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investigations ofProvidsr. To the extent that Provider is delogated authority for authorization ofservices, Provider
<br />shall comply with all utilization management requirements described in the State Contract,
<br />3.5. Debarment Certification. Providsr represents and warrants that it is not presently debaned,
<br />suspended, proposed for debarmenl declared ineligible, or voluntarily exclucled by any State or federal department
<br />or agency from participating in hansactions, Provider shall immediately notifu Health Plan in writing if, during the
<br />tenl of the Agreemen! (a) Provider becomes debarred" suspended, proposed for debarment, declared ineligible or
<br />voluntarily exclude{ or ft) Provider or any of Provider's employees are subjeot to disciplinary action agairst
<br />accreditation, certification, lice,nse and/or regishation. Further, Provider shall not pay for goods and services
<br />furnished by an excluded person, at the medioal direction, or on the prescription of an excluded person
<br />3.6, Records. Provider shall maintain a1l financial bifling, medical and other records pertinent to the
<br />Agreement, including but not limited to reoords related to service rendered, quality, appropriateness, and timeliness
<br />of service, any administrative, civil or criminal investigation or prosecution. All finanoial records shall follow
<br />generally accepted accounting principles. Other records shall be maintained as necessary to clearly reflect all actions
<br />taken by Provider related to the Agreement. All records and reports relating to the Agreement shall be retained by
<br />ProviderforaminimumoflOyearsafterfinalpaymentismadeundertheAgreement. However,whenaninspection,
<br />audiL litigation, or other action involving records is initiated prior to the end of said period, records shall be
<br />maintained for a minimum of 10 years following resolution of such action.
<br />3.7, Inspection. Provider shall fully cooperate with and permit State, including HCA, Medicaid Fraud
<br />Control Units (MFCU) and state auditor, CMS, auditors from the federal Government Accountability Office, federal
<br />Office of the Inspector General, federal Office of Management andBudget, the Office of the Inspector General, the
<br />Comptroller Ge,neral, and their designees, to access, irspect and audit any books, records' contracts, or documents of
<br />Provider that pertain to any aspect of services and activitias performed, including any computerized data stored by
<br />Provider, and shall pennit inspection of the premises, physical facilities, and cpipment where Medicaid-related
<br />activities or work is conducted, at any time whether such visit is announced or unannounced. Provider shall make
<br />staff available to assist in such inspection" review, audit, investigation, monitoring or evaluation, including the
<br />provision of adequate E)ace on the premises to reasonably accorrnodate HCA, MFCD or other state or federal
<br />agency. Provider shall make copies of records and shall deliver them to the requestor, without cost, within 30 calendar
<br />days of request. The right for the parties named above to audit, access ancl inspeot under this section exists for 10
<br />years from the finai date of the contract period or from the date of completion of any audit, whichever is later. If the
<br />State, CMS or the fbdsral Office of the Inspector General cletermines that there is a reasonable possibility of fraud or
<br />similar risk, the State, CMS, or the federal Office of the Lrspector General may inspecf evaluate, and audit the
<br />zubcontractor at any time.
<br />3,8. Interpreter Services. Provider shall provide interpreter services, free ofchargeo for all interactions
<br />with Covered Persons or poterrtial Covered Persons, including but not limited to: (a) customer service, (b) a1l
<br />appointments with any provider for auy Covered Servicq (c) emergency services, and (d) all steps necessary to file
<br />grievances and appeals including requests for Lrdepsndent Review ofFlealth Pian decisions.
<br />3.9. Marketine Materials. All information to be provided to Covered Persons, e.g, rnarketing materials,
<br />must be accuratg not misleading, comprehensible to its intended audience, designed to provide the greatest degree
<br />of understanding and written at a sixth grade reading level, in addition to any other requiremqds irnFosed by Health
<br />Plan based on the nature of the materials. Such rraterials must generally be approved by Health Plan prior to use,
<br />and must comply with the State Contract.
<br />3.10. Coorclination ofBenefits. Services and bonefits available under the Agreement shall be secondary to
<br />any other medical coveragq except in accordance with Chapter 284-51 WAC, as applicable. Health Plan shall not
<br />refuse or reduce services provided under the Agreement solely due to the existence of similar benefits under any other
<br />health care contract, except in accord with applicable coordination of benefi.ts nrles in WAC 284-51. Health Plan
<br />shall provide prenatal care and preventive pediatric care and then seek reimbwsement from third parties. Provider
<br />shall comply with all applicable Third-Party Liability and Coordination of Benefits provisions of Section 17 of the
<br />PPA WA - I(ttitas County Public l{ealth - 05.07.2A25 - ICMPr ovidaAgreernent_360268 Page 3 of 12
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