Auditing Program Integrity Operations. The FSSA PI Unit may conduct audits of Contractor’s Special Investigation (SI) Unit activities to determine the effectiveness of Contractor’s operations. Such audit activities may include conducting interviews of relevant staff, reviewing all documentation and systems used for Special Investigation Unit activities, and reviewing the SI Unit’s performance metrics. The FSSA PI Unit may issue a corrective action or performance improvement plan and outline timelines for improvement measures. The failure to adhere to operational improvement measures may result in the State’s imposing liquidated damages up to the amount of overpayments recovered from Contractor’s providers by FSSA PI Unit audits for the preceding calendar year, or imposing other non-compliance remedies including liquidated damages as authorized by Exhibit 3.
Auditing Program Integrity Operations. The FSSA PI Unit may conduct audits of Broker’s program integrity activities to determine the effectiveness of Broker’s operations. Such audit activities may include conducting interviews of relevant staff, reviewing all documentation and systems used for Program Integrity activities. The FSSA PI Unit may issue a corrective action or performance improvement plan and outline timelines for improvement measures. The failure to adhere to operational improvement measures may result in the State’s imposing liquidated damages up to the amount of overpayments recovered from Broker’s providers by FSSA PI Unit audits for the preceding calendar year, or imposing other non-compliance remedies including liquidated damages. 2018 Non-Emergency Medical Transportation Broker Capitation Rates Effective June 1, 2018 through April 30, 2019 All rates before adjustment for 2.00% withhold and before risk adjustment. NEMT Statewide Composite Rate Per member per month - $8.63 It is the State’s primary goal to ensure that the Contractor is accountable for delivering services as defined and agreed to in the Contract. This includes, but is not limited to, performing all items described in the Scope of Work Attachment A, completing all deliverables in a timely manner described in the Scope of Work, and generally performing to the satisfaction of the State. Failure to perform in a satisfactory manner may result in corrective actions and the measures described below. It is the intent of FSSA to remedy any non-performance through specific remedies at no additional cost to the State. In the event that the Contractor fails to meet requirements set forth in the Contract, the State will provide the Contractor with a written notice of non-compliance and may require any of the corrective actions or remedies described in the Contract.
