{"component": "clause", "props": {"groups": [{"snippet_links": [{"key": "mco-must", "type": "clause", "offset": [4, 12]}, {"key": "texas-health-steps", "type": "definition", "offset": [25, 43]}, {"key": "to-submit", "type": "definition", "offset": [54, 63]}, {"key": "for-services", "type": "clause", "offset": [71, 83]}, {"key": "the-cms", "type": "clause", "offset": [141, 148]}, {"key": "claim-form", "type": "definition", "offset": [154, 164]}, {"key": "hipaa-compliant", "type": "definition", "offset": [177, 192]}, {"key": "code-set", "type": "definition", "offset": [193, 201]}, {"key": "required-by", "type": "definition", "offset": [202, 213]}, {"key": "encounter-data", "type": "definition", "offset": [220, 234]}, {"key": "review-of", "type": "clause", "offset": [262, 271]}, {"key": "random-sample", "type": "definition", "offset": [274, 287]}, {"key": "eligible-enrollees", "type": "clause", "offset": [310, 328]}, {"key": "by-the-mco", "type": "clause", "offset": [369, 379]}, {"key": "to-validate", "type": "definition", "offset": [429, 440]}, {"key": "reported-data", "type": "definition", "offset": [507, 520]}, {"key": "network-providers", "type": "clause", "offset": [642, 659]}, {"key": "notice-to-the", "type": "clause", "offset": [724, 737]}, {"key": "the-provider", "type": "definition", "offset": [745, 757]}], "snippet": "The MCO must require all Texas Health Steps Providers to submit claims for services paid (either on a capitated or fee-for service basis) on the CMS 1500 claim form and use the HIPAA compliant code set required by HHSC. Encounter Data will be validated by chart review of a random sample of Texas Health Steps eligible enrollees against monthly Encounter Data reported by the MCO. HHSC or its designee will conduct chart reviews to validate that all screens are performed when due and as reported, and that reported data is accurate and timely. Substantial deviation between reported and charted Encounter Data could result in the MCO and/or Network Providers being investigated for potential Fraud, Abuse, or Waste without notice to the MCO or the Provider.", "samples": [{"hash": "4FJNnohiPic", "uri": "/contracts/4FJNnohiPic#data-validation", "label": "Contract (Centene Corp)", "score": 25.5530452728, "published": true}, {"hash": "af1fZYDcKWr", "uri": "/contracts/af1fZYDcKWr#data-validation", "label": "Contract Amendment (Centene Corp)", "score": 25.1396312714, "published": true}, {"hash": "9Ct0e8TOLeU", "uri": "/contracts/9Ct0e8TOLeU#data-validation", "label": "Contract Amendment (Centene Corp)", "score": 25.1396312714, "published": true}], "size": 14, "hash": "a80a369284d81ad4cd03e745e80c3e8f", "id": 2}, {"snippet_links": [{"key": "of-information", "type": "definition", "offset": [144, 158]}, {"key": "the-provider", "type": "definition", "offset": [160, 172]}, {"key": "to-ensure", "type": "clause", "offset": [198, 207]}], "snippet": "Integration of multiple datasets together can be fraught with difficulty, including inconsistent fields, missing datasets, and conflicting sets of information. The Provider solution will need rules to ensure referential integrity between datasets:", "samples": [{"hash": "eGuZu2qQIYG", "uri": "/contracts/eGuZu2qQIYG#data-validation", "label": "Amendment", "score": 30.5243167877, "published": true}, {"hash": "8mMNbHsquH1", "uri": "/contracts/8mMNbHsquH1#data-validation", "label": "Master Agreement for Arts and Cultural Enrichment, Academic Support, and Student Health and Wellness Services", "score": 30.1848831177, "published": true}, {"hash": "5826mRGU2hJ", "uri": "/contracts/5826mRGU2hJ#data-validation", "label": "Master Agreement for Arts and Cultural Enrichment, Academic Support, and Student Health and Wellness Services", "score": 30.1520347595, "published": true}], "size": 16, "hash": "3779403201889f103fc8dc640069d925", "id": 1}, {"snippet_links": [{"key": "the-parties-agree-that", "type": "clause", "offset": [3, 25]}, {"key": "the-services", "type": "definition", "offset": [50, 62]}, {"key": "for-purposes-of", "type": "clause", "offset": 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1945]}, {"key": "confidence-level", "type": "definition", "offset": [2006, 2022]}, {"key": "a-non", "type": "clause", "offset": [2024, 2029]}, {"key": "employees-who", "type": "clause", "offset": [2194, 2207]}, {"key": "time-periods", "type": "clause", "offset": [2228, 2240]}, {"key": "once-the-parties", "type": "clause", "offset": [2564, 2580]}, {"key": "the-requirements", "type": "clause", "offset": [2619, 2635]}, {"key": "paragraphs-3", "type": "clause", "offset": [2639, 2651]}, {"key": "beginning-date", "type": "clause", "offset": [2720, 2734]}, {"key": "commencement-of-the", "type": "clause", "offset": [2743, 2762]}, {"key": "as-specified", "type": "clause", "offset": [2800, 2812]}, {"key": "agreed-to", "type": "clause", "offset": [2844, 2853]}, {"key": "measuring-compliance", "type": "clause", "offset": [2882, 2902]}, {"key": "conclusion-of", "type": "clause", "offset": [2928, 2941]}, {"key": "the-current", "type": "clause", "offset": [3189, 3200]}, {"key": "for-performance", 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[4681, 4694]}, {"key": "measurement-of-performance", "type": "clause", "offset": [4796, 4822]}, {"key": "ability-to", "type": "clause", "offset": [4871, 4881]}, {"key": "performance-standard", "type": "definition", "offset": [4894, 4914]}, {"key": "dispute-resolution-processes", "type": "clause", "offset": [5098, 5126]}, {"key": "draft-report", "type": "definition", "offset": [5196, 5208]}, {"key": "complete-the", "type": "clause", "offset": [5426, 5438]}, {"key": "after-receipt-of", "type": "clause", "offset": [5487, 5503]}, {"key": "to-submit", "type": "definition", "offset": [5553, 5562]}, {"key": "final-report", "type": "clause", "offset": [5672, 5684]}, {"key": "the-provisions-of-section", "type": "clause", "offset": [5731, 5756]}, {"key": "public-information", "type": "clause", "offset": [5785, 5803]}, {"key": "public-documents", "type": "definition", "offset": [5919, 5935]}, {"key": "identifying-information", "type": "definition", "offset": [5966, 5989]}, {"key": "other-confidential-information", "type": "definition", "offset": [5994, 6024]}, {"key": "in-accordance-with", "type": "definition", "offset": [6092, 6110]}, {"key": "confidentiality-order", "type": "definition", "offset": [6115, 6136]}, {"key": "by-the-court", "type": "clause", "offset": [6145, 6157]}, {"key": "all-parties", "type": "definition", "offset": [6307, 6318]}, {"key": "cost-of", "type