Provider, the Contractor is prohibited from paying for any Claims for Covered Services to Enrollees which were furnished, ordered, or prescribed by Excluded Providers except as allowed by 42 CFR 1001.1901(c).

  • In the event that the Parties are unable to resolve any such Customer concerns of the applicable party’s designation as an Excluded Provider, then Customer may terminate this order by express written notice for products and services not yet shipped or rendered prior to a date of exclusion.

  • For Excluded Providers, in accordance with Article 6.4.2 (I), the Contractor shall notify the Department of the Exclusion by electronically submitting the information on the Department’s Disclosure of Excluded Provider Form.

  • Practitioner/Provider Services Services provided by an Excluded Provider are not Covered.

  • As of the date of the sale of this product, Philips represents and warrants that Philips, its employees and subcontractors, are not debarred, excluded, suspended or otherwise ineligible to participate in a federal or state health care program, nor have they been convicted of any health care related crime for the products and services provided under these Terms and Conditions of Sale (Excluded Provider).

  • At the time of securing a new employee or service provider, Contractor shall conduct or cause to be conducted a screening and provide documentation to County certifying that its new employee or service provider is not listed on the Excluded Provider List of the Office of the Inspector General or the Medi-Cal List of Excluded Providers.

  • Within 30 calendar days of either identifying an Excluded Provider or receiving Exclusion information from a Provider, the Contractor shall notify the Department of the Exclusion by electronically submitting the information on the Department’s Disclosure of Excluded Provider Form.

  • In the event that the Parties are unable to resolve any such Customer concerns of the applicable party’s designation as an Excluded Provider, then Customer may terminate this Agreement by express written notice for Services not yet rendered prior to the date of exclusion.

  • For Excluded Providers, in accordance with Article 6.4.2(I), the Contractor shall notify the Department of the Exclusion by electronically submitting the information on the Department’s Disclosure of Excluded Provider Form.


More Definitions of Excluded Provider

Excluded Provider means a legal entity with is debarred, excluded, suspended or otherwise ineligible to participate in a U.S. federal health care program, or convicted of any U.S. health care related crime.
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Excluded Provider means a legal entity which is debarred, excluded, suspended, or otherwise ineligible to participate in a U.S. federal healthcare program, or convicted of any U.S. health care related crime. Each Party will promptly notify the other Party in writing if it becomes aware that any of its employees or subcontractors has become an Excluded Provider, and thereupon either Party may terminate this Agreement upon written notice citing the fact that the other Party or its subcontractors or employees has become an Excluded Provider.
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Excluded Provider means a person or entity that either (i) has been convicted of a crime related to health care, or (ii) is currently listed by a federal agency as debarred, excluded or otherwise ineligible for participation in federally funded programs (including federally-funded health care programs such as Medicare and Medicaid). Monogram shall notify Pfizer within five (5) days after Monogram receives notice that it is an Excluded Provider.
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Excluded Provider means a provider of services falling within paragraphs 2(k)(i) to (iii),
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Excluded Provider means a Provider that was Excluded from a Zenith Network based upon either a Qualitative Consideration, Objective Consideration or Partnership Consideration.
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Excluded Provider means a person or entity that is currently excluded, debarred or otherwise ineligible for participation in a federal health care program, such as Medicare and Medicaid, pursuant to Sections 1128 and/or 1156 of the Social Security Act.
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Related to Excluded Provider

  • Affiliated provider means a health professional, licensed hospital, licensed pharmacy, or any other institution, organization, or person that has entered into a participating provider contract, directly or indirectly, with a health maintenance organization to render 1 or more health services to an enrollee. Affiliated provider includes a person described in this subdivision that has entered into a written arrangement with another person, including, but not limited to, a physician hospital organization or physician organization, that contracts directly with a health maintenance organization.

  • Designated provider means a person who:

  • Qualified provider means a person or business experienced in the design, implementation, and installation of energy conservation measures. A qualified provider to whom the contract is awarded shall give a sufficient bond to the school district for its faithful performance.

  • Approved provider means a provider of services registered with the appropriate association or organization to render services to a member and approved by Latrobe to render services to its members.

  • Preferred Provider or “Network Provider” means a doctor, hospital, medical facility or other provider of health care which is included in a network which has been designated by the Fund to render health related services to Fund participants.

  • Excluded Person means each Defendant, the directors and officers of each Defendant, the subsidiaries or affiliates of each Defendant, the entities in which each Defendant or any of that Defendant’s subsidiaries or affiliates have a controlling interest and the legal representatives, heirs, successors and assigns of each of the foregoing.

