Delegated Activities Clause Samples
Delegated Activities. Any activities delegated to Subcontractor by United shall be set forth in the Agreement or such other written delegation agreement or addendum between the parties. The Agreement or delegation agreement/addendum shall specify the activities and reporting responsibilities delegated to Subcontractor and provide for revoking delegation or imposing other sanctions if Subcontractor’s performance is inadequate. Prior to delegating any activities to Subcontractor under the State Contract, United will evaluate Subcontractor’s ability to perform such activities.
Delegated Activities. Participating Facility acknowledges and agrees that to the extent DentaQuest, in its sole discretion, elects to delegate any administrative activities or functions to Participating Facility, Participating Facility understands and agrees that: (i) Participating Facility may not delegate, transfer, or assign any of Participating Facility’s obligations under the Agreement and/or any separate delegation agreement without DentaQuest’s prior written consent; and (ii) Participating Facility must demonstrate, to DentaQuest’s satisfaction, Participating Facility’s ability to perform the activities to be delegated, and (iii) the parties will set out in writing: (1) the specific activities or functions to be delegated and performed by Participating Facility; (2) any reporting responsibilities and obligations pursuant to DentaQuest’s or Plan’s policies and procedures and/or the requirements of the Medicare Contract; (3) monitoring and oversight activities by DentaQuest or Plan including without limitation review and approval by DentaQuest or Plan of Participating Facility’s credentialing process, as applicable, and audit of such process on an ongoing basis; and (4) corrective action measures, up to and including termination or revocation of the delegated activities or functions and reporting responsibilities if CMS or DentaQuest or Health Plan determines that such activities have not been performed satisfactorily. The parties agree, notwithstanding anything set forth in the Agreement, that the Plan monitors and oversees the performance of delegated activities and is accountable to CMS for any functions or responsibilities that are described in the CMS regulations.
Delegated Activities. The following shall apply with respect to any activities for which the Company is responsible under the CMS Contract, and that have been delegated to Agent under the Agreement:
a. Agent shall provide or arrange for the provision of the services set forth in the Agreement.
b. Agent shall comply with any existing reporting responsibilities as are set forth in the Agreement.
c. Agent shall comply with all applicable Medicare laws, regulations and CMS instructions, and cooperate with the Company in its efforts to comply with the laws, regulations and other requirements of applicable regulatory authorities. Agent shall perform the services set forth in the Agreement in a manner consistent with and in compliance with the Company’s contractual obligations under the CMS Contract.
d. Agent acknowledges that the Company oversees on an on-going basis, and is ultimately accountable to CMS for, any functions or responsibilities that are contained in the CMS Contract, including those that Agent has agreed to perform in accordance with the Agreement. In instances where CMS or the Company determines that Agent has not performed satisfactorily, or has failed to meet all reporting and disclosure requirements in a timely manner, the Company has the right to revoke and assume the delegated activities or reporting and disclosure requirements upon written notice to Agent, or the Company may terminate the Agreement upon 30 days advance written notice to Agent. Agent shall cooperate with the Company regarding any delegated activities or reporting and disclosure requirements which have been revoked and assumed by the Company.
e. If Agent has any arrangements with affiliates, subsidiaries or any other sub-contractors (collectively, “subcontractors”), directly or through another person or entity, to perform any of the services Agent is obligated to perform under the Agreement that is the subject of this Addendum, Agent shall ensure that all such arrangements are in writing and duly executed. Agent shall also ensure that all such agreements are duly amended to incorporate the terms contained in this Addendum, and shall provide notice to the Company of such amendment. Agent shall ensure that the terms of this Addendum are included in all future and pending agreements with subcontractors that relate to the same subject matter. Agent shall ensure that any such delegation or subcontract shall be performed by the subcontractor in accordance with the Company’s contractual obligations to CM...
Delegated Activities. Vendor shall perform such delegated activities as United deems appropriate, including the Credentialing of Practitioners and Components in accordance with the Credentialing Plan, as may be amended from time to time, and the requirements set forth by the Credentialing Authorities. Vendor understands and agrees that Practitioners and Components may not provide health care services to a Member unless and until such Practitioners and Components are properly Credentialed and have executed or are otherwise subject to a Participation Agreement. Vendor will not communicate anything to the contrary to a Practitioner or Component.
