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LJUUU.1.lyll CIIVCIUpu IU. L, Iz7VIrUY.M.-/ 1 V%,F-LJO%,OUV <br />4.13. Certified Public Expenditures <br />The MAC invoice must document that there are adequate non-federal, local <br />matching funds to support the costs of allowable MAC activities and be used as <br />CPE. <br />The Contractor is: <br />4.13.1, Prohibited from using any source of funds as CPE that do not comply <br />with federal, state, HCA and CMS Regulations, the CAP, Manual, and <br />this Agreement; <br />4.13.2. Required to certify all sources of funds used as for CPE are accurate, <br />allowable, and in compliance with all federal, state, HCA and CMS <br />Regulations, the CAP, Manual, and this Agreement quarterly by <br />completing a Certified Public Expenditure Local Match Certification <br />quarterly and by signing the A19; <br />4.13.3. Required to use the Budgeting, Accounting and Reporting System <br />(BARS manual) prescribed accounting and reporting for local <br />governments to identify and document the revenue account codes for <br />all local matching funds reported as CPE; <br />4.13.4. Required to ensure the source of all CPE funds are not federal tax <br />money and are not used as a match for federal money (by the <br />Contractor or any other agency); <br />4.13.5. Only permitted to use these funds to supplement, not supplant the <br />amount of federal, state and local funds otherwise expended or services <br />provided under this Agreement; <br />4.13.6. Required to have funds available for MAC activities and the funds must <br />be within the Contractor's control and budget; <br />4.13.7. Prohibited from using provider -related donations or impermissible heath <br />care related tax source for CPE; <br />4.13.8. Prohibited from using any private donations or non-public funds as a <br />source for CPE without authorization from CMS' Center for Medicaid <br />and State Operations' National Institutional Reimbursement Team <br />(N I RT); <br />4.13.9. Prohibited from requiring or allowing private non -profits to participate in <br />the financing of the non-federal share of expenditures; <br />4.13.10. Prohibited from allowing non -governmental units to voluntarily provide, <br />or be contractually required to provide, any portion of the non-federal <br />share of the Medicaid expenditures; <br />Washington State 28 HCA Contract #K8630 <br />Health Care Authority Attachment 5 <br />