Contract Management and Readiness Review Requirements Clause Samples
The 'Contract Management and Readiness Review Requirements' clause establishes the obligations for both parties to actively manage the contract and participate in readiness reviews before key project milestones or service commencement. Typically, this involves regular meetings, documentation submissions, and formal assessments to ensure that all contractual, technical, and operational prerequisites are met. By setting clear expectations for oversight and preparedness, this clause helps prevent misunderstandings, delays, and non-compliance, ensuring that both parties are aligned and ready to proceed at each critical stage of the contract.
Contract Management and Readiness Review Requirements.
2.2.1. Contract Readiness Review Requirements
2.2.1.1. CMS and ODM, or their designee, will conduct a Readiness Review of each ICDS Plan, which must be completed successfully, as determined by CMS and ODM, prior to the Contract Operational Start Date.
2.2.1 2. CMS and ODM Readiness Review Responsibilities
2.2.1.2.1. CMS and ODM or their designee will conduct a Readiness Review of each ICDS Plan that will include, at a minimum, one on-site review. This review shall be conducted prior to marketing to and Enrollment of Beneficiaries into the ICDS Plan. CMS and ODM or their designee will conduct the Readiness Review to verify the ICDS Plan’s assurances that the ICDS Plan is ready and able to meet its obligations under the Contract.
2.2.1.2.2. The scope of the Readiness Review will include, but is not limited to, a review of the following elements:
2.2.1.2.2.1. Network Provider composition and access, in accordance with Sections 2.6, 2.7, 2.8 of this Contract;
2.2.1.2.2.2. Staffing, including key management positions and functions directly impacting Beneficiaries (e.g., adequacy of Beneficiary Services staffing), in accordance with Sections 2.2.3 and 2.9 of this Contract;
2.2.1.2.2.3. Capabilities of First Tier, Downstream and Related Entities, in accordance with Section 2.7 and Appendix C of this Contract;
2.2.1.2.2.4. Care Coordination capabilities, in accordance with Sections 2.5 of this Contract;
2.2.1.2.2.5. Beneficiary services capability (materials, processes and infrastructure, e.g., call center capabilities), in accordance with Section 2.9 of this Contract;
2.2.1.2.2.6. Comprehensiveness of quality management/quality improvement and Utilization Management strategies, in accordance with Section 2.11 of this Contract;
2.2.1.2.2.7. Internal Grievance and Appeal policies and procedures, in accordance with Section 2.10 of this Contract;
2.2.1.2.2.8. Fraud and abuse and program integrity, in accordance with Section 2.1 of this Contract;
2.2.1.2.2.9. Financial solvency, in accordance with Section 2.13 of this Contract;
2.2.1.2.2.10. Information systems, including Claims payment system performance, interfacing and reporting capabilities and validity testing of Encounter Data, in accordance with Sections 2.14 and 2.15 of this Contract, including IT testing and security assurances.
2.2.1.2.3. No individual shall be enrolled into the ICDS Plan unless and until CMS and the ODM determine that the ICDS Plan is ready and able to perform its obligations under the Co...
Contract Management and Readiness Review Requirements. A. Contract Readiness Review Requirements
1. CMS and EOHHS, or their designee, will conduct a Readiness Review of each Contractor, which must be completed successfully prior to the Contract Operational Start Date.
2. CMS and EOHHS Readiness Review Responsibilities
a. CMS and EOHHS or their designee will conduct a Readiness Review of each Contactor that will include, at a minimum, one on-site review. This review shall be conducted prior to enrollment of Medicare-Medicaid Beneficiaries into the Contractor’s Plan. CMS and EOHHS or their designee will conduct the Readiness Review to verify the Contractor’s assurances that the Contractor is ready and able to meet its obligations under the Contract.
b. The scope of the Readiness Review will include, but is not limited to, a review of the following elements:
(1) Network Provider composition and access, in accordance with
(2) Staffing, including Key Personnel and functions directly impacting Enrollees (e.g., adequacy of Enrollee Services staffing), in accordance with Sections 2.10 and 5.3;
(3) Capabilities of First Tier, Downstream and Related Entities, in accordance with Appendix D;
(4) Care Coordination capabilities, in accordance with Section 2.5.C;
(5) Content of Provider Contracts, including any Provider Performance Incentives, in accordance with Sections 2.7 and 5.1.G;
(6) Enrollee Services capabilities (materials, processes and infrastructure, e.g., call center capabilities), in accordance with Section 2.10;
(7) Comprehensiveness of quality management/quality improvement and Utilization Management strategies, in accordance with Section 2.13;
(8) Internal Grievance and Appeal policies and procedures, in accordance with Section 2.1 and Section 2.12;
(9) Fraud and Abuse and program integrity policies and procedures, in accordance with Section 2.8;
(10) Financial solvency, in accordance with Section 2.15;
(11) Information systems, including claims payment system performance, interfacing and reporting capabilities and validity testing of Encounter Data, in accordance with Section 2.17, including IT testing and security assurances.
▇. ▇▇ individual shall be enrolled into the Contractor’s ICO unless and until CMS and the Commonwealth determine that the Contractor is ready and able to perform its obligations under the Contract as demonstrated during the Readiness Review.
d. CMS and EOHHS or their designee will identify to the Contractor all areas where the Contractor is not ready and able to meet its obligations un...
Contract Management and Readiness Review Requirements. Contract Readiness Review Requirement
Contract Management and Readiness Review Requirements