SHJ25-011 UNITED HEALTHCARE & KCJ Carceral 2025 Medicaid Contract - PARTIALLY EXECUTED

Home Browse Search

3.18 Conflict of Interest. Provider shall cooperate with Carrier's policies and procedures related to detecting and preventing conflicts of interest in accordance with federal laws for parties involved in public contracting. 3.19 Excluded Individuals and Entities. By signing the Agreement, Provider certifies to the best of Provider's knowledge and belief that neither it nor any of its principals, nor any providers, subcontractors or consultants with whom Provider contracts and who are providing items or services that are significant and material to Provider's obligations under the Agreement is: i) excluded from participation in federal health care programs under either Section 1 128 or section 1128A of the Social Security Act; or ii) debarred, suspended or otherwise excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in nonprocurement activities under regulations issued under Executive Order no. 12549 or under guidelines implementing Executive Order No. 12549; or an affiliate, as defined in the Federal Acquisition Regulation, of such a person. Provider is obligated to screen its employees and contractors initially and on an ongoing monthly basis to determine whether any of them have been excluded from participation in Medicare, Medicaid, CHIP, or any Federal Health Care Programs (as defined in Section 1128B(f) of the Social Security Act). Provider shall not employ or contract with an individual or entity that has been excluded. Provider shall immediately report to Carrier any exclusion information discovered. Provider acknowledges and agrees that civil monetary penalties may be imposed against Provider if he or she employs or enters into contracts with excluded individuals or entities to provide items or Covered Services. Provider can search the HHS-01G website, at no cost, by the names of any individuals or entities. The databases are called LEiE and EPLS and can be accessed at http://www.oig.hlis.goy/fraud/exclusions.M. Carrier will terminate the Agreement immediately and exclude from its network any provider who has been excluded from the Medicare, Medicaid or CHIP program in any state. Carrier may also terminate the Agreement if Provider or Provider's owners, agents, or managing employees are found to be excluded on a State or federal exclusion list. 3.20 Disclosure. Provider must be screened and enrolled into the State's Medicaid or CHIP program, as applicable and submit disclosure to HCA on ownership and control, significant business transactions, and persons convicted of crimes, including any required criminal background checks, in accordance with 42 CFR Part 455 Subparts B and E. Provider shall not give employees, volunteers, and/or subcontractor staff access to children and/or vulnerable adults until a criminal history background check is performed and a positive result is reported. Provider must submit information related to ownership and control of subcontractors or wholly owned suppliers within thirty-five (35) calendar days of a request for such information in accordance with 42 CFR 455.105. Additionally, Provider must cooperate with HCA for submission of fingerprints upon a request from HCA or CMS in accordance with 42 CFR 455.434. If Provider fails to submit such information or fingerprints in a form and manner to be determined by HCA or CMS within thirty (30) calendar days when requested by HCA or CMS, the Carrier must terminate or deny enrollment to Provider. 3.21 Cultural Competency and Access. Provider shall participate in Carrier's and the State's efforts to promote the delivery of services in a culturally competent manner to all Covered Persons, including those with limited English proficiency, physical and mental disabilities, and diverse cultural and ethnic backgrounds, disabilities, and regardless of gender, sexual orientation or gender identity, and shall provide interpreter services in a Covered Person's primary language and for the hearing impaired for all appointments and emergency services. Provider shall provide UHUSTATE PROGRAMS REGAPX. WA.02.25 35