Common use of Imposition of Sanctions Clause in Contracts

Imposition of Sanctions. As specified in Michigan Mental Health Code: 330.1232b Specialty Prepaid Health Plans, “the MDCH may invoke sanctions if it makes a determination that a specialty prepaid health plan is not in substantial compliance with promulgated standards and with established federal regulations, that the specialty prepaid health plan has misrepresented or falsified information reported to the state or to the federal government, or that the specialty prepaid health plan has failed substantially to provide necessary covered services to recipients under the terms of the contract. Sanctions may include intermediate actions including, but not limited to, a monetary penalty imposed on the administrative and management operation of the specialty prepaid health plan, imposition of temporary state management of a community mental health services program operating as a specialty prepaid health plan, or termination of the department's Medicaid managed care contract with the community mental health services program. Before imposing a sanction on a community mental health services program that is operating as a specialty prepaid health plan, the department shall provide that specialty prepaid health plan with timely written notice that explains both of the following: a) The basis and nature of the sanction. b) The opportunity for a hearing to contest or dispute the department's findings and intended sanction, prior to the imposition of the sanction. A hearing under this section is subject to the provisions governing a contested case under the Administrative Procedures Act of 1969, 1969 PA 306, MCL

Imposition of Sanctions. As specified in Michigan Mental Health Code: 330.1232b Specialty Prepaid Health Plans, “the MDCH may invoke sanctions if it makes a determination that a specialty prepaid health plan is not in substantial compliance with promulgated standards and with established federal regulations, that the specialty prepaid health plan has misrepresented or falsified information reported to the state or to the federal government, or that the specialty prepaid health plan has failed substantially to provide necessary covered services to recipients under the terms of the contract. Sanctions may include intermediate actions including, but not limited to, a monetary penalty imposed on the administrative and management operation of the specialty prepaid health plan, imposition of temporary state management of a community mental health services program operating as a specialty prepaid health plan, or termination of the department's Medicaid managed care contract with the community mental health services program. Before imposing a sanction on a community mental health services program that is operating as a specialty prepaid health plan, the department shall provide that specialty prepaid health plan with timely written notice that explains both of the following: a) The basis and nature of the sanction. b) The opportunity for a hearing to contest or dispute the department's findings and intended sanction, prior to the imposition of the sanction. A hearing under this section is subject to the provisions governing a contested case under the Administrative Procedures Act of 1969, 1969 PA 306, MCLMCL 24.201 to 24.328, unless otherwise agreed to in the specialty prepaid health plan contract.”

Imposition of Sanctions. As specified in Michigan Mental Health Code: 330.1232b Specialty Prepaid Inpatient Health Plans, “the MDCH may invoke sanctions if it makes a determination that a specialty prepaid inpatient health plan is not in substantial compliance with promulgated standards and with established federal regulations, that the specialty prepaid inpatient health plan has misrepresented or falsified information reported to the state or to the federal government, or that the specialty prepaid inpatient health plan has failed substantially to provide necessary covered services to recipients under the terms of the contract. Sanctions may include intermediate actions including, but not limited to, a monetary penalty imposed on the administrative and management operation of the specialty prepaid inpatient health plan, imposition of temporary state management of a community mental health services program operating as a specialty prepaid inpatient health plan, or termination of the department's Medicaid managed care contract with the community mental health services programcontract. Before imposing a sanction on a community mental health services program that is operating as a specialty prepaid inpatient health plan, the department shall provide that specialty prepaid inpatient health plan with timely written notice that explains both of the following: a) a. The basis and nature of the sanction. b) b. The opportunity for a hearing to contest or dispute the department's findings and intended sanction, prior to the imposition of the sanction. A hearing under this section is subject to the provisions governing a contested case under the Administrative Procedures Act of 1969, 1969 PA 306, MCLMCL 24.201 to 24.328, unless otherwise agreed to in the specialty prepaid health plan contract.”