Common use of Access to Information and Records Clause in Contracts

Access to Information and Records. Provider agrees that (a) it will forward all pertinent information relating to the health care of Enrollees to Enrollees' primary care provider and, as required, to Managed Care Plan in a timely fashion; (b) ILS Community Network, Managed Care Plan any Federal or State regulatory authority, or any designee shall have timely access, during normal business hours, on at least twenty-four (24) hours advance notice, or such shorter notice as may be imposed on ILS Community Network or Managed Care Plan by a Federal or State regulatory agency or accreditation organization, to all data and information obtained, created or collected by Provider, or any Affiliates, related to Enrollees relevant to this Agreement and necessary for payment of claims; (c) ILS Community Network and Managed Care Plan (including ILS Community Network and Managed Care Plan's authorized designee) and Federal, state, and local Government Sponsor and their agents having jurisdiction, including but not limited to DHHS, State Medicaid Agency, MPI and MFCU, upon request, shall have the right to inspect, review, make copies, evaluate and audit all of the following related to this Agreement, all pertinent books, financial records, medical/case records, and other documents, papers and records (including, but not limited to, contracts and medical and financial records) and information relating to this Agreement and to those services rendered by Provider to Enrollees ("Records"); (d) consistent with the consents and authorizations required by this Agreement, ILS Community Network and Managed Care Plan or its agents or designees shall have access to Enrollee Records for the purpose of assessing quality of services, conducting audits, and, where applicable, performing utilization management functions; (e) applicable Federal and State authorities and their agents shall have access to any Records pertinent to the Government Sponsored program contract and for assessing the quality, appropriateness and timeliness of services or investigating Enrollee grievances or complaints; and (f) where applicable, Enrollees shall have access to their health information as required by 45 C.F.R. § 164.524 and applicable State law, be provided with an accounting of disclosures of information when and as required by 45 C.F.R. § 164.528 and applicable State law, and have the opportunity to amend or correct the information as required by 45 C.F.R. § 164.526 and applicable State law. Provider agrees to supply copies of information and Records within fourteen (14) days of the receipt of a request, where practicable, and in no event later than the date required by any Mandate or regulatory authority. Copies of such records shall be at no additional cost to ILS Community Network or Managed Care Plan or the Enrollee. Copies provided to third parties shall be provided at Provider cost unless the copies are needed in connection with Provider related issues, in which case, the copies shall be free of charge. This Section shall survive the termination of this Agreement, regardless of the cause of termination.

Appears in 8 contracts

Samples: ilshealth.com, ilshealth.com, ilshealth.com

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