47. AMOUNT OF PERFORMANCE BOND
63
48. ACCUMULATED FUND DEFICIT
63
49. ADVANCES, DISTRIBUTIONS, LOANS AND INVESTMENTS
63
50. FINANCIAL VIABILITY STANDARDS / PERFORMANCE GUIDELINES
63
51. SEPARATE INCORPORATION
64
52. MERGER, REORGANIZATION AND CHANGE OF OWNERSHIP
65
53. COMPENSATION
65
54. PAYMENTS TO CONTRACTORS
66
55. CAPITATION ADJUSTMENTS
67
56. INCENTIVES
67
57. REINSURANCE
68
58. COORDINATION OF BENEFITS / THIRD PARTY LIABILITY
71
59. COPAYMENTS
74
60. MEDICARE SERVICES AND COST SHARING
74
61. MARKETING
75
62. CORPORATE COMPLIANCE
75
63. RECORDS RETENTION
76
64. DATA EXCHANGE REQUIREMENTS
77
65. ENCOUNTER DATA REPORTING
77
66. ENROLLMENT AND CAPITATION TRANSACTION UPDATES
78
67. PERIODIC REPORT REQUIREMENTS
79
68. REQUESTS FOR INFORMATION
79
69. DISSEMINATION OF INFORMATION
79
70. OPERATIONAL AND FINANCIAL READINESS REVIEWS
79
71. OPERATIONAL AND FINANCIAL REVIEWS
80
72. SANCTIONS
80
73. BUSINESS CONTINUITY AND RECOVERY PLAN
81
74. TECHNOLOGICAL ADVANCEMENT
82
75. PENDING LEGISLATIVE / OTHER ISSUES
83
76. BALANCED BUDGET ACT OF 1997 (BBA)
83
77. RESERVED
83
78. MEDICARE MODERNIZATION ACT (MMA)
83
SECTION E: CONTRACT CLAUSES
85
1) APPLICABLE LAW
85
2) AUTHORITY
85
3) ORDER OF PRECEDENCE
85
4) CONTRACT INTERPRETATION AND AMENDMENT
85
5) SEVERABILITY
85
6) RELATIONSHIP OF PARTIES
85
7) ASSIGNMENT AND DELEGATION
85
8} INDEMNIFICATION
85
9) INDEMNIFICATION - PATENT AND COPYRIGHT
86
10) COMPLIANCE WITH APPLICABLE LAWS, RULES AND REGULATIONS
86
11) ADVERTISING AND PROMOTION OF CONTRACT
86
12) PROPERTY OF THE STATE
86
13) THIRD PARTY ANTITRUST VIOLATIONS
86
14) RIGHT TO ASSURANCE
86
15) TERMINATION FOR CONFLICT OF INTEREST
87
16) GRATUITIES
87
17) SUSPENSION OR DEBARMENT
87
18) TERMINATION FOR CONVENIENCE
87
- 3 -
CYE '07 Acute Care Renewal
Final
August 16, 2006
TABLE OF CONTENTS
Contract/RFP No. YH04-0001
19) TEMPORARY MANAGEMENT/OPERATION OF A CONTRACTOR AND TERMINATION
87
20) TERMINATION -AVAILABILITY OF FUNDS
88
21) RIGHT OF OFFSET
88
22) NON-EXCLUSIVE REMEDIES
88
23) NON-DISCRIMINATION
89
24) EFFECTIVE DATE
89
25) INSURANCE
89
26) DISPUTES
89
27) RIGHT TO INSPECT PLANT OR PLACE OF BUSINESS
90
28) INCORPORATION BY REFERENCE
90
29) COVENANT AGAINST CONTINGENT FEES
90
30) CHANGES
90
31) TYPE OF CONTRACT
90
32) AMERICANS WITH DISABILITIES ACT
90
33) WARRANTY OF SERVICES
90
34) NO GUARANTEED QUANTITIES
90
35) CONFLICT OF INTEREST
90
36) DISCLOSURE OF CONFIDENTIAL INFORMATION
91
37) COOPERATION WITH OTHER CONTRACTORS
91
38) ASSIGNMENT OF CONTRACT AND BANKRUPTCY
91
39) OWNERSHIP OF INFORMATION AND DATA
91
40) AHCCCSA RIGHT TO OPERATE CONTRACTOR
91
41) AUDITS AND INSPECTIONS
92
42) LOBBYING
92
43) CHOICE OF FORUM
92
44) DATA CERTIFICATION
92
45) OFF SHORE PERFORMANCE OF WORK PROHIBITED
92
46) FEDERAL IMMIGRATION AND NATIONALITY ACT
93
47) IRS W-9 FORM
93
48) CONTINUATION OF PERFORMANCE THROUGH TERMINATION
93
SECTION F: INDEX - PROGRAM REQUIREMENTS AND CONTRACT CLAUSES
94
ATTACHMENT A: MINIMUM SUBCONTRACT PROVISIONS
97
1. ASSIGNMENT AND DELEGATION OF RIGHTS AND RESPONSIBILITIES
97
2. AWARDS OF OTHER SUBCONTRACTS
97
3. CERTIFICATION OF COMPLIANCE - ANTI-KICKBACK AND LABORATORY TESTING
97
4. CERTIFICATION OF TRUTHFULNESS OF REPRESENTATION
97
5. CLINICAL