Implementation Report. Within 90 days after the Effective Date, ▇▇▇▇▇▇▇▇▇▇ shall submit a written report to OIG summarizing the status of his implementation of the requirements of this IA (Implementation Report). The Implementation Report shall, at a minimum, include: 1. a copy of the notice ▇▇▇▇▇▇▇▇▇▇ posted in his office as required by Section III.A, a description of where the notice is posted, and the date the notice was posted; 2. the following information regarding the one hour of training required by Section III.B to be completed within 60 days of the Effective Date: a copy of the training program registration for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request. 3. the following information regarding each IRO: (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this IA; (d) a summary and description of any and all current and prior engagements and agreements between ▇▇▇▇▇▇▇▇▇▇ and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Chatterjee; 4. a copy of the documentation demonstrating that ▇▇▇▇▇▇▇▇▇▇ has screened all Covered Persons against the Exclusion Lists, as required by section III.E, within 30 days of the Effective Date; 5. a copy of any certifications from Chatterjee and the third party billing company required by Section III.I (if applicable); 6. a list of all of ▇▇▇▇▇▇▇▇▇▇’▇ locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which ▇▇▇▇▇▇▇▇▇▇ currently submits claims;
Appears in 1 contract
Sources: Integrity Agreement
Implementation Report. Within 90 days after the Effective Date, ▇▇▇▇▇▇▇▇▇▇ shall submit a written report to OIG summarizing the status of his implementation of the requirements of this IA (Implementation Report). The Implementation Report shall, at a minimum, include:
1. a copy of the notice ▇▇▇▇▇▇▇▇▇▇ posted in his office as required by Section III.A, a description of where the notice is posted, and the date the notice was posted;
2. the following information regarding the one hour of training required by Section III.B to be completed within 60 days of the Effective Date: a copy of the training program registration for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request.
3. the following information regarding each IRO: (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this IA; (d) a summary and description of any and all current and prior engagements and agreements between ▇▇▇▇▇▇▇▇▇▇ and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Chatterjee▇▇▇▇▇;
4. a copy of the documentation demonstrating that ▇▇▇▇▇▇▇▇▇▇ has screened all Covered Persons against the Exclusion Lists, as required by section III.E, within 30 days of the Effective Date; 5. a copy of any certifications from Chatterjee ▇▇▇▇▇ and the third party billing company required by Section III.I (if applicable);
6. a list of all of ▇▇▇▇▇▇▇▇▇▇’▇ Anand’s locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which ▇▇▇▇▇▇▇▇▇▇ currently submits claims;
Appears in 1 contract
Sources: Integrity Agreement
Implementation Report. Within 90 days after the Effective Date, ▇▇▇▇▇▇▇▇▇▇ shall submit a written report to OIG summarizing the status of his its implementation of the requirements of this IA (Implementation Report). The Implementation Report shall, at a minimum, include:
1. a copy of the notice ▇▇▇▇▇▇▇▇▇▇ posted in his office as required by Section III.A, a description of where the notice is posted, and the date the notice was posted;
2. the following information regarding the one hour of training required by Section III.B to be completed within 60 days of the Effective Date: a copy of the training program registration for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request.
3. the following information regarding each the IRO: (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this IA; (d) a summary and description of any and all current and prior engagements and agreements between ▇▇▇▇▇▇▇▇▇▇ and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Chatterjee▇▇▇▇▇▇▇;
4. a copy of the documentation demonstrating that ▇▇▇▇▇▇▇▇▇▇ has screened all Covered Persons against the Exclusion Lists, as required by section III.EIII.D, within 30 days of the Effective Date; 5. a copy of any certifications from Chatterjee ▇▇▇▇▇▇▇ and the third party billing company required by Section III.I III.H (if applicable);
6. a list of all of ▇▇▇▇▇▇▇▇▇▇’▇ Krentel’s practice locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which ▇▇▇▇▇▇▇ currently submits claims; and
7. a certification by ▇▇▇▇▇▇▇ currently submits claims;that: (a) he has reviewed the IA in its entirety, understands the requirements described within, and maintains a copy for reference; (b) to the best of his knowledge, except as otherwise described in the Implementation Report, ▇▇▇▇▇▇▇ is in compliance with all of the requirements of this IA; and (c) he has reviewed the Implementation Report and has made a reasonable inquiry regarding its content and believes that the information is accurate and truthful.
