Ineligible entities. Neither PBM nor any of its subcontractors may be: i. Entities convicted of a criminal offense related to delivery of Title XVIII, T-XIX, or T-XXI services. ii. Entities convicted of payment abuse. iii. Entities convicted of fraud or other financial misconduct. iv. Entities convicted of obstructing an investigation. v. Entities convicted of offenses relating to controlled substances. vi. Entities terminated from the T-XIX Program. vii. Entities terminated from the T-XXI Program. viii. Entities that meet the following criteria: • An individual who is debarred, suspended, or otherwise excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non-procurement activities under regulations issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549. • An individual who is an affiliate, as defined in the Federal Acquisition Regulation, of a person described in paragraph (a)(1). The relationship is described as follows: • A director, officer, or partner of the MCO, PCCM, PIHP, PAHP • A person with beneficial ownership of five percent or more of the MCO’s, PCCM’s, PIHP’s or PAHP’s equity. • A person with an employment, consulting or other arrangement with the MCO, PCCM, PIHP, or PAHP obligations under its contract with the State. Please refer to the Federal Debarment List located at ▇▇▇.▇▇▇▇.▇▇▇▇▇.▇▇▇ for a listing of federally debarred and suspended individuals.
Appears in 2 contracts
Sources: Pharmacy Benefit Management Services Agreement, Pharmacy Benefit Management Services Agreement (Express Scripts Inc)