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Fully Executed Interlocal
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2025
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12. December
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2025-12-16 10:00 AM - Commissioners' Agenda
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Fully Executed Interlocal
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Last modified
1/12/2026 1:21:01 PM
Creation date
1/12/2026 1:20:33 PM
Metadata
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Meeting
Date
12/16/2025
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Fully Executed Version
Supplemental fields
Item
Request to Approve a Resolution to Authorize an Interagency Agreement between the Kittitas County Public Health Department and the Washington State Health Care Authority
Order
14
Placement
Consent Agenda
Row ID
139120
Type
Resolution
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Docusign Envelope lD: C1 90C449-709E-4E00-A409-44l 6CEDBC800 <br />2.3.Maintenance of Records <br />During the term of any contract and for six (6) years following the termination or <br />expirttion of the Contract, the parties must maintain records sufficient to: <br />2.3.1. Document performance of all acts required by any contract and <br />applicable statutes, Regulations, and rules; <br />2.3.2. Substantiate the Contractor's statement of its organization's structure, <br />tax status, administrative capabilities, and performance; <br />2.3"3. Demonstrate accounting procedures, practices, and records which <br />sufficiently and properly document all invoices, expenditures, and <br />payments; <br />2.3.4. Maintain all documentation related to MAC claiming and staff <br />participation in the RMTS according to section 1902(a) (4) of the Act <br />and 42 CFR 431.17. See also 45 CFR 74.53 and 42 CFR 433.32(a), <br />requiring source documentation to support accounting records, and 45 <br />cFR74.20 and 42 CFR 433.32(b) and (c), retention period for records, <br />and as described in Delivering Services in School-Based Settinqs:A <br />comprehensive Guide to Medicaid services and Administrative <br />Claiminq; and <br />2.3.5. Provide any and all information and documentation as requested by <br />HCA, state and/or federal Auditors and reviewers in a readable and <br />usable format. <br />Billing and Claiming <br />The Contractor must submit invoices for reimbursement to HCA for review and approval <br />within one hundred twenty (120) calendar days following the end of each Billing Quarter. <br />Upon approval, the Contractor must submit a signed A19-1A invoice voucher within thirty (30) <br />calendar days. <br />3.1. lnvoices submitted after one hundred twenty (120) calendar days following the end <br />of the Billing Quarter may result in corrective action. <br />3.2. HCA will not offset negative balances against future A19s. The Contractor must <br />immediately remit a check to HCA for any funds requiring repayment. <br />3.3. HCA is not a recovery agent and any overpayments that are at or beyond the one <br />hundred eighty (180) calendar day mark will be turned over to the Office of <br />Financial Recovery (OFR). <br />g.4. HCA will not seek reimbursement for any invoice received after the 23rd month of <br />the two-year federal filing deadline. <br />3. <br />Washington State <br />Health Care Authority <br />HCA Contract #K8630 <br />Attachment 5 <br />22
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