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Docusign Envelope lD: C'l 90C649-709E*4E00-A409-441 6CED8C800 <br />1.1.7 <br />1.1.9. <br />1.1.10 <br />1.2. <br />1.2.1 <br />1.2.2 <br />1.2.3 <br />1.2.4 <br />1.2.5. <br />1.2.6. <br />Washington State <br />Health Care Authority <br />2 CFR 225 Cost Principles for State, Local, and lndian Tribal <br />Governments; <br />Maintain all documentation related to staff participation in the RMTS <br />according to section 1902(aX4) of the Act and 42 CFR $ 431.17; see <br />also 45 CFR S 74.53 and 42 CFR S 433.32(a) (requiring source <br />documentation to support accounting records) and 45 CFR S 74-2O and <br />42 CFR S 433.32(b and c) (retention period for records) and as <br />described in Deliverinq Services in School-Based Settinqs:A <br />comprehensive Guide to Medicaid services and Administrative <br />Claiminq 2023; <br />Maintain all documentation related to MAC claiming, according to <br />section 1902(aX4) of the Act and 42 CFR S 431.17:, see also 45 CFR S <br />74.53 and 42 CFR S 433.32(a) (requiring source documentation to <br />support accounting records) and 45 CFR S 74.20 and 42 CFR S <br />433.32(b and c) (retention period for records) and as described in <br />Deliverinq Services in School-Based Settinqs:A Comprehensive Guide <br />to Medicaid Services and Administrative Claiminq 2023; <br />Comply with the SOS records retention schedule; <br />Assure all documentation is immediately accessible and available, must <br />be in a useful and readable format, and must be stored electronically <br />within the System at every opportunity as determined by HCA; <br />Provide any and all information and documentation requested by HCA <br />within thirty (30) business days, or within a written, mutually agreed <br />upon time frame; and <br />submit any Audit related to its MAC program to HCA within thirty (30) <br />business days of receipt of the final report. This includes but is not <br />limited to sAo Audits, oMB Circular compliance supplement Audits, <br />HCA Contract #K8630 <br />Attachment 5 <br />1.1.8.OMB Compliance SuPPlements; <br />Washington State Medicaid Plan; and <br />Secretary of State (SOS) records retention schedule <br />Maintain documentation to support each administrative claim submitted to HCA for <br />reimbursement as required by federal, state, HCA and CMS Regulations, the CAP, <br />the Manual and this Agreement. The documentation must be sufficiently detailed in <br />order to determine wnetner the activities are necessary for the proper and efficient <br />administration of the Medicaid State Plan and support the appropriateness of the <br />administrative claim. <br />The Contractor must <br />17