ATTACHMENT J. Add new Section 16.5(e) as follows: 16.5
ATTACHMENT J. Program Pricing CFM and Airline both recognize that it is desirable that Airline maintains a spare-to-installed engine ratio of CFM56-5B engines that will be sufficient to assure optimal stability in Airline’s A320 family flight operations. In order to induce Airline to purchase sufficient CFM56-5B engines to achieve this objective, CFM is offering a Spare Engine purchase price credit to Airline, in accordance with the following terms.
ATTACHMENT J. Fourth Revised and Restated Reporting Requirements is revised and restated in its entirety to incorporate reports associated with the Healthy Opportunities Pilot as set forth in Attachment 5: Attachment J. Fifth Revised and Restated Reporting Requirements to this Amendment.
ATTACHMENT J. HIPAA PRIVACY BUSINESS ASSOCIATE AGREEMENT This Contract is entered into this ___ day of_________, 200_, between the County of Orange (the “County”) acting on behalf of the County Group Health Plans and the Management and Attorney Dental Plan (the “Plan(s)”), and _________________. (“Business Associate”). The parties intend to use this Amendment to satisfy the Business Associate contract requirements in the regulations at 45 CFR 164.502(e) and 164.504(e), issued under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).
ATTACHMENT J. 1 – CONTRACTOR INFORMATION SPREADSHEET
ATTACHMENT J. 2 – SYSTEM FOR AWARD MANAGEMENT CERTIFICATION
ATTACHMENT J. How the state must calculate the impact of the transformation. The attachment will outline all of the costs that should be captured in the pre and post transformation implementation. This will assist the state and CMS in tracking whether transformation is being accomplished.
ATTACHMENT J. Acknowledgement of Receipt of Provider Manual Provider hereby acknowledges receipt of Health Plan’s Provider Manual. Date of receipt: ________________________ Initials of authorized representative of Provider: _________________________ ATTACHMENT K BUSINESS ASSOCIATE AGREEMENT This BUSINESS ASSOCIATE AGREEMENT (“BAA”) is entered into effective the _____ day of __________, 20____ (the “Effective Date”) by and between Ventura County Medi-Cal Managed Care Commission doing business as Gold Coast Health Plan (“Health Plan”) and _______________________________________________________, (“Business Associate”), each a “Party” and collectively the “Parties”.
ATTACHMENT J. Please provide the results of the GeoAccess analysis requested in Section II, Part 3, Section E. Summary results should be provided in hard copy. Full results should be provided on CD-ROM. While we understand eligibility for each product will differ, please use the total census population for all GeoAccess reports GeoAccess Summary – As appropriate Include the number of providers who meet the access criteria outlined in the table for each plan you are providing a response for: MEDICARE ADVANTAGE HMO (MEDICARE RISK/MEDICARE CHOICE) CALIFORNIA ONLY MEDICARE ADVANTAGE PPO/PFFS (PRIVATE FEE-FOR- SERVICE) NATIONAL COMMERCIAL NON-MEDICARE NARROW NETWORK HMO CALIFORNIA ONLY COMMERCIAL NON-MEDICARE HMO CALIFORNIA ONLY 1 PCP 5 MILES 2 PCPS 8 MILES 2 OB/GYNS 10 MILES 1 HOSPITAL 15 MILES Please provide a total count for the number of providers for each plan from the GeoAccess analysis: MEDICARE ADVANTAGE HMO (MEDICARE RISK/MEDICARE CHOICE) MEDICARE ADVANTAGE PPO/PFFS (PRIVATE FEE-FOR- SERVICE) COMMERCIAL NON-MEDICARE NARROW NETWORK HMO CALIFORNIA ONLY COMMERCIAL NON-MEDICARE HMO PCP’S OB/GYNS SPECIALISTS HOSPITAL Attachment K
ATTACHMENT J. All purchase orders issued by Participating Entities under this Addendum shall include the Participating State contract number: SPO Price List Contract No. 16-07 and the NASPO ValuePoint Master Agreement Number 06913. Purchase Orders and Payments shall be made to add contractor name or authorized subcontractors, if any. 9. Participating Entity as Individual Customer: Each Participating Entity shall be treated as an individual customer. Except to the extent modified by this Addendum, each Participating Entity will be responsible to follow the terms and conditions of the Master Agreement; and will have the same rights and responsibilities for their purchases as the Lead State has in the Master Agreement. Each Participating Entity will be responsible for its own charges, fees, and liabilities. Each Participating Entity will have the same rights to any indemnity or to recover any costs allowed in the Master Agreement for their purchases. The Contractor will apply the charges to each Participating Entity individually.
