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DocuSig n Envelope ID: 78CDD188-656B-44 E9-9F46-9AFBF222884F <br />(1) The RMTS and Fiscal Coordinator roles may be assumed by one individual if <br />desired . <br />(2) The Contractor must submit contact informat ion to the HCA Contract <br />Manager for each co ordinator. including the ir assigned role . name , teleph one <br />number, fax number , e mail , and address prior to participation in the MAC <br />program , w ithin seve n (7) ca lendar days of the change. <br />(3) The Coordinators must participate in the monthly statewide coordinator <br />conference calls. <br />(4) The Coordinators must participate in any scheduled RMTS consortium <br />conference calls . <br />(5) The Coordinators must ensure federal, state , and HCA MAC policies are <br />implemented . <br />(6) The Contractor must ensure the Coordinators accurately perform all <br />responsibilities listed in the CAP, Manual, and this Agreement. <br />iii) Certify all data entered into the System is true and accurate, and based on actual <br />expenditures incurred during the period of performance of the invoice. This <br />certification must be maintained within the System. This includes , but is not limited <br />to : calendaring, Staff/Participant lists, salary and benefits, direct charges or other <br />claimed costs, indirect rate, MER and any other data used to generate a claim to <br />HCA for reimbursement; <br />iv) Verify all data that is determined necessary to be stored electronically within the <br />System or other associated websites, or databases as described in the CAP , <br />Manual and this Agreement is physically entered and stored according to the SOS <br />Retention Schedule. This data includes , but is not limited to : calendaring, <br />Staff/Participant lists, salary and benefits, direct charges or other claimed costs, <br />indirect rate , MER and any other data used to generate a claim to HCA for <br />reimbursement; <br />v) Prepare an annual MER proposal to include the MER calculation and formula, the <br />data sources used to determine the MER , the data collection process, the <br />Contractor's monitoring process to ensure accuracy of the MER and any other <br />relevant information ; <br />(1) The proposal must be submitted to HCA no later than December first of each <br />year <br />(2) The proposal must be updated and re-submitted if the data source or <br />collection , calculations , or monitoring changes thirty (30) calendar days prior <br />to the change. <br />vi) Submit a quarterly MER certification with each invoice validating the accuracy of <br />the MER (this certification may be maintained in the System); <br />vii) Submit a quarterly CPE certification identifying the revenue account codes as <br />found in the BARS manual with each invoice validating the accuracy of the CPE; <br />State of Wash ington <br />Health Care Authority <br />Page 29 of 42 HCA Contract No. K1407-1