  • Related provider trust means a titling trust or other trust established by a licensed viatical settlement provider or a financing entity for the sole purpose of holding the ownership or beneficial interest in purchased policies in connection with a financing transaction. The trust shall have a written agreement with the licensed viatical settlement provider under which the licensed viatical settlement provider is responsible for ensuring compliance with all statutory and regulatory requirements and under which the trust agrees to make all records and files related to viatical settlement transactions available to the commissioner as if those records and files were maintained directly by the licensed viatical settlement provider.

  • Registered Provider means a registered provider of social housing (see section 80 of the Housing and Regeneration Act 2008);

  • Excluded Party has the meaning set forth in Section 7.4(b).

  • Excluded Affiliate means any Affiliate of any Agent that is engaged as a principal primarily in private equity, mezzanine financing or venture capital.

  • Excluded Persons means (A) the Company or any Regency Entity; (B) a trustee or other fiduciary holding securities under an employee benefit plan of the Company or any Regency Entity; (C) an underwriter temporarily holding securities pursuant to an offering of such securities; or (D) a corporation owned, directly or indirectly, by the shareholders of the Company in substantially the same proportions as their ownership of stock in the Company.

  • Preferred Provider Organization or "PPO" means an entity through which a group of health care providers, such as doctors, hospitals and others, agree to provide specific medical and hospital care and some related services at a negotiated price.

  • Excluded Products means the items described on the applicable restricted products per country, any other applicable Program Policy, or any other information made available to you by LINIO.

  • Excluded Asset means any asset of any Grantor excluded from the security interest hereunder by virtue of Section 2.2 hereof but only to the extent, and for so long as, so excluded thereunder.

  • Acquired Person means, with respect to any specified Person, any other Person which merges with or into or becomes a Subsidiary of such specified Person.

  • Excluded Property shall have the meaning set forth in the Security Agreement.

  • incorporated provision has the meaning specified in Section 107.

  • New Provider means any replacement service provider or providers engaged to provide the Services (or part thereof) or substantially similar services or the Authority itself where the Services or substantially similar services or part thereof continue to be provided by the Authority after partial termination, termination or expiry of this Contract;

  • Third-party logistics provider means a person that provides or coordinates warehousing of or other logistics services for a drug or device in interstate commerce on behalf of a manufacturer, wholesale distributor, or dispenser of the drug or device but does not take ownership of the product or have responsibility for directing the sale or disposition of the product.

  • Derivative Provider Trigger Event means (i) an Event of Default with respect to which Party A is a Defaulting Party, (ii) a Termination Event with respect to which Party A is the sole Affected Party or (iii) an Additional Termination Event with respect to which Party A is the sole Affected Party.

  • Downstream Affiliate means an entity whose outstanding Voting Shares were, at the date of issuance of the Qualifying Guarantee, more than 50 per cent. owned, directly or indirectly, by the Reference Entity.

  • Permitted Special Servicer/Affiliate Fees Any commercially reasonable treasury management fees, banking fees, title insurance and/or other insurance commissions and fees, title agency fees, and appraisal review fees received or retained by the Special Servicer or any of its Affiliates in connection with any services performed by such party with respect to any Serviced Loan or REO Property, in each case, in accordance with Article III of this Agreement.

  • Recognised Provider (Approved Provider) means a provider of services registered with the appropriate association or organization to render services to a member and approved Latrobe to render services to its members.

  • Lockbox Processor means Regulus Group II LLC, or its successors or assigns.

  • Third Party Content means all software, data, text, images, audio, video, photographs and other content and material, in any format, that are obtained or derived from third party sources outside of Oracle that You may access through, within, or in conjunction with Your use of, the Services. Examples of Third Party Content include data feeds from social network services, rss feeds from blog posts, Oracle data marketplaces and libraries, dictionaries, and marketing data. Third Party Content includes third-party sourced materials accessed or obtained by Your use of the Services or any Oracle-provided tools.

  • Dedicated FX Traffic means those calls routed by means of a physical, dedicated circuit delivering dial tone or otherwise serving an End User’s station from a serving Central Office (also known as End Office) located outside of that station’s mandatory local calling area. Dedicated FX Service permits the End User physically located in one exchange to be assigned telephone numbers resident in the serving Central (or End) Office in another “foreign” exchange, thereby creating a local presence in that “foreign” exchange.