Appears in 1 contract
Sources: Integrity Agreement
Implementation Report. Within 90 days after the Effective Date, ▇▇▇▇▇▇▇▇▇▇ shall submit a written report to OIG summarizing the status of his its implementation of the requirements of this IA (Implementation Report). The Implementation Report shall, at a minimum, include:
1. a copy of the notice ▇▇▇▇▇▇▇▇▇▇ posted in his office its offices as required by Section III.A, a description of where the notice is posted, and the date the notice was posted;
2. the following information regarding the one hour of training required by Section III.B to be completed within 60 days of the Effective Date: a copy of the training program registration for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request.
3. the following information regarding each IRO: the IRO(s): (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this IA; (d) a summary and description of any and all current and prior engagements and agreements between ▇▇▇▇▇▇▇▇▇▇ and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Chatterjee▇▇▇▇▇;
4. a copy of the documentation demonstrating that ▇▇▇▇▇▇▇▇▇▇ has screened all Covered Persons against the Exclusion Lists, as required by section III.EIII.D, within 30 days of the Effective Date; 5. a copy of any certifications from Chatterjee ▇▇▇▇▇ and the third party billing company required by Section III.I III.H (if applicable);
6. a list of all of ▇▇▇▇▇▇▇▇▇▇’▇ ’ locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which ▇▇▇▇▇ currently submits claims; and
7. a certification by ▇▇. ▇▇▇▇▇ currently submits claims;that: (a) he has reviewed the IA in its entirety, understands the requirements described within, and maintains a copy for reference; (b) to the best of his knowledge, except as otherwise described in the Implementation Report, ▇▇▇▇▇ is in compliance with all of the requirements of this IA; and (c) he has reviewed the Implementation Report and has made a reasonable inquiry regarding its content and believes that the information is accurate and truthful.
Appears in 1 contract
Sources: Integrity Agreement
Implementation Report. Within 90 days after the Effective Date, ▇▇▇▇▇▇▇▇▇▇ -JCA shall submit a written report to OIG summarizing the status of his its implementation of the requirements of this IA (Implementation Report). The Implementation Report shall, at a minimum, include:
1. a copy of the notice ▇▇▇▇▇▇▇▇▇▇ -JCA posted in his its office as required by Section III.A, a description of where the notice is posted, and the date the notice was posted;
2. the following information regarding the one hour of training required by Section III.B III.C to be completed within 60 days of the Effective Date: a copy of the training program registration for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request.
3. the following information regarding each IRO: (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this IA; (d) a summary and description of any and all current and prior engagements and agreements between ▇▇▇▇▇▇▇▇▇▇ - JCA and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Chatterjee▇▇▇▇▇-JCA;
4. the following information regarding the Independent Cardiology Consultant: (a) identity, address, and phone number; (b) a copy of the engagement letter, including a description of duties under the consulting agreement; (c) information to demonstrate that the Independent Cardiology Consultant has the expertise in utilization review and oversight of quality of care matters, and in the rules governing submission of claims to Federal health care programs for cardiology items and services; (d) a summary and description of any and all current and prior engagements and agreements between ▇▇▇▇▇-JCA and the Independent Cardiology Consultant; and (e) a certification from the Independent Cardiology Consultant regarding his/her professional independence and objectivity with respect to ▇▇▇▇▇-▇▇▇;
5. a copy of the documentation demonstrating that ▇▇▇▇▇▇▇▇▇▇ -JCA has screened all Covered Persons against the Exclusion Lists, as required by section III.E, within 30 days of the Effective Date; 5. a copy of any certifications from Chatterjee and the third party billing company required by Section III.I (if applicable);
6. a list of all of ▇▇▇▇▇▇▇▇▇▇’▇ locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which ▇▇▇▇▇▇▇▇▇▇ currently submits claims;
Appears in 1 contract
Sources: Integrity Agreement
Implementation Report. Within 90 days after the Effective Date, ▇▇▇▇▇▇▇▇▇▇ shall submit a written report to OIG summarizing the status of his its implementation of the requirements of this IA (Implementation Report). The Implementation Report shall, at a minimum, include:
1. a copy of the notice ▇▇▇▇▇▇▇▇▇▇ posted in his their office as required by Section III.A, a description of where the notice is posted, and the date the notice was posted;
2. the following information regarding the one hour of training required by Section III.B to be completed within 60 days of the Effective Date: a copy of the training program registration for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request.
