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1 <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />9 <br />10 <br />11 <br />12 <br />13 <br />14 <br />15 <br />16 <br />17 <br />18 <br />19 <br />20 <br />21 <br />22 <br />23 <br />24 <br />25 <br />26 <br />27 <br />28 <br />29 <br />30 <br />31 <br />32 <br />33 <br />34 <br />35 <br />36 <br />37 <br />3. CONTRACTOR shall screen all current Covered Individuals and subcontractors to ensure <br />that they have not become Ineligible Persons. CONTRACTOR shall also request that its subcontractors <br />use their best efforts to verify that they are eligible to participate in all federal and State of California <br />health programs and have not been excluded or debarred from participation in any federal or state health <br />care programs, and to further represent to CONTRACTOR that they do not have any Ineligible Person in <br />their employ or under contract. <br />4. Covered Individuals shall be required to disclose to CONTRACTOR immediately any <br />debarment, exclusion or other event that makes the Covered Individual an Ineligible Person. <br />CONTRACTOR shall notify ADMINISTRATOR immediately upon such disclosure. <br />5. CONTRACTOR acknowledges that Ineligible Persons are precluded from providing federal <br />and state funded health care services by contract with COUNTY in the event that they are currently <br />sanctioned or excluded by a federal or state law enforcement regulatory or licensing agency. If <br />CONTRACTOR becomes aware that a Covered Individual has become an Ineligible Person, <br />CONTRACTOR shall remove such individual from responsibility for, or involvement with, COUNTY <br />business operations related to this Agreement. <br />6. CONTRACTOR shall notify ADMINISTRATOR immediately if a Covered Individual or <br />entity is currently excluded, suspended or debarred, or is identified as such after being sanction screened. <br />Such individual or entity shall be immediately removed from participating in any activity associated <br />with this AGREEMENT. ADMINISTRATOR will determine if any repayment is necessary from <br />CONTRACTOR for services provided by ineligible person or individual. <br />D. REIMBURSEMENT STANDARDS <br />1. CONTRACTOR shall take reasonable precaution to ensure that the coding of health care <br />claims, billings and/or invoices for same are prepared and submitted in an accurate and timely manner <br />and are consistent with federal, state and county laws and regulations. <br />2. CONTRACTOR shall submit no false, fraudulent, inaccurate or fictitious claims for <br />payment or reimbursement of any kind. <br />3. CONTRACTOR shall bill only for those eligible services actually rendered which are also <br />fully documented. When such services are coded, CONTRACTOR shall use accurate billing codes to <br />accurately describe the services provided and to ensure compliance with all billing and documentation <br />requirements. <br />4. CONTRACTOR shall act promptly to investigate and correct any problems or errors in <br />coding of claims and billing, if and when, any such problems or errors are identified. <br />E. COMPLIANCE TRAINING -ADMINISTRATOR shall make General Compliance Training <br />and Provider Compliance Training, where appropriate, available to Covered Individuals. <br />1. CONTRACTOR shall use its best efforts to encourage completion by Covered Individuals; <br />provided, however, that at a minimum CONTRACTOR shall assign at least one (1) designated <br />representative to complete all Compliance Trainings when offered. <br />C1TY OF SANTA ANA 6 of 1 7 <br />X:\CONTRACTS - 20 I O-\2.010-201 5\MIHS\POD-EQUIV-MASTER-10-15-BG.?oc SAN 14-MAPOD03 MIKK 1 5