ACA Section 1557 Coordinator Clause Samples

ACA Section 1557 Coordinator. The terms and conditions of Section 24, Exhibit E in the Medicaid Contract are incorporated by reference and have the same force and effect as though they are fully set forth herein. The terms and conditions of Exhibit F in the Medicaid Contract are incorporated by reference and have the same force and effect as though they are fully set forth herein. 1. Delivery System Network Provider Monitoring and Reporting Overview a. Contractor shall employ or enter into Network Provider agreements with, in accordance with the standards set forth in CFR § 438.206, Ex. B, Part 4 and any other applicable provisions of this Contract, enough Providers to meet the needs of its Members in all categories of service, and types of service Providers, such that Members have timely and appropriate access to services. Contractor shall develop its Provider Network that is consistent with 42 CFR § 438.68, 42 CFR § 457.1230, and OAR 410-141-3515. Contractor shall only employ or otherwise contract with Providers who agree to provide services to HOP, COFA, Veteran, and Medicaid Members and who comply with all applicable state and federal non-discrimination laws including, without limitation, ORS 659A.440 through 659A.409 and the federal Civil Rights Act. Contractor shall incorporate the priorities from its Community Health Assessment, its Community Health b. The terms and conditions of Paragraph b of Section 1, Exhibit G in the Medicaid Contract are incorporated by reference and have the same force and effect as though they are fully set forth herein. c. The terms and conditions of Paragraph c of Section 1, Exhibit G in the Medicaid Contract are incorporated by reference and have the same force and effect as though they are fully set forth herein. d. The terms and conditions of Paragraph d of Section 1, Exhibit G in the Medicaid Contract are incorporated by reference and have the same force and effect as though they are fully set forth herein. e. Contractor shall promptly and fully remedy any Provider Network deficiencies identified through the course of self-assessment, in the event of a Material Change, or as a result of OHA Monitoring, or EQRO review under the Medicaid Contract. f. The terms and conditions of Paragraph f of Section 1, Exhibit G in the Medicaid Contract are incorporated by reference and have the same force and effect as though they are fully set forth herein. g. The terms and conditions of Paragraph g of Section 1, Exhibit G in the Medicaid Contract are incorporated...
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ACA Section 1557 Coordinator a. As required by Section 1557 of the ACA, if Contractor employs fifteen (15) or more persons, then Contractor must designate and authorize at least one (1) employee to coordinate Contractor’s compliance with its responsibilities under Section 1557 in its health programs and activities, including the investigation of any grievance communicated to it alleging noncompliance with Section 1557 or alleging any action that would be prohibited by Section 1557 (“Section 1557 Coordinator”). As appropriate, Contractor may assign one or more designees to carry out some of these responsibilities, but the Section 1557 Coordinator must retain ultimate oversight for ensuring coordination with Contractor’s compliance. b. Contractor must ensure that, at minimum, its Section 1557 Coordinator: (1) Receives, reviews, and processes grievances, filed under the grievance procedure as set forth in § 92.8(c); (2) Coordinates Contractor’s recordkeeping requirements as set forth in § 92.8(c); (3) Coordinates effective implementation of Contractor’s language access procedures as set forth in § 92.8(d); (4) Coordinates effective implementation of Contractor’s effective communication procedures as set forth in § 92.8(e); (5) Coordinates effective implementation of Contractor’s reasonable modification procedures as set forth in § 92.8(f); and (6) Coordinates training of relevant employees as set forth in § 92.9, including maintaining documentation required by such section. Exhibit F – Insurance Requirements Exhibit G – Reporting of Delivery System Network Providers, Cooperative Agreements, and Hospital Adequacy 1. Delivery System Network Provider Monitoring and Reporting Overview a. Contractor shall employ or enter into Network Provider agreements with, in accordance with the standards set forth in CFR § 438.206, Ex. B, Part 4 and any other applicable provisions of this Contract, enough Providers to meet the needs of its Members in all categories of service, and types of service Providers, such that Members have timely and appropriate access to services. Contractor shall develop its Provider Network that is consistent with 42 CFR § 438.68, 42 CFR b. If necessary to ensure access to an adequate Provider Network, Contractor may be required to contract with Providers located outside of the defined Service Area. c. Contractor shall Monitor, document, report and evaluate its Provider Network as set forth in this Ex. G. d. Contractor’s obligations under Para. c, above of this Ex. G, shall inc...
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Related to ACA Section 1557 Coordinator

