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21.1 Medical and behavioral health advice for Members from licensed health care <br />professionals; <br />21.2 Triage concerning the emergent, urgent or routine nature of medical and <br />behavioral health conditions by licensed health care professionals; and <br />21.3 The toll -free line staff must be able to make a warm handoff to the regional crisis <br />line. <br />22. Health Information Systems. Facility shall maintain a health information system that <br />complies with the requirements of 42 C.F.R. § 438.242 and provides the information necessary <br />to meet CHPW's obligations under the State Contract. Facility shall: <br />22.1 Collect, analyze, integrate, and report data. The system must provide information <br />on areas that include but are not limited to utilization, grievance and appeals, and terminations of <br />enrollment for other than loss of Medicaid eligibility; and <br />22.2 Ensure data provided to CHPW is accurate and complete by: (a) Verifying the <br />accuracy and timeliness of reported data; (b) Screening the data for completeness, logic, and <br />consistency; and (c) Collecting service information on standardized formats to the extent feasible <br />and appropriate. <br />23. Release of Necessary Information. Facility acknowledges and agrees to release to <br />CHPW any information necessary to perform any of CHPW's obligations under the State <br />Contract. <br />24. Encounter Data Reporting. Facility shall submit complete, accurate and timely <br />encounter data to CHPW in accordance with current encounter submission guidelines published <br />by HCA or as otherwise specified by CHPW. Facility represents and warrants that it has the <br />capacity to submit all data required by HCA to enable CHPW to meet the reporting requirements <br />in the Encounter Data Reporting Guide published by HCA. <br />25. Clinical Data Repository. If Facility utilizes a certified electronic health record system <br />(EHR), Facility is required to submit automated exports of standard CCD/CODA, or subsequent <br />ONC-specified standard healthcare transactions, from Facility's EHR to HCA's Clinical Data <br />Repository (CDR) via the State Health Information Exchange (HIE), as specified by HCA. <br />26. Credible Allegations of Fraud. Facility shall refer credible allegations of fraud to HCA <br />and the Medicaid Fraud Control Unit as described in Subsection 12.6 of the State Contract, or its <br />successor. <br />27. Subrogation. Facility agrees to subrogate to the State for all criminal, civil and <br />administrative action recoveries undertaken by any government entity, including, but not limited <br />to, all claims Facility has or may have against any entity or individual that directly or indirectly <br />receives funds under the State Contract including, but not limited to, any Health Care Provider, <br />manufacturer, wholesale or retail supplier, sales representative, laboratory, or other provider in <br />the design, manufacture, marketing, pricing, or quality of drugs, pharmaceuticals, medical <br />supplies, medical devices, durable medical equipment, or other health care related products or <br />services. For the purposes of this Section, "subrogation" means the right of any State <br />2020 Facility Exh B I B - McaidProv Page 35 of 51 Contract #(Contract #)-{PRC Agreement TDl <br />