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25. This Agreement does not terminate Health Plan's legal responsibility to HCA for any work performed
<br />under the Washington Medicaid Contract nor for oversight of any functions and/or responsibilities Health
<br />Plan delegates to Provider.
<br />26. The Health Plan and its subcontractors shall forthwith produce all records, documents, or other data
<br />requested as part of such inspection, review, audit, investigation, monitoring, or evaluation If the requesting
<br />agency asks for copies of records, documents, or other data, the Health Plan and its subcontractors shall
<br />make copies of records and shall deliver them to the requestor, within thirty (30) calendar days of request,
<br />or any shorter timeframe as authorized by law or court order. Copies of records and documents shall be
<br />made at no cost to the requesting agency. (42 C.F.R. § 455.21(a)(2); 42 C.F.R. § 431.107(b)(2)). The right
<br />for the parties named above to audit, access, and inspect under this Section exists for ten (10) years from the
<br />final date of the contract period or from the date of completion of any audit, whichever is later, or any other
<br />timeframe authorized by law. (42 C.F.R. § 438.3(h)).
<br />27. As applicable, Health Plan and its subcontractors are required to comply with chapter 71.32 RCW (Mental
<br />Health Advance Directives).
<br />28. Provider shall agree to subrogate, to the state of Washington for all criminal, civil and administrative action
<br />recoveries undertaken by any government entity, including, but not limited to, all claims the Contractor or
<br />subcontractor has or may have against any entity or individual that directly or indirectly receives funds
<br />under this Contract including, but not limited to, any Health Care Provider, manufacturer, wholesale or
<br />retail supplier, sales representative, laboratory, or other provider in the design, manufacture, marketing,
<br />pricing, or quality of drugs, pharmaceuticals, medical supplies, medical devices, Medical Equipment, or
<br />other health care related products or services.
<br />29. Provider agrees to Release to Health Plan any information that is necessary for Health Plan to perform any
<br />of its obligations under the HCA Contract.
<br />30. As applicable, Health Plan may not prohibit a Provider acting within their lawful scope of practice from
<br />advising or advocating on behalf of a Member who is their patient for any information the Member needs to
<br />decide among all relevant treatment options.
<br />31. Provider shall investigate and disclose to Health Plan at contract execution or renewal, and upon request by
<br />Health Plan, the identity of any person who has been convicted of a criminal offense related to that person's
<br />involvement in any program under Medicare, Medicaid, or the title XX services program since the
<br />inception of those programs and who is a person who has an ownership or control interest in Provider, an
<br />agent or person who has been delegated the authority to obligate or act on behalf of Provider, or an agent,
<br />managing employee, general manager, business manager, administrator, director, or other individual who
<br />exercises operational or managerial control over, or who directly or indirectly conducts the day-to-day
<br />operation of Provider pursuant to 42 C.F.R. § 455.106(a) and § 455.101.
<br />32. If Provider is also a home health agency, Provider shall be in compliance with the surety bond requirements
<br />of Section 4312(b) of the Balanced Budget Act of 1997 and 42 C.F.R. § 441.16.
<br />33. Provider agreement shall be in writing and be consistent with the provisions of 42 C.F.R. § 434.6, §
<br />438.230 and § 438.214, as applicable and shall identify services to be performed by Provider. If Health Plan
<br />allows Provider to further subcontract, all requirements under the HCA contract must be propagated to any
<br />other lower tiered subcontracts.
<br />34. Provider agrees to allow a process for monitoring the Provider's performance and a periodic schedule for
<br />formally evaluating performance, consistent with industry standards or state managed care laws and
<br />regulations. Provider agrees the Health Plan may conduct compliance reviews when the Health Plan has
<br />identified deficiencies or areas requiring improvement and provide for corrective action. Provider shall
<br />provide Health Plan with reports sufficient to show that Provider has complied with all data submission
<br />requirements established by HCA for all services funded by HCA under this Agreement.
<br />MHWPROV22.3 MHWHA/Revised Jan 2024 Page 25 of 25
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