NCQA Accreditation Sample Clauses

NCQA Accreditation. As applicable in the performance of the Agreement, Provider is subject to all applicable accreditation standards (e.g., National Committee for Quality Assurance (“NCQA”) accreditation), as may be set forth in the Agreement and any applicable attachments thereto.
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NCQA Accreditation. The ICDS Plan must hold and maintain, or must be actively seeking and working towards, accreditation by the National Committee for Quality Assurance (NCQA) for the Ohio Medicare or Medicaid line of business. The ICDS Plan must achieve and/or maintain an excellent, commendable or accredited status from NCQA. For the purposes of meeting this accreditation requirement, ODM will only accept the use of the NCQA corporate survey to the extent deemed allowable by NCQA. Upon completion of the accreditation survey, the ICDS Plan must submit to ODM a copy of the “Final Decision Letter” no later than ten (10) calendar days upon receipt from NCQA. Thereafter and on an annual basis between accreditation surveys, the ICDS Plan must submit a copy of the “Accreditation Summary Report” issued as a result of the annual HEDIS update no later than ten (10) calendar days upon receipt from NCQA. Upon ODM’s request, the ICDS Plan must provide any and all documents related to achieving accreditation.
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NCQA Accreditation. 2.15.5.1 The CONTRACTOR shall obtain NCQA accreditation by November 30, 2009 and shall maintain it thereafter. Any accreditation status granted by NCQA under the New Health Plan (NHP) program or the MCO Introductory Survey option will not be acknowledged by TENNCARE. Accreditation obtained under the NCQA Full Accreditation Survey or Multiple Product Survey options will be acknowledged by TENNCARE if the TennCare product is specifically included in the NCQA survey. TENNCARE will accept the use of the NCQA Corporate Survey process, to the extent deemed allowable by NCQA, in the accreditation of the CONTRACTOR. In order to ensure that the CONTRACTOR is making forward progress, TENNCARE shall require that the following information and/or benchmarks be met: EVENT REQUIRED DEADLINE CALENDAR YEAR 2007 NCQA Accreditation Survey Application Submitted and Pre Survey Fee paid December 15, 2007 EVENT REQUIRED DEADLINE CALENDAR YEAR 2008 Submit copy of signed NCQA Survey contract to TENNCARE January 15, 2008 Purchase NCQA ISS Tool for 2009 MCO Accreditation Survey August 15, 2008 Copy of signed contract with NCQA approved vendor to perform 2009 CAHPS surveys (Adult, Child and Children with Chronic Conditions to TENNCARE) November 15, 2008 Copy of signed contract with NCQA approved vendor to perform 2009 HEDIS Audit to TENNCARE (The CONTRACTOR must perform the complete Medicaid HEDIS Data Set with the exception of dental related measures) November 15, 2008 CALENDAR YEAR 2009 Notify TENNCARE of date for ISS Submission and NCQA On-site review January 15, 2009 HEDIS Baseline Assessment Tool completed and submitted to Contracted HEDIS Auditor, TENNCARE, and the EQRO February 15, 2009 Audited Medicaid HEDIS and CAHPS results submitted to NCQA and TENNCARE June 15, 2009 Finalize preparations for NCQA Survey (Final payment must be submitted to NCQA sixty (60) calendar days prior to submission of ISS) Notify TennCare of final payment within five (5) business days of submission to NCQA. Submission of ISS to NCQA Notify TennCare within five (5) business days of submission to NCQA. NCQA Survey Completed and copy of NCQA Final Report to TENNCARE: November 30, 2009 • Excellent, Commendable, or Accredited • Provisional — Corrective Action required to achieve status of Excellent, Commendable, or Accredited; resurvey within twelve ( 12) months. • Accreditation Denied — Results in termination of this Agreement.
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NCQA Accreditation. ‌ If the Contractor intends to continue provision of contracted managed care services for the HCA past December 31, 2014, the Contractor must provide evidence of application for NCQA certification for Medicaid no later than September 30, 2014. Such evidence may be application documents with verification from the NCQA that the application process has begun. If the Contractor is already NCQA certified for Medicaid, the Contractor shall submit its current NCQA accreditation certificate for Medicaid to HCA no later than September 30, 2014.‌
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NCQA Accreditation. CONTRACTING PROVIDER agrees that if, during the term of this Agreement, NCQA develops criteria or standards for the accreditation of eye care organizations, then CONTRACTING PROVIDER shall use good faith efforts to obtain such accreditation. If CONTRACTING PROVIDER fails to secure such NCQA accreditation, following formal NCQA review, then Anthem BC&BS shall have the right to terminate this Agreement pursuant to Section 8.4 (b) hereof.
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NCQA Accreditation. Cimarron Health Plan, the Company’s subsidiary operating in New Mexico as a health maintenance organization (the “HMO Subsidiary”), is currently accredited by the National Committee for Quality Assurance (the “NCQA”) with a “commendable” rating for both its commercial and Medicaid lines of business. The Company previously has delivered to Acquiror true, correct and complete copies of the HMO Subsidiary’s most recent NCQA accreditation survey report and recommendations, if any. The Company and the HMO Subsidiary have taken all reasonable steps to address the recommendations as appropriate as described on Schedule 4.26 attached hereto. The most recent such NCQA accreditation survey report resulted in continued NCQA accreditation of the HMO Subsidiary for a period of up to three years.
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NCQA Accreditation. 7.4.1 The Contractor shall maintain NCQA accreditation at a level of “accredited” or better.
Sample 1
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Related to NCQA Accreditation

  • Accreditation The School shall be accredited as provided by rule of the state board of education.

