Preclusion List definition

Preclusion List means the CMS-compiled list of providers and prescribers who are precluded from receiving payment for Medicare Advantage (MA) items and services or Part D drugs furnished or prescribed to Medicare beneficiaries.
Preclusion List. The list maintained by CMS under42 C.F.R. § 422.222 and defined in 42 C.F.R. § 422.2.
Preclusion List means the CMS Preclusion List and/or the OIG exclusion list.

Examples of Preclusion List in a sentence

  • IEHP does notcontract with prospective Hospitals and entities for the IEHP Medicare line of business if the Provider is on the CMS Preclusion List or has opted-out of the Medicare Program.

  • A monthly review of the Department of Health Care Services Medi-Cal Suspended and Ineligible list and Centers for Medicare and Medicaid Services Preclusion List.

  • A Grievance is a complaint by a Teacher or by the Association in its behalf, concerning any alleged violation, misinterpretation or misapplication of this Agreement or any disciplinary action administered to a Teacher.

  • CMS Preclusion List Ancillary ProvidersYou must send Clover a completed Facility/Ancillary Provider Credentialing Application that is signed and dated (application is valid for 180 days).

  • Thus, a plan may provide a beneficiary with more than 60 days’ notice, and if a plan does so, the plan should not deny payments/reject claims earlier than 90 days after publication of the associated Preclusion List.

  • Have been convicted of a felony under federal or state law within the previous ten years that CMS determines is detrimental to the best interests of the Medicare program.[13]Of note, the second criteria listed above allows for a provider not currently enrolled in Medicare to be placed on the CMS Preclusion List.

  • On April 1, 2019, the Center for Medicare and Medicaid Services (“CMS”) announced a new exclusion sanction: the CMS Preclusion List.

  • A monthly review of the Department of Health Care Services Medi-Cal Suspended and Ineligible list and the Centers for Medicare and Medicaid Services Preclusion List.

  • All prescribers who write prescriptions for PACE Participants will be checked against the OIG List of Excluded Individuals/Entities, the GSA Excluded Parties Listing System, the CMS Preclusion List, and/or any state exclusion lists maintained by state Medicaid programs on an annual basis.

  • The rate of suicide in the CDCR was 18.6 suicides per 100,000 inmates in 2015 and 17.0 per 100,000 in 2014.


More Definitions of Preclusion List

Preclusion List shall be added to the Contract as follows:
Preclusion List means the CMS-compiled list of individuals and entities that -

Related to Preclusion List

  • Exclusion List means the HHS/OIG List of Excluded Individuals/Entities (LEIE) (available through the Internet at xxxx://xxx.xxx.xxx.xxx).

  • Update means a hotfix, patch or minor version update to any Platform software; and

  • Statement of Grievance shall name the grievant(s) involved, the facts giving rise to the grievance, provision(s) of the Agreement alleged to be violated and the remedy (specific relief) requested.

  • System Impact Study means an assessment by the Transmission Provider of (i) the adequacy of the Transmission System to accommodate a Completed Application, an Interconnection Request or an Upgrade Request, (ii) whether any additional costs may be incurred in order to provide such transmission service or to accommodate an Interconnection Request, and (iii) with respect to an Interconnection Request, an estimated date that an Interconnection Customer’s Customer Facility can be interconnected with the Transmission System and an estimate of the Interconnection Customer’s cost responsibility for the interconnection; and (iv) with respect to an Upgrade Request, the estimated cost of the requested system upgrades or expansion, or of the cost of the system upgrades or expansion, necessary to provide the requested incremental rights. System Protection Facilities: “System Protection Facilities” shall refer to the equipment required to protect (i) the Transmission System, other delivery systems and/or other generating systems connected to the Transmission System from faults or other electrical disturbance occurring at or on the Customer Facility, and (ii) the Customer Facility from faults or other electrical system disturbance occurring on the Transmission System or on other delivery systems and/or other generating systems to which the Transmission System is directly or indirectly connected. System Protection Facilities shall include such protective and regulating devices as are identified in the Applicable Technical Requirements and Standards or that are required by Applicable Laws and Regulations or other Applicable Standards, or as are otherwise necessary to protect personnel and equipment and to minimize deleterious effects to the Transmission System arising from the Customer Facility. Transmission Facilities:

  • Informed decision means a decision by a qualified patient, to request and obtain a prescription for medication that the qualified patient may self-administer to end his or her life in a humane and dignified manner, that is based on an appreciation of the relevant facts and after being fully informed by the attending physician of:

  • Finalist means an Offeror who meets all the mandatory specifications of this Request for Proposals and whose score on evaluation factors is sufficiently high to merit further consideration by the Evaluation Committee.

  • Particulate matter means any airborne finely divided solid or liquid material with an aerodynamic diameter smaller than 100 micrometers.

  • Responsive Proposal means a Proposal that complies with the material provisions of this RFP.

  • Safety Data Sheet means a safety data sheet within the meaning of regulation 5 of the CHIP Regulations;

  • Amended Complaint means the Consolidated Amended Class Action Complaint, dated February 12, 2015, filed in this Action.

  • Policy Grievance shall be signed by a xxxxxxx or a Union representative or, in the case of an Employer's policy grievance, by the Employer or its representative.