ORANGE, COUNTY OF (9) - 2010 - Laserfiche WebLink

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1 3. CONTRACTOR shall screen all current Covered Individuals and subcontractors to ensure 2 that they have not become Ineligible Persons. CONTRACTOR shall also request that its subcontractors 3 use their best efforts to verify that they are eligible to participate in all federal and State of California 4 health programs and have not been excluded or debarred from participation in any federal or state health 5 care programs, and to further represent to CONTRACTOR that they do not have any Ineligible Person in 6 their employ or under contract. 7 4. Covered Individuals shall be required to disclose to CONTRACTOR immediately any 8 debarment, exclusion or other event that makes the Covered Individual an Ineligible Person. 9 CONTRACTOR shall notify ADMINISTRATOR immediately upon such disclosure. 10 5. CONTRACTOR acknowledges that Ineligible Persons are precluded from providing federal 11 and state funded health care services by contract with COUNTY in the event that they are currently 12 sanctioned or excluded by a federal or state law enforcement regulatory or licensing agency. If 13 CONTRACTOR becomes aware that a Covered Individual has become an Ineligible Person, 14 CONTRACTOR shall remove such individual from responsibility for, or involvement with, COUNTY 15 business operations related to this Agreement. 16 6. CONTRACTOR shall notify ADMINISTRATOR immediately if a Covered Individual or 17 entity is currently excluded, suspended or debarred, or is identified as such after being sanction screened. 18 Such individual or entity shall be immediately removed from participating in any activity associated 19 with this AGREEMENT. ADMINISTRATOR will determine if any repayment is necessary from 20 CONTRACTOR for services provided by ineligible person or individual. 21 D. REIMBURSEMENT STANDARDS 22 1. CONTRACTOR shall take reasonable precaution to ensure that the coding of health care 23 claims, billings and/or invoices for same are prepared and submitted in an accurate and timely manner 24 and are consistent with federal, state and county laws and regulations. 25 2. CONTRACTOR shall submit no false, fraudulent, inaccurate or fictitious claims for 26 payment or reimbursement of any kind. 27 3. CONTRACTOR shall bill only for those eligible services actually rendered which are also 28 fully documented. When such services are coded, CONTRACTOR shall use accurate billing codes to 29 accurately describe the services provided and to ensure compliance with all billing and documentation 30 requirements. 31 4. CONTRACTOR shall act promptly to investigate and correct any problems or errors in 32 coding of claims and billing, if and when, any such problems or errors are identified. 33 E. COMPLIANCE TRAINING - ADMINISTRATOR shall make General Compliance Training 34 and Provider Compliance Training, where appropriate, available to Covered Individuals. 35 1. CONTRACTOR shall use its best efforts to encourage completion by Covered Individuals; 36 provided, however, that at a minimum CONTRACTOR shall assign at least one (1) designated 37 representative to complete all Compliance Trainings when offered. CITY OF SANTA ANA 6 of 17 X:\CONTRACTS - 201 0-\2010-201 1 \MIHS\POE)- PLAN-MASTER-1 0- 1 1 -BG.Doc SAN 13-MAPODOI MIKKI 1