Access to and Audit of Contract Records Sample Clauses

Access to and Audit of Contract Records. Throughout the duration of this contract, and after termination of this contract, the MCO shall provide duly authorized agents of the state or federal government access to all records and material relating to the contract’s provision of and reimbursement for activities contemplated under this contract. The rights of access in this paragraph are not limited to the required retention period, but shall last as long as records are retained. Such access shall include the right to inspect, audit and reproduce all such records and material and to verify reports furnished in compliance with the provisions of this contract. All information so obtained will be accorded confidential treatment as provided under applicable law.
Access to and Audit of Contract Records. For the purpose of review of items and services furnished under the terms of this Contract and duplication of any books and records, County Associates shall allow CalOptima, its regulators and/or their duly authorized agents and representatives access to said books and records, including medical records, contracts, documents, electronic systems for the purpose of direct physical examination of the records by CalOptima or its regulators and/or their duly authorized agents and representatives at the County's premises. County Associates shall be given advance notice of such visit in accordance with CalOptima Policies. Such access shall include the right to directly observe all aspects of County Associate's operations and to inspect, audit and reproduce all records and materials and to verify Claims and reports required according to the provisions of this Contract. County Associates shall maintain records in chronological sequence and in an immediately retrievable form in accordance with the laws and regulations applicable to such record keeping. County Associates shall also comply with any other audit and access requirements set forth in this Contract, as applicable. IfDHCS, CMS or the DHHS Inspector General determines there is a reasonable possibility of fraud or similar risk, DHCS, CMS, or the DHHS Inspector General may inspect, evaluate, and audit County Associates at any time. Upon resolution of a full investigation of fraud, DHCS reserves the right to suspend or terminate County Associates from participation in the Medi-Cal program; seek recovery of payments made to County Associates; impose other sanctions provided under the State Plan, and County Associate's contract may be terminated due to fraud."
Access to and Audit of Contract Records. Throughout the duration of this contract, and after termination of this contract, the MCO shall provide duly authorized agents of the state or federal government access to all records and material relating to the contract’s provision of and reimbursement for activities contemplated under this contract. The rights of access in this paragraph are not limited to the required retention period, but shall last as long as records are retained, if longer. Such access shall include the right to inspect, audit and reproduce all such records and material and to verify reports furnished in compliance with the provisions of this contract. All information so obtained will be accorded confidential treatment as provided under applicable law. The rights to access, inspect, and audit premises and contract records described in Article XIII.H.1.-2. exist for 10 years from the final date of the contract period or from the date of completion of any audit, whichever is later. If the State, CMS, or the HHS Inspector General determines there is a reasonable possibility of fraud or similar risk, these access and audit rights may be exercised at any time. K. Program Integrity Plan, Program and CoordinationThe MCO must establish a Regulatory Compliance Committee on the MCO’s governing board and at the senior management level charged with overseeing the organization’s compliance program and its compliance with the requirements under the contract.The MCO must have administrative and management arrangements or procedures, and a Program Integrity Plan, that are designed to guard against fraud, waste, and abuse.The MCO’s governing board or its designee shall approve a written Program Integrity Plan that is developed by a designated MCO program integrity compliance officer and a compliance committee which is accountable to senior management. The plan will describe the MCO’s commitment to operational initiatives designed to prevent, detect, and correct instances of fraud and abuse including details describing the scope of activity, goals, objectives and timelines associated with the monitoring program. The program integrity plan must be submitted to the Department and approved on an annual basis prior to the effective date of the new contract year. In this subsection, the term abuse means any practice that is inconsistent with sound fiscal, business or medical practices and results in unnecessary program costs.1. ProceduresThe MCO’s arrangements or procedures must include the following: