Common use of Liability for Payment Clause in Contracts

Liability for Payment. (42 CFR §438.106). i. The Contractor shall ensure that its beneficiaries are not held liable for any of the following: a. The Contractor’s debts, in the event of the entity’s insolvency. b. Covered services provided to the beneficiary, for which: i. The state does not pay the Contractor; or ii. The Contractor or the Department does not pay the individual or health care provider that furnished the services under a contractual, referral, or other arrangement. c. Payments for covered services furnished under a contract, referral, or other arrangement, to the extent that those payments are in excess of the amount that the beneficiary would owe if the Contractor covered the services directly.