  • Licensing and Accreditation (a) Each of the Loan Parties and their Subsidiaries has, except to the extent such failure to do so would not reasonably be expected to result in a Material Adverse Effect, to the extent applicable: (i) obtained (or been duly assigned) all required Governmental Approvals and certificates of need or determinations of need as required by the relevant state Governmental Authority for the acquisition, construction, expansion of, investment in or operation of its businesses and Facilities as currently operated; (ii) obtained and maintains in good standing all Governmental Approvals and Healthcare Permits; (iii) obtained and maintains accreditation from all generally recognized accrediting agencies where required by applicable Law or necessary for reimbursement by any applicable Medical Reimbursement Program; (iv) entered into and maintains in good standing its Medicare Provider Agreements and, to the extent applicable, Medicaid Provider Agreements; and (v) ensured that all such Healthcare Permits are in full force and effect on the date hereof and have not been revoked or suspended or otherwise limited (collectively, “Certificates, Licenses and Accreditation”). No event has occurred or other fact exists with respect to the Certificates, Licenses and Accreditation and Governmental Approvals that allows, or after notice or lapse of time or both, would allow, revocation, suspension, restriction, limitation or termination of any of the Certificates, Licenses and Accreditation and Governmental Approvals, except to the extent such failure to do so would not reasonably be expected to result in a Material Adverse Effect. No written notice from any Governmental Authority in respect to the revocation, suspension, restriction, limitation or termination of any material Certificates, Licenses and Accreditation and Governmental Approvals has been delivered or issued or, to the knowledge of the Loan Parties, threatened in writing, in any such case, that could reasonably be expected to result in a Material Adverse Effect.

  • Licensure The Contractor covenants that it has:

  • Health Care Authorizations The Company has submitted and possesses, or qualifies for applicable exemptions to, such valid and current registrations, listings, approvals, clearances, licenses, certificates, authorizations or permits and supplements or amendments thereto issued or required by the appropriate state, federal or foreign regulatory agencies or bodies necessary to conduct their business, including, without limitation, all such certificates, authorizations and permits required by the United States Food and Drug Administration (the “FDA”), the United States Department of Health and Human Services (“HHS”), the United States Centers for Medicare & Medicaid Services (“CMS”), the European Medicines Agency (“EMEA”), Health Canada or any other state, federal or foreign agencies or bodies engaged in the regulation of medical devices (including diagnostic products), drugs or biohazardous materials, and the Company have not received any notice of proceedings relating to the revocation or modification of, or non-compliance with, any such license, certificate, authorization or permit, except for such registrations, listings, approvals, clearances, licenses, certificates, authorizations or permits, the lack of which would not, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect.

  • Authorization, Etc This Agreement and the Notes have been duly authorized by all necessary corporate action on the part of the Company, and this Agreement constitutes, and upon execution and delivery thereof each Note will constitute, a legal, valid and binding obligation of the Company enforceable against the Company in accordance with its terms, except as such enforceability may be limited by (i) applicable bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors’ rights generally and (ii) general principles of equity (regardless of whether such enforceability is considered in a proceeding in equity or at law).

  • Health Care Compliance Neither the Company nor any Affiliate has, prior to the Effective Time and in any material respect, violated any of the health care continuation requirements of COBRA, the requirements of FMLA, the requirements of the Health Insurance Portability and Accountability Act of 1996, the requirements of the Women's Health and Cancer Rights Act of 1998, the requirements of the Newborns' and Mothers' Health Protection Act of 1996, or any amendment to each such act, or any similar provisions of state law applicable to its Employees.

  • Legal Compliance; Permits To the Seller’s Knowledge, currently and since December 31, 2002, each Acquired Company has complied and is in compliance with all applicable Laws of all Governmental Authorities. Neither Seller nor any Acquired Company has received any written notice of or has been charged with the violation of any material Laws applicable to the Acquired Company Assets. To the Seller’s Knowledge, the Acquired Companies currently have all material Permits that are necessary to operate the Acquired Company Assets and the operations related thereto in the Ordinary Course of Business, all such Permits are in full force and effect, and no Acquired Company is in material default or violation (and no event has occurred which, with notice or the lapse of time or both, would constitute a material default or violation) of any term, condition or provision of any such Permits. Notwithstanding the previous sentences, the Seller makes no representations or warranties in this Section 4(e) with respect to Taxes or Environmental Laws, for which the sole representations and warranties of the Seller are set forth in Sections 4(f) and 4(i), respectively.

  • Healthcare Compliance 10 (v) Fraud and Abuse................................................11 (w)

  • Permits; Compliance The Company and each of its Subsidiaries is in possession of all franchises, grants, authorizations, licenses, permits, easements, variances, exemptions, consents, certificates, approvals and orders necessary to own, lease and operate its properties and to carry on its business as it is now being conducted (collectively, the “Company Permits”), and there is no action pending or, to the knowledge of the Company, threatened regarding suspension or cancellation of any of the Company Permits. Neither the Company nor any of its Subsidiaries is in conflict with, or in default or violation of, any of the Company Permits, except for any such conflicts, defaults or violations which, individually or in the aggregate, would not reasonably be expected to have a Material Adverse Effect. Since September 30, 2016, neither the Company nor any of its Subsidiaries has received any notification with respect to possible conflicts, defaults or violations of applicable laws, except for notices relating to possible conflicts, defaults or violations, which conflicts, defaults or violations would not have a Material Adverse Effect.

  • Permits and Compliance 17 Section 4.9

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