COST SETTLEMENT Clause Samples
The Cost Settlement clause defines how costs incurred during the performance of a contract are reviewed, reconciled, and finalized between the parties. Typically, this clause outlines the process for submitting cost documentation, the timeline for review, and the method for resolving discrepancies or disputes over allowable expenses. For example, it may require the contractor to provide detailed invoices and supporting receipts, which the client then audits before approving final payment. The core function of this clause is to ensure transparency and fairness in the allocation and reimbursement of costs, thereby preventing misunderstandings or disputes over financial obligations at the conclusion of the contract.
COST SETTLEMENT. A. If the Contractor provides mental health services as defined in CCR Title 9 (whether Medi-Cal or non-Medi-Cal), Contractor shall provide County a Certified Annual Mental Health Cost Report. Contractor shall certify and submit a Cost Report covering the preceding County fiscal year of July 1 through June 30, in a form satisfactory to the Director and as prescribed by the State in the Cost Reporting Data Collection Manual and ▇▇▇▇▇-▇▇▇▇▇/Medi-Cal cost report instructions. This Cost Report is due to the County no later than October 31 unless otherwise specified by the Director. In the event that this Agreement expires or is terminated on a date other than June 30, Contractor shall provide County such a Cost Report, covering the preceding period of July 1 through the date of expiration or termination no later than forty-five (45) days after the date of expiration or termination unless otherwise specified by the Director.
B. Contractor may use unaudited financial statements as the basis of cost information for completion of the Cost Report. Contractor will forward a copy of the unaudited financial statements to County along with the completed Cost Report.
C. This Cost Report is subject to examination and audit by County, State and/or Federal government, and their authorized representatives, to determine its compliance with this Agreement and any applicable laws and regulations.
D. County shall inform Contractor of any audit finding relevant to the Contractor. Contractor and County shall take any necessary actions to respond to, correct, and resolve the audit findings.
E. Should the County, State and/or Federal government, and their authorized representatives, disallow any paid goods and/or services, or determine that Contractor has misspent funds, or been overpaid based on the requirements of this Agreement and applicable laws and regulations, County shall demand repayment from Contractor for any amount determined disallowable.
F. Should the County, State and/or Federal government, and their authorized representatives, determine that Contractor’s actual expenses for goods and/or services provided under this Agreement are more than the compensation paid to Contractor by County, County shall reimburse the Contractor.
G. Method of repayment, either due from the County to Contractor or vice versa, is detailed in Exhibit C.
H. County shall determine the final compensation to the Contractor based on the final audited Cost Report at the actual rate and the total co...
COST SETTLEMENT. 1. If the Contractor does not generate Medi-Cal reimbursable services to meet the annual targets established in Paragraphs I.C.1.a, I.D.1.a. and I.E.1.a. of this Exhibit B, then Contractor shall reimburse the difference between the target and the amount so generated in a single payment. Any such payment(s) shall incorporate any prior adjustment to the MPA made through the adjustment process described in those same paragraphs.
2. If the annual Cost Reports provided to County show that total payments to Contractor exceeds the total actual costs for services rendered by Contractor during the reporting period, following any payment made subject to Paragraph I.Q.1. of this Exhibit B above, a single payment in the amount of the contract savings shall be made to County by Contractor, unless otherwise authorized by the Chief of the Health System or designee.
3. Cost settlement for this purpose shall be conducted for each fiscal year, and shall take place no later 180 days past the end of the fiscal year.
4. Should Contractor provide fewer annual units than what are identified in Paragraph I.D.6. of Exhibit A, payment rates by County to Contractor may not exceed the State Maximum Allowance (“SMA”). In such case, the amount of the difference between the actual costs for services provided that exceed the SMA and the costs of those same number of units provided at the SMA shall be reimbursed by Contractor to the County in a single payment.
5. In any case, the total payments shall not exceed the total amounts for each area of service and each reporting period as established in this Exhibit B.
COST SETTLEMENT. The monthly payments made pursuant to the terms and conditions of this Agreement shall be subject to the cost settlement process set forth herein. Cost settlement shall be based upon the budgetary requirements set forth in Exhibit B – Budgetary Requirements, which is attached hereto and incorporated herein by reference as if set forth in full, as well as the final cost report submitted pursuant to the terms and conditions of this Agreement. If it is determined that the cost incurred by CONTRACTOR is less than the actual payments made by COUNTY, CONTRACTOR shall reimburse COUNTY for the overpayment as set forth herein.
COST SETTLEMENT. Contractor will submit an annual Cost Report on the State mandated forms—in compliance with the State Cost Report manual—to County by September 30th, after the close of the fiscal year. Contractor may request extension of due date for good cause—at its discretion, County will provide written approval or denial of request. The Cost Report requires the reporting of all services to the County on one Cost Report. The Cost Report calculates the Cost per unit as the lowest of Actual Cost, Published Charge, or SDHCS County Maximum Allowance (CMA). A Cost Report Settlement will be completed by County within a reasonable timeline and will be based on a comparison of the allowed Medi-Cal reimbursement or other authorized non-billable services per unit in the Cost Report compared to the payment per unit paid by the County. Settlement amount will be net of rental income. Payment will be required by County or Contractor within 60 days of Settlement or as otherwise mutually agreed. Contractor will be subject to SDHCS/Federal Medi-Cal or Quality Assurance audits at any time. Contractor and County will each be responsible for any errors or omissions on their part. The annual SDHCS/Federal Audit may not occur until five years after close of fiscal year and not be settled until all audit appeals are completed/closed. Final findings must be paid by County or Contractor within 60 days of final audit report or as otherwise agreed.
COST SETTLEMENT. A. The Contractor’s Cost Report:
▇. ▇▇ to be submitted annually by September 30th, shall include all services delivered through June 30th of that fiscal year.
2. Settlement to cost will be made through the submission and acceptance of this Cost Report in accordance with Federal Medicaid requirements and the approved Medicaid state plan and waivers.
COST SETTLEMENT a. All DHCS required cost settlement documents, including but not limited to the Contractor’s Cost Report, the Narcotic Treatment Program Report of Expenditures and Revenues, the performance report, and any other forms required for the completion of the County’s Cost Reporting Responsibilities to DHCS:
i. Are to be submitted to the County annually by September 30th, shall include all services delivered through June 30th of that fiscal year.
ii. Settlement to cost will be made through the submission and acceptance of this Cost Report in accordance with Federal Medicaid requirements and the approved Medicaid state plan and waivers.
b. The Cost Report shall be in the format and completed within the guidelines provided in writing by September 30 2021.
c. Failure to complete cost report may result in termination of this Agreement at the discretion of MCBHRS.
COST SETTLEMENT
COST SETTLEMENT