3. the following information regarding each the IRO: (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this IA; (d) a summary and description of any and all current and prior engagements and agreements between ▇▇▇▇▇▇▇▇▇▇ and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Chatterjee▇▇▇▇▇;
4. a copy of the documentation demonstrating that ▇▇▇▇▇▇▇▇▇▇ has screened all Covered Persons against the Exclusion Lists, as required by section III.EIII.D, within 30 days of the Effective Date; 5. a copy of any certifications from Chatterjee ▇▇▇▇▇ and the third party billing company required by Section III.I III.H (if applicable);
6. a list of all of ▇▇▇▇▇▇▇▇▇▇’▇ locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which ▇▇▇▇▇ currently submits claims; and
7. a certification by ▇▇. ▇. Borio that: (a) he has reviewed the IA in its entirety, understands the requirements described within, and maintains a copy for reference; (b) to the best of his or her knowledge, except as otherwise described in the Implementation Report, ▇▇▇▇▇ currently submits claims;is in compliance with all of the requirements of this IA; and (c) he has reviewed the Implementation Report and has made a reasonable inquiry regarding its content and believes that the information is accurate and truthful.
Appears in 1 contract
Sources: Integrity Agreement
Implementation Report. Within 90 days after the Effective Date, ▇▇▇▇▇▇▇▇▇▇ shall submit a written report to OIG summarizing the status of his its implementation of the requirements of this IA (Implementation Report). The Implementation Report shall, at a minimum, include:
1. a copy of the notice ▇▇▇▇▇▇▇▇▇▇ posted in his office as required by Section III.A, a description of where the notice is posted, and the date the notice was posted;
2. the following information regarding the one hour of training required by Section III.B to be completed within 60 days of the Effective Date: a copy of the training program registration for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request.
3. the following information regarding each IRO: the IRO(s): (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this IA; (d) a summary and description of any and all current and prior engagements and agreements between ▇▇▇▇▇▇▇▇▇▇ Qin and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Chatterjee▇▇▇;
4. a copy of the documentation demonstrating that ▇▇▇▇▇▇▇▇▇▇ has screened all Covered Persons against the Exclusion Lists, as required by section III.EIII.D, within 30 days of the Effective Date; 5. a copy of any certifications from Chatterjee ▇▇▇ and the third party billing company required by Section III.I III.H (if applicable);
6. a list of all of ▇▇▇▇▇▇▇▇▇▇’▇ Qin’s locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which ▇▇▇▇▇▇▇▇▇▇ currently submits claims;; and
7. a certification by ▇▇▇ that: (a) he has reviewed the IA in its entirety, understands the requirements described within, and maintains a copy for reference; (b) to the best of his knowledge, except as otherwise described in the Implementation Report, Qin is in compliance with all of the requirements of this IA; and (c) he has reviewed the Implementation Report and has made a reasonable inquiry regarding its content and believes that the information is accurate and truthful.
Appears in 1 contract
Sources: Integrity Agreement
Implementation Report. Within 90 days after the Effective Date, ▇▇▇▇▇▇▇▇▇▇ GSCS shall submit a written report to OIG summarizing the status of his its implementation of the requirements of this IA (Implementation Report). The Implementation Report shall, at a minimum, include:
1. a copy of the notice ▇▇▇▇▇▇▇▇▇▇ GSCS posted in his office each of its locations as required by Section III.A, a description of where the notice is posted, and the date the notice was posted;
2. the following information regarding the one hour of training required by Section III.B to be completed within 60 days of the Effective Date: a copy of the training program registration for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request.
3. the following information regarding each the IRO: (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this IA; (d) a summary and description of any and all current and prior engagements and agreements between ▇▇▇▇▇▇▇▇▇▇ GSCS and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to ChatterjeeGSCS;
4. a copy of the documentation demonstrating that ▇▇▇▇▇▇▇▇▇▇ GSCS has screened all Covered Persons against the Exclusion Lists, as required by section III.EIII.D, within 30 days of the Effective Date; 5. a copy of any certifications from Chatterjee GSCS and the third party billing company required by Section III.I III.H (if applicable);
6. a list of all of ▇▇▇▇▇▇▇▇▇▇’▇ GSCS’s locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which ▇▇▇▇▇▇▇▇▇▇ GSCS currently submits claims;; and
7. a certification by GSCS that: (a) it has reviewed the IA in its entirety, understands the requirements described within, and maintains a copy for reference; (b) to the best of its knowledge, except as otherwise described in the Implementation Report, GSCS is in compliance with all of the requirements of this IA; and (c) it has reviewed the Implementation Report and has made a reasonable inquiry regarding its content and believes that the information is accurate and truthful.
Appears in 1 contract
Sources: Integrity Agreement