Provider Qualifications and Performance Clause Samples

Provider Qualifications and Performance. 2.7.2.1. Written Provider Protocols: The Contractor must have written protocols in the following areas: 2.7.2.1.1. Credentialing, re-credentialing, certification, and performance appraisal processes that demonstrate that all members of the Provider Network maintain current knowledge, ability, and expertise in the service or specialty in which they practice. Providers must meet board certification, continuing education, and other requirements, as appropriate. The Contractor shall demonstrate to CMS and EOHHS, by reporting annually that all providers within the Contractor‘s Provider/Pharmacy Network are credentialed according to Section 2.8.3 of the Contract. The protocol must also include: Enrollee Complaints and Appeals; results of quality reviews; utilization management information; and Enrollee surveys; 2.7.2.1. 2. Practice guidelines, in accordance with 42 C.F.R. § 438.236 and 42 C.F.R. § 422.202(b);
View SourceView Similar (6)
Provider Qualifications and Performance. 2.9.9.1. All Network Providers of Covered Services must be qualified in accordance with current applicable legal, professional, and technical standards and appropriately licensed, certified or registered. All providers must have good standing in the Medicare and Medi-Cal programs and a valid NPI number, as applicable. Providers that have been terminated from or suspended either Medicare or Medi-Cal cannot participate in Contractor’s Provider Network. 2.9.9.1.1. Contractor is responsible for the oversight of all Network Providers delivering non-Covered Services (e.g., CPO Services).
View SourceView Similar (3)
Provider Qualifications and Performance. Written Provider Protocols: The Contractor must have written protocols in the following areas:
View Source
Provider Qualifications and Performance. 1. Written Provider Protocols The Contractor must have and comply with written protocols in the following areas: a. Credentialing, re-credentialing, certification, and performance appraisal processes that demonstrate that all members of the Provider Network maintain current knowledge, ability, and expertise in the service or specialty in which they practice. Providers must meet board certification, continuing education, and other requirements, as appropriate, including 42 CFR 493.1 and 493.
View Source
Provider Qualifications and Performance 
View SourceView Similar (5)

Related to Provider Qualifications and Performance

  • STAFF QUALIFICATIONS a) CONTRACTOR shall ensure that all individuals employed, contracted, and/or otherwise hired by CONTRACTOR to provide classroom and/or individualized instruction or related services hold a license, certificate, permit, or other document equivalent to that which staff in a public school are required to hold in the service rendered consistent with Education Code section 56366.1(n)(1) and are qualified pursuant to Title 5 of the California Code of Regulations sections 3064 and 3065. b) Only those NPS/A located outside of California that employ staff that hold a current valid credential or license to render special education and related services as required by that state shall be eligible to be certified. NPA/NPS staff shall be required to hold credentials and licenses within the state where they are providing services regardless of where the agency is located. c) When CONTRACTOR is a nonpublic school, NPS, an appropriately qualified person shall serve as curricular and instructional leader, and be able to provide leadership, oversight and professional development. The administrator of the NPS holds or is in the process of obtaining one of the following: (A) An administrative credential granted by an accredited postsecondary educational institution and two years of experience with pupils with disabilities.

  • Contractor Qualifications Contractor warrants that Contractor has the necessary licenses, experience and technical skills to provide services under this Contract.

  • Professional Qualifications It shall be a condition of continued professional employment that employees must apply for enrolment in their appropriate professional licensing body by the thirtieth day of continuous service.

  • Insurer Qualifications Without limiting any obligations or liabilities of the Professional, the Professional shall purchase and maintain, at its own expense, hereinafter stipulated minimum insurance with insurance companies authorized to do business in the State of Texas with an A.M. Best, Inc. rating of A- VII or above with policies and forms satisfactory to NBU. Failure to maintain insurance as specified herein may result in termination of this Agreement at NBU’s option.

  • Personnel Qualifications Contractor shall assign properly qualified and experienced personnel to the program contemplated under this Agreement, and Contractor shall use reasonable efforts to retain such personnel on Customer’s program for the duration of such program.