Delegated Activities. If Plan has delegated activities to Provider, then the Plan will provide the following information to Provider and Provider shall provide such information to any of its subcontracted entities:
12.4.1 A list of delegated activities and reporting responsibilities;
12.4.2 Arrangements for the revocation of delegated activities;
12.4.3 Notification that the performance of the contracted and subcontracted entities will be monitored by the Plan;
12.4.4 Notification that the credentialing process must be approved and monitored by the Plan; and
12.4.5 Notification that all contracted and subcontracted entities must comply with all applicable Medicare laws, regulations and CMS instructions.
Delegated Activities. If Customer has delegated activities to Producer, then the Customer will provide the following information to Producer and Producer shall provide such information to any of its subcontracted entities:
a. A list of delegated activities and reporting responsibilities;
b. Arrangements for the revocation of delegated activities;
c. Notification that the performance of the contracted and subcontracted entities will be monitored by the Customer;
d. Notification that the credentialing process, if applicable, must be approved and monitored by the Customer; and
e. Notification that all contracted and subcontracted entities must comply with all applicable Medicare laws, regulations and CMS instructions.
Delegated Activities. The activities or responsibilities with regard to Plan’s QHP products that are delegated to Agent are specified in the ▇▇▇▇▇▇▇▇▇. [▇▇ ▇▇▇ 156.340(b)(1)]
Delegated Activities. The activities or responsibilities with regard to Plan’s QHP products that are delegated to Provider are specified in the Agreement. [45 CFR 156.340(b)(1)]
Delegated Activities. If County is specifically delegated by CalOptima, delegated activities and reporting requirements will be further set forth in a separate attachment or addendum to this Contract. Such delegation may include, Claims processing, utilization management, quality improvement, Health Equity activities, credentialing activities, and any other obligation that CalOptima is permitted to delegated to County, to the extent agreed upon between CalOptima and Provider. County agrees to perform and will require its Subcontractors to perform the obligations and functions of CalOptima undertaken pursuant to the Contract, including reporting responsibilities, in compliance with CalOptima’s obligations under the DHCS Contract in accordance with 42 CFR § 438.230(c)(1)(ii). County agrees to the revocation of the delegated activities and/or obligations, and/or any other specific remedies in instances where DHCS or CalOptima determine that County has not performed satisfactorily. If CalOptima delegates quality improvement activities, the Parties agree that the Contract will include provisions that address, at a minimum: (i) quality improvement responsibilities, and specific delegated functions and activities of CalOptima and County; (ii) CalOptima’s oversight, monitoring, and evaluation processes and County’s agreement to such processes; (iii) CalOptima’s reporting requirements and approval processes, including, County’s responsibility to report findings and actions taken as a result of the quality improvement activities at least quarterly; and (iv) CalOptima’s actions/remedies if County’s obligations are not met. [DHCS Contract, Exhibit A, Attachment III, §§ 3.1.1, 3.1.5(B.1), (B.8), (B.20), and (B.28); APL 19-001, Attachment A, Requirement 22]
Delegated Activities. PHC assigns, to Napa County, authority under its Medi-Cal contract with the Department of Health Services (“DHCS”), to provide delegated services on behalf of PHC. Delegate’s policies and procedures shall remain in compliance with the requirements of PHC through contract with DHCS and all applicable state and federal laws and regulations, including, without limitation, Titles 22 and 28 of the California Code of Regulations, the ▇▇▇▇ ▇▇▇▇▇ Act, DHCS All Plan Letters (“APLs”), Plan Letters (“PLs”), and applicable components of the DHCS Fee- For-Service Provider Manual. On request of PHC or DHCS, Delegate shall provide documentation in demonstration of compliance with these directives and requirements. Responsibilities for which PHC has provided the Delegate authority to perform, “delegated responsibilities,” are specific to the administration of Community Supports (CS) for Covered Services as described in Exhibit A of the CS Network Provider Agreement. Delegated responsibilities as follows:
I. Credentialing and Recredentialing to include provider screening, validation and/or enrollment;
II. Network Management to include Provider Contracting
III. Claims Processing and Payment;
IV. Member Services and Call Center; and