Audit Accounting and Retention of Records. BMS may, at its option, conduct an audit of the MCO’s and its Subcontractors’ operations as they pertain to services and recoveries pursuant to the contracted services. The MCO and its Subcontractors, for purposes of audit, must provide the State of West Virginia, the Secretary of the U.S. Department of Health and Human Services, the OIG, the Comptroller General and his/her designees, and any other legally authorized governmental entity or their authorized agents access to all the MCO and its Subcontractors’ materials and information pertinent to the services provided under this Contract, at any time, until the expiration of ten (10) years from the completion date of this Contract as extended, or from the date of completion of any audit, whichever is later. The MCO agrees to comply with the provisions of Section 1861 (v)(1)(I) of the Social Security Act, as amended, governing the maintenance of documentation to verify the cost of services rendered under this Contract. The MCO and its Subcontractors agree that authorized State representatives including, but not limited to, BMS personnel, the State Auditor, and other State and/or any applicable Federal agencies providing funds will have access to and the right to examine the items listed above during the Contract period and during the ten- year post-Contract period, or until final resolution of all pending audit questions and litigation. During the Contract period, access to these items will be provided to BMS or its designee at all reasonable times. This may require the identification and collection of data for use by medical audit personnel. During the ten (10) year post-Contract period, delivery of and access to the listed items will be at no cost to the State. The State and its authorized agents may record any information and make copies of any materials maintained for the purposes of this Contract necessary for the audit, except enrollee and provider quality assurance and quality improvement records when confidentiality is protected by law. Any Subcontract with an approved MCO Subcontractor must include a provision specifically authorizing audits in accordance with the terms set forth in this Section.
Audit Accounting and Retention of Records. The MCO, for purposes of audit, must provide the State of West Virginia, the Secretary of the U.S. Department of Health and Human Services and his/her designated agent, and any other legally authorized governmental entity or their authorized agents access to all the MCO’s materials and information pertinent to the services provided under this contract, at any time, until the expiration of five years from the completion date of this contract as extended. The MCO agrees to comply with the provisions of Section 1861 (v)(1)(I) of the Social Security Act, as amended, governing the maintenance of documentation to verify the cost of services rendered under this contract. The MCO agrees that authorized State representatives including, but not limited to, Department personnel, the State Auditor and other State and/or any applicable Federal agencies providing funds will have access to and the right to examine the items listed above during the contract period and during the five year post-contract period or until final resolution of all pending audit questions and litigation. During the contract period, access to these items will be provided to BMS at all reasonable times. This may require the identification and collection of data for use by medical audit personnel. During the five year post-contract period, delivery of and access to the listed items will be at no cost to the State. BMS may, at its option, conduct an audit of the MCO’s operations as they pertain to services and recoveries pursuant to the contracted services. The State and its authorized agents may record any information and make copies of any materials maintained for the purposes of this contract necessary for the audit, except member and provider quality assurance and quality improvement records when confidentiality is protected by law.
Audit Accounting and Retention of Records. DHHR may, at its option, conduct an audit of the MCO’s and its Subcontractors’ operations as they pertain to services and recoveries pursuant to the contracted services. The MCO and its Subcontractors, for purposes of audit, must provide the State of West Virginia, the Secretary of the U.S. Department of Health and Human Services and his/her designated agent, and any other legally authorized governmental entity or their authorized agents access to all the MCO and its Subcontractors’ materials and information pertinent to the services provided under this Contract, at any time, until the expiration of ten years from the completion date of this Contract as extended. The MCO agrees to comply with the provisions of Section 1861 (v)(1)(I) of the Social Security Act, as amended, governing the maintenance of documentation to verify the cost of services rendered under this Contract. The MCO and its Subcontractors agree that authorized State representatives including, but not limited to, Department personnel, the State Auditor, and other State and/or any applicable Federal agencies providing funds will have access to and the right to examine the items listed above during the Contract period and during the ten
Audit Accounting and Retention of Records. BMS may, at its option, conduct an audit of the MCO’s and its Subcontractors’ operations as they pertain to services and recoveries pursuant to the contracted services. The MCO and its Subcontractors, for purposes of audit, must provide the State of West Virginia, the Secretary of the U.S. Department of Health and Human Services and his/her designated agent, and any other legally authorized governmental entity or their authorized agents access to all the MCO and its Subcontractors’ materials and information pertinent to the services provided under this Contract, at any time, until the expiration of ten (10) years from the completion date of this Contract as extended. The MCO agrees to comply with the provisions of Section 1861
