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DocuSign Envelope ID: 78CDD188-656B-44E9-9F46-9AFBF222884F <br />V) Review all claimed costs prior to issuing reimbursement to ensure they are <br />allowable, reasonable, and are supported by documentation that is sufficiently <br />detailed to permit HCA, CMS, or others to determine whether the costs are <br />necessary for the proper and efficient administration of the state plan. This includes <br />but is not limited to; source documentation of staff costs, operating expenses, and <br />subcontracted vendor costs. <br />vi) Review the RMTS Consortia organization and membership, including the Lead <br />Agency identified, annually and issuing an official notice of approval or denial. The <br />Contractor is prohibited from participating in a Consortium without express, written <br />approval of the Consortia organization and membership; <br />vii) Review all MAC related training materials prior to their use in the MAC program - <br />and issuing an official notice of approval or denial. This includes multimedia video, <br />audio, digital or other electronic sources, and paper based training materials. The <br />Contractor is prohibited from using any training materials without express, written <br />approval from HCA; <br />viii) Evaluate RMTS and claiming data prior to issuing quarterly reimbursements to <br />ensure the RMTS results and claimed costs are appropriate according to all <br />applicable laws, Regulations and guidelines specific to the MAC program. This <br />evaluation will also be used to identify trends, best practices for the MAC program, <br />quality assurance, training needs, areas in need of improvement, or other concerns <br />related to the MAC program and HCA's oversight responsibilities; <br />ix) Issue corrective action plans as necessary and determined by HCA's oversight <br />capacity that includes but is not limited to, quarterly reviews of RMTS and claiming <br />data, the Contractor's failure to be in compliance with all applicable laws, <br />Regulations and guidelines specific to the MAC program and this Agreement, or <br />other quality assurance needs. The Contractor is required to comply with any <br />corrective action plan issued. Failure to do so will result in sanctions that may <br />include, but is not limited to, reduced reimbursement and/or termination of this <br />Agreement; and <br />x) Produce and update the CAP, manual , contracts, training materials, or other MAC <br />related documentation as needed and make it available to the Contractor. <br />4. MINIMUM RESPONSE RATE AND NON-RESPONSES <br />Non-responses are moments not completed by Participant within five (5) business days, with <br />the exception of expired moments where the Participant was on paid or unpaid leave. The <br />return rate of valid responses for the RMTS must be a minimum of eighty five percent (85%). <br />The following remedial action is required of the Contractor if the RMTS response rate drops <br />below eighty five percent (85%). <br />a) Non-response rates greater than fifteen percent (15%): <br />i) HCA will send written notification to the Contractor requesting a Corrective Action <br />Plan to ensure a minimum eighty five percent (85%) compliance rate for the RMTS <br />is achieved in subsequent quarters. <br />ii) The Contractor must develop and submit the plan to HCA for approval within thirty <br />(30) calendar days of HCA's notification. <br />State of Washington <br />Health Care Authority <br />Page 32 of 42 HCA Contract No. K1407-1