Excluded Providers definition

Excluded Providers means that the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services has the authority to exclude individuals and entities from Federally funded health care programs pursuant to sections 1128 and 1156 of the Social Security Act and maintains a list of all currently excluded individuals and entities called the List of Excluded Individuals and Entities (LEIE). Anyone who hires an individual or entity on the LEIE may be subject to civil monetary penalties (CMP). In addition, the Patient Protection Affordable Care Act requires States to deny or terminate enrollment to providers that have been terminated from another State’s Medicaid or CHIPS program.
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Examples of Excluded Providers in a sentence

  • To check the Maryland Medicaid List of Excluded Providers and Entities prior to hiring or contracting with individuals or entities and periodically check the website to determine the participation/exclusion status of current employees and contractors.

  • 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).

  • 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.

  • Directions for Online Access to Excluded Providers To ensure compliance with this regulation, identification of excluded entities and individuals can be found on the Office of Inspector General (OIG) website at https://oig.hhs.gov/exclusions/exclusions_list.asp Attycv/Exh SA GPB-LSO-JET (Rev.

  • 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.

  • Additionally, given Medicare payment may not be made for items or services furnished by an excluded provider or entity, applicant should follow the guidance provided in the January 13, 2010 HPMS memo entitled Claims for Drugs Prescribed or Dispensed by Excluded Providers.

  • 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.

  • On a monthly basis, Contractor shall conduct or cause to be conducted a screening of all employees, contractors or agents and shall sign a certification documenting that neither Contractor nor any of its employees, contractors or agents are listed on the Excluded Provider List of the Office of the Inspector General or the Medi-Cal List of Excluded Providers.

  • Before contracting with or employing a Provider, and as part of the credentialing and recredentialing processes, the Contractor shall search the SAM and LEIE databases, and any other databases required by the Department, to ensure that the Providers are not Excluded Providers.

  • 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).

Related to Excluded Providers

  • 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.

  • 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 Equipment means (i) defibrillators, enhanced emergency medical kits and other medical equipment, (ii) airphones and other components or systems installed on or affixed to the Airframe that are used to provide individual telecommunications or electronic entertainment to passengers aboard the Aircraft, (iii) galley carts, beverage carts, waste containers, liquor kits, food tray carriers, ice containers, oven inserts, galley inserts, and other branded passenger convenience or service items, (iv) any items, equipment or systems leased by Company or any Permitted Lessee (other than items, equipment, or systems that are leased from Company pursuant to the applicable Lease) or owned by Company or any Permitted Lessee subject to a conditional sales agreement or a security interest (other than the security interest granted under the Indenture), and (v) cargo containers.

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

  • Excluded Properties the collective reference to the fee or leasehold interest in real properties owned by the Parent Borrower or any of its Subsidiaries not described in Schedule 5.8.

  • 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.

  • 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.

  • Excluded Assets has the meaning set forth in Section 2.2.

  • Excluded IP has the meaning assigned to such term in the U.S. Security Agreement.

  • Excluded Items means any items which the Committee determines shall be excluded in fixing Performance Goals, including, without limitation, any gains or losses from discontinued operations, any extraordinary gains or losses and the effects of accounting changes.

  • Excluded Parties shall have the meaning assigned to such term in Section 9.16.

  • Excluded Proceeds means, with respect to any Asset Sale or Casualty Event, the sum of, (1) any Net Proceeds therefrom that constitute Declined Proceeds and (2) any Net Proceeds therefrom that otherwise are waived by the Required Facility Lenders from the requirement to be applied to prepay the applicable Term Loans pursuant to Section 2.05(2)(b).

  • Excluded Downtime has the meaning set forth in Section 2 below.

  • Excluded Data None – All data that falls into the sets below will be shared Data Being Sent for Categories A (Clinicians & Prescribing professionals) in 6.3 of this agreement. Below data items are coded data and free text Demographics data Previous and Future Appointments Discharge Summaries Clinic Letters Diagnosis Chronic Problems Allergies Current Medications Immunisations Data Being Sent for Category B (Other clinically supervised staff providing direct care) in 6.3 of this agreement. Below data items are coded data only and exclude free text Demographics data Previous and Future Appointments Discharge Summaries Clinic Letters Diagnosis Chronic Problems Allergies Current Medications Immunisations Data Being Sent for Category C (Administrative Staff supporting direct care) in 6.3 of this agreement Demographics data Previous and Future Appointments Receiving Organisations for this data: London Borough of Xxxxxxx - Care City of London – Social Care London Borough of Newham – Social Care Receiving Data from Agreement Name : East London Patient Record (eLPR) Method for receiving Data : East London Patient Record using the Cerner HIE This following table represents which roles in Homerton University Hospital Community that will fall into Categories A, B and C in terms of viewing shared data from other organisations. Name Code Category A Category B Category C Biomedical Scientist Access Role A Clinical Practitioner Access Role A Health Professional Access Role A Midwife Access Role A Nurse Access Role A Privacy Officer A Medical secretaries B Clinical administrators B Receptionists C The Caldicott Guardian or equivalent for the Homerton University Hospital will authorise the sending of this data and the receiving of any reciprocal data by accepting or rejecting this agreement in the Data Controller Console. The Caldicott Guardian for each provider will be added via the Data Controller Console. Providers will need to notify xxxx.xxxxx@xxx.xxx if there is a change in Caldicott Guardian or if there are any other changes: See Appendix E for more detail on the role of the Caldicott Guardian with this tool Appendix A continued: Homerton University Hospital – Acute Sharing arrangements for east London Patient Record – HEALTH ONLY Agreement Name : East London Patient Record (eLPR) Method for Sending – East London Patient Record using the Cerner HIE Purpose for sharing data : Individual Care (or Direct Care)

  • Excluded Personal Property has the meaning set forth in Section 2.2(c).

  • Contractor-acquired property means property acquired, fabricated, or otherwise provided by the Contractor for performing a contract, and to which the Government has title.

  • Physical Collocation shall have the meaning set forth in Section 8.1.1.

  • Included Assets has the meaning in Section 5.1(d)(ii)(A).

  • Excluded Deposit Accounts means (i) any payroll account, (ii) any withholding tax, benefits, escrow, trust, customs or any other fiduciary account and (iii) any zero balance deposit account.

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

  • Excluded License means an open source or other software license that requires, as a condition of license, use, modification, distribution or conveyance, that (a) the code be disclosed or distributed in source code form; (b) others have the right to modify or create derivative works of it; and/or (c) the code becomes redistributable at no charge.

  • 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.

  • Third Party Contracts means any agreements entered into by the Retailer and/or the Customer with any third parties, such as the Transmission Licensee and the MSSL, to enable the Retailer to retail electricity to Contestable Consumers. For the purposes of this Electricity Agreement, Third Party Contracts shall include, but is not limited to, the Retailer Use of Systems Agreement, the Market Support Services Agreement, and the Power System Operator•Market Participant Agreement (as defined under the Market Rules);

  • Excluded Waste means waste material of the nature that the Project is not designed or authorised to receive, manage, process and dispose which includes (i) Hazardous Waste, (ii) Bio-Medical Waste (iii) Dead Remains, (iv) E- Waste and (v) construction and demolition waste;

  • Excluded Employees has the meaning set forth in Section 2.5(a)(iv).

  • Excluded Collateral shall have the meaning assigned to such term in the Security Agreement.