Non-Inclusion of Providers Clause Samples

Non-Inclusion of Providers. (A) The Contractor shall report to the Department when a Provider is denied Network Provider status. Such denial can include when a Provider is denied admission to the Contractor’s provider panel, is removed from the Contractor’s panel, or voluntarily withdraws from the panel when the denial, removal, or withdrawal is due to a substantive issue. Substantive issues include violations of DOPL regulations, and allegations of Fraud, Waste or Abuse. (B) The Contractor shall electronically submit information relating to the non- inclusion of Providers to the Department within 30 calendar days of the non- inclusion action using the Department-specified form. (C) The Contractor shall not report non-inclusion of Providers when due to non- substantive issues. Non-substantive issues include instances where the Provider fails to complete the credentialing process or the Contractor has sufficient network capacity.
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Non-Inclusion of Providers. (A) The Contractor shall report to the Department when a Provider is denied Network Provider
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Non-Inclusion of Providers. The Contractor shall report to the Department when a Provider has been denied admission to the Contractor’s Provider Panel, has been removed from the Contractor’s Provider Panel, or voluntarily withdraws from the panel for substantive issues. Substantive issues include suspension or termination of licensure by the Department of Occupational and Professional Licensing (DOPL), violations of DOPL’s laws, sanctioning, debarment, exclusion, fraud, abuse, quality of care concerns, etc. Non-substantive issues include the provider failing to complete the credentialing process, etc.
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Related to Non-Inclusion of Providers

  • Reliance on Third Party Service Providers Each Party may allow Reporting Financial Institutions to use third party service providers to fulfill the obligations imposed on such Reporting Financial Institutions by a Party, as contemplated in this Agreement, but these obligations shall remain the responsibility of the Reporting Financial Institutions.

  • Incorporation of Provisions The contractor will include the provisions of paragraphs one through six in every subcontract, including procurements of materials and leases of equipment, unless exempt by the Acts, the Regulations and directives issued pursuant thereto. The contractor will take action with respect to any subcontract or procurement as the sponsor or the Federal Aviation Administration may direct as a means of enforcing such provisions including sanctions for noncompliance. Provided, that if the contractor becomes involved in, or is threatened with litigation by a subcontractor, or supplier because of such direction, the contractor may request the sponsor to enter into any litigation to protect the interests of the sponsor. In addition, the contractor may request the United States to enter into the litigation to protect the interests of the United States.