  • Coordinator 6.4.1 The Coordinator shall be the intermediary between the Parties and the Funding Authority and shall perform all tasks assigned to it as described in the Grant Agreement and in this Consortium Agreement. 6.4.2 In particular, the Coordinator shall be responsible for: - monitoring compliance by the Parties with their obligations - keeping the address list of Members and other contact persons updated and available - collecting, reviewing to verify consistency and submitting reports, other deliverables (including financial statements and related certifications) and specific requested documents to the Funding Authority - transmitting documents and information connected with the Project to any other Parties concerned - administering the financial contribution of the Funding Authority and fulfilling the financial tasks described in Section 7.3 - providing, upon request, the Parties with official copies or originals of documents which are in the sole possession of the Coordinator when such copies or originals are necessary for the Parties to present claims. If one or more of the Parties is late in submission of any project deliverable, the Coordinator may nevertheless submit the other parties’ project deliverables and all other documents required by the Grant Agreement to the Funding Authority in time. 6.4.3 If the Coordinator fails in its coordination tasks, the General Assembly may propose to the Funding Authority to change the Coordinator. 6.4.4 The Coordinator shall not be entitled to act or to make legally binding declarations on behalf of any other Party or of the consortium, unless explicitly stated otherwise in the Grant Agreement or this Consortium Agreement 6.4.5 The Coordinator shall not enlarge its role beyond the tasks specified in this Consortium Agreement and in the Grant Agreement. [Option: 6.5 Management Support Team (Optional, where foreseen in Grant Agreement or otherwise decided by the consortium) The Management Support Team shall be proposed by the Coordinator. It shall be appointed by the Executive Board and shall assist and facilitate the work of the Executive Board and the Coordinator for executing the decisions of the General Assembly as well as the day-to-day management of the Project.] [Option: 6.6 External Expert Advisory Board (EEAB) (Optional, where foreseen in the Grant Agreement or otherwise decided by the consortium) An External Expert Advisory Board (EEAB) will be appointed and steered by the Executive Board. The EEAB shall assist and facilitate the decisions made by the General Assembly. The Coordinator is authorised to execute with each member of the EEAB a non-disclosure agreement, which terms shall be not less stringent than those stipulated in this Consortium Agreement, no later than 30 calendar days after their nomination or before any confidential information will be exchanged, whichever date is earlier. The Coordinator shall write the minutes of the EEAB meetings and prepare the implementation of the EEAB's suggestions. The EEAB members shall be allowed to participate in General Assembly meetings upon invitation but have not any voting rights.]

  • Service Coordinators Each Party has designated an employee or title as the key contact for the day-to-day implementation or monitoring of each Service as specified in the applicable Transition Service Schedule (each, a “Service Coordinator”). The Parties shall direct communications relating to specific Services to the applicable Service Coordinators. The Service Coordinators shall report to the Transition Committee from time to time, as directed by the members of the Transition Committee designated by the applicable Party.

  • Scheduling Coordinator Buyer shall act as the Scheduling Coordinator for the Project. In that regard, Buyer and Seller shall agree to the following:

  • Coordinators The contractor shall assign coordinators as needed to coordinate At-Sea Monitor deployment and provide At-Sea Monitor support services. The coordinator shall be designated as key personnel under this contract (per section H.

  • Joint Union/Management Committee It shall be appropriate for either the Union or the University to request that a Joint Union/Management committee be convened, with Environmental Health and Safety as a participating member, to discuss health and safety concerns and to explore options for addressing those concerns through appropriate training or other approaches.