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FULL PACKET_2016-03-15
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FULL PACKET_2016-03-15
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3/15/2016 10:49:12 AM
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City Clerk
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Agenda Packet
Agency
Clerk of the Council
Date
3/15/2016
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I federal or state health care programs, and to further represent to CONTRACTOR that they do not have <br />2 any Ineligible Person in their employ or under contract. <br />3 5, Covered Individuals shall be required to disclose to CONTRACTOR immediately any <br />4 debarment, exclusion or other event that makes the Covered Individual an Ineligible Person, <br />5 CONTRACTOR shall notify ADMINISTRATOR immediately if a Covered Individual providing <br />6 services directly relative to this Agreement becomes debarred, excluded or otherwise becomes an <br />7 Ineligible Person. <br />8 6. CONTRACTOR acknowledges that Ineligible Persons are precluded from providing federal <br />9 and state funded health care services by contract with COUNTY in the event that they are currently <br />10 sanctioned or excluded by a federal or state law enforcement regulatory or licensing agency. If <br />II CONTRACTOR becomes aware that a Covered Individual has become an Ineligible Person, <br />12 CONTRACTOR shall remove such individual from responsibility for, or involvement with, COUNTY <br />13 business operations related to this Agreement. <br />14 7. CONTRACTOR shall notify ADMINISTRATOR immediately if a Covered Individual or <br />15 entity is currently excluded, suspended or debarred, or is identified as such after being sanction screened. <br />16 Such individual or entity shall be immediately removed from participating in any activity associated <br />17 with this Agreement. ADMINISTRATOR will determine appropriate repayment from, or sanction(s) to <br />18 CONTRACTOR for services provided by ineligible person or individual. CONTRACTOR shall <br />19 promptly return any overpayments within forty -five (45) business days after the overpayment is verified <br />20 by the ADMINISTRATOR. <br />21 C. COMPLIANCE TRAINING — ADMINISTRATOR shall make General Compliance Training <br />22 and Provider Compliance Training, where appropriate, available to Covered Individuals. <br />23 1. CONTRACTOR shall use its best efforts to encourage completion by Covered Individuals; <br />24 provided, however, that at a minimum CONTRACTOR shall assign at least one (1) designated <br />25 representative to complete all Compliance Trainings when offered. <br />26 2. Such training will be made available to Covered Individuals within thirty (30) calendar days <br />27 of employment or engagement. <br />28 3. Such training will be made available to each Covered Individual annually. <br />29 4. Each Covered Individual attending training shall certify, in writing, attendance at <br />30 compliance training. CONTRACTOR shall retain the certifications. Upon written request by <br />31 ADMINISTRATOR, CONTRACTOR shall provide copies of the certifications. <br />32 D. MEDICAL BILLING, CODING, AND DOCUMENTATION COMPLIANCE STANDARDS <br />33 1. CONTRACTOR shall take reasonable precaution to ensure that the coding of health care <br />34 claims, billings and/or invoices for same are prepared and submitted in an accurate and timely manner <br />35 and are consistent with federal, state and county laws and regulations. <br />36 2. CONTRACTOR shall not submit any false, fraudulent, inaccurate and/or fictitious claims <br />37 for payment or reimbursement of any kind. <br />8 of 25 <br />X'�CONTRACTS- 2015'2015- 2016PHTFFCU15SM1Ni yi*7s+5ANT3 <br />AN FY 15- 16CA.Doc SAN15PHKKI6 <br />
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