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Asuris and KCPHD Agreement
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2018-06-05 10:00 AM - Commissioners' Agenda
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Asuris and KCPHD Agreement
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Last modified
5/31/2018 1:16:16 PM
Creation date
5/31/2018 1:14:19 PM
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Meeting
Date
6/5/2018
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Alpha Order
k
Item
Request to Approve an Agreement between Asuris Northwest Health and the Kittitas County Public Health Department
Order
11
Placement
Consent Agenda
Row ID
45299
Type
Agreement
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6. Enforcement of Disciplinary Standards: FDR agrees to establish and publish its own disciplinary <br />standards, which include its expectation that employees report compliance issues and unethical or <br />illegal behavior. FDR's disciplinary standards must state that any violation of these standards will <br />result in appropriate disciplinary action, up to and including termination of employment. FDR's <br />violation of this provision may result in Asuris's termination of the Agreement. 42 C.F.R. §§ <br />422.503(b)(4)(vi)(E) and 423.504(b)(4)(vi)(E). <br />OIG Exclusion 1 GSA Debarment: Pursuant to Federal law, FDR certifies that neither it nor any of its <br />employees or governing body members are on: (a) the List of Excluded Individuals and Entities <br />("LEIE") from the HHS Office of Inspector General ("OIG"); and (b) the General Services <br />Administration ("GSA") Debarment List. If an employee or governing body member is on either list, <br />FDR will immediately remove that person from any work related directly or indirectly to any Federal <br />healthcare program. FDR agrees to check both lists prior to hire and on a monthly basis to ensure <br />that none of its employees have become excluded from participation in Federal programs. The term <br />"employees" includes temporary employees, volunteers, and consultants. If applicable, FDR will <br />establish a process to identify and prevent payment for claims at point-of-sale for any drugs or <br />services prescribed, dispensed or delivered by excluded providers. 42 C.F.R. §§ 422.503(b)(4)(vi)(F), <br />422.752(a)(8), 423.504(b)(4)(vi)(F), 423.752(a)(6); and 42 C.F.R. § 1001.1901. <br />8. Record Retention and Audit Rights: FDR agrees to retain any books, contracts, records, and <br />documents related to Asuris's contract with CMS for a period of ten (10) years from the final date of <br />the contract period or the completion of any audit, whichever is later. FDR agrees to comply with any <br />document requests by Asuris pursuant to an audit or to monitor FDR's compliance with the terms of <br />this Agreement or Compliance Addendum. FDR will provide these documents to Asuris without <br />charge. 42 C.F.R. §§ 422.504(d), 422.504(e), 422.504(i)(4)(iii), 423.504(d)(2), 423.505(i)(4)(iii). <br />HHS Audit Rights: FDR agrees to allow HHS, the Comptroller General, or their designees to audit <br />and inspect any books, contracts, computer or other electronic systems, including medical records <br />and documentation, related to Asuris's contract with CMS. This right to audit and inspect any <br />pertinent information for any particular contract period will exist through ten (10) years, from the final <br />date of the contract period or from the date of completion of any audit, whichever is later. 42 C.F.R §§ <br />422.504(i)(2) and 423.505(i)(2). FDR's failure to comply with this section could result in referral to law <br />enforcement and/or implementation of corrective action. 42 C.F.R. Subpart O. <br />10. Enrollee Protections: FDR agrees that it will not hold any of Asuris's Medicare enrollees liable for the <br />payment of any fees that are the legal obligation of Asuris. Asuris agrees to indemnify its Medicare <br />enrollees for the payment of any fees that are the legal obligation of Asuris for services furnished by <br />providers who do not contract, or who have not entered into an agreement with Asuris, to provide <br />services to Asuris's members. For Asuris's Medicare enrollees that are hospitalized as of the <br />termination date of Asuris's agreement with CMS, FDR will continue to provide covered services <br />through such enrollee's date of discharge. 42 C.F.R §§ 422.504(g), 422.504(i)(3)(i), and 423.505(8). <br />11. Credentialinn : Asuris will either (a) review the credentials of medical professionals affiliated with FDR; <br />or (b) review and approve a credentialing process, which Asuris may audit on an ongoing basis. 42 <br />C.F.R § 422.504(i)(4)(iv). <br />12. Accountability Provisions: Asuris agrees that it may only delegate functions to FDRs in a manner <br />consistent with 42 C.F.R §§ 422.504(i)(3)(ii), 422.504(1)(4), 423.505(i)(3)(ii), and 423.505(1)(4). <br />13. Monitoring and Termination: Asuris will monitor FDR's performance under the Agreement on an <br />ongoing basis. Asuris has the option to terminate the Agreement with FDR if CMS or Asuris <br />determines that FDR has (a) not performed satisfactorily under the terms of the Agreement or <br />Compliance Addendum, (b) failed to maintain compliance, or (c) engaged in FWA. 42 C.F.R §§ <br />422.504(i)(4)(ii), 423.505(i)(4)(ii), and 423.505(i)(4)(iii). <br />14. Flow -Down Provision: FDR shall incorporate the terms of this Compliance Addendum into any and all <br />subcontracts entered into delegating any of FDR's obligations to Asuris under the Agreement or <br />Compliance Addendum. 42 C.F.R §§ 422.504 (1)(3),422.504 (i)(4)(v) 423.505 (i)(3)(iii), and <br />423.505(i)(4). <br />15. Confidentiality and Accuracy of Records: FDR shall comply with the applicable confidentiality and <br />enrollee accuracy requirements, including: (a) all applicable Federal and State laws regarding <br />Asuris MA Compliance Addendum 10/2016 A18816854AA Page 2 of 3 <br />
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