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6. IDl!2t~n:Le,U_g_LQ!i~lRlilliID._filanc;Lal31!: FDR agrees to establish and publish its own disciplinary
<br />alandards , wh ch include its e,cpectation that employees report compliance issues and uneth ical or
<br />Illegal behavior. FDR's disciplinary standards must state that any violation of these standards will
<br />result in appropria te dlsc!i:illnary aclion, 1,1p to and ll'clvdlng term in ation of employmi\tnt. FDR's
<br />violation of th s proviislon may result In As.uris's termination of the Agreement . 42 C.F .R. §§
<br />422-503(b)(4)(vi)(E) and 423.504(b)(4)(\/i)(E).
<br />7 9IG E!!P.!Ja!Q.IJ-/ G A Oebann~nl'. Pursuant to Federal law, FDR certifies that nellher it nor any of its
<br />ernployees or govern ing body members are on: (11) the List of exclU<led Individ ual~ and Enlilles
<br />("LEIE") from lhe I !HS Office of Inspector General ("OIG")i and {b) lhe General Services
<br />Administration ("GS A') Debarment Li si . If an employee or governing bo.dy membe r is on either fist,
<br />FOR wm Immedia tely remove tl\at person from any work rela~d directly-ot l ndl recUy to any Federal
<br />hea lthcare program . FDR agrees-lo clieek oo.tll lists pr 9r to hire and on a monthly basis to ensu re
<br />that none of (ts employees have become excluded from participation in Fede ral programs. The term
<br />"employ.ees ' includes temporary employees , volunteers , and consultants . If applicable. FD R will
<br />eslabllsh a process to ldenUfy and _prevent payment ro~ clalrn.s al po l nt-of-5ale fo~ any drugi; o.r
<br />.sei'vicl:!S i:)tescrlbed , dispensed or delivered by excluded providers. 42 C.F.R. §§ 422 .503(b)(4){vf)(F),
<br />422.752(a}(B), 423.504(b)(4)(vi)(F), 423 .752(a)(6); and 42 C.F.R. § 1001.1901.
<br />8. Record Retenjlol'land Audjl]lighls : FDR agrees to retain any books, contracts, records, and
<br />documents related to Asuris's wntract with CMS ror a period of ten (10) years from the final date of
<br />the contract period or the ~ompletion of any audit, whichever Is later. FDR a.9rees io comply with any
<br />document requests by Asuri& pursuant to an aud it or to monitor FDR's compllance 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 />9. !:!l:!.S--1ll!QIL~!l\ll: 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 (1 O) years, from the final
<br />date of the contract period or from the date of completion or any audit, whictiever is later. 42 C.F .R §§
<br />422.504(1)(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 0.
<br />10. Enroll _Pr9tectio1J..~: 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. Asurls agrees to Indemnify its Medicare
<br />e~lees for the pay.men I of any fee.8 that are the legal obligation of Asuris for serv ices furnished by
<br />provldem 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 or the
<br />termination date of AsurJs's agreement wllh CMS, FOR 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(g).
<br />11 . ~q]!_l)g: Aaurts will either (a) review the credentials of medical professionals affiliated with FDR ;
<br />or (b) review and approve a credenllallng process, which Asuris may audit on an ongoing basis. 42
<br />C.F.R § 422.504(I)(4)(iv).
<br />12. 8~yntabill)Y_Prci11Ision : Asuris agrees that ii 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. M2nl!QrJn ,and Ierminatron: Asurls wiU 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(~(4)(il), 423.505(i)(4)(il), and 423.505 (I)(4 )(iii).
<br />14. fl ow,Down Pr~y~or.i: FDR shall Incorporate the terms of this Compliance Addendum into any and all
<br />subcontracts eritered 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(1)(4).
<br />15. ~tlfu1~oJl~r of ~: FOR shall comply with the applicable confidentiality and
<br />enrollee accuracy requirements, including: (a) all applicable Federal and State Jaws regarding
<br />Aaurfs MA Compliance Addendum 10/2016 A18818864M Page 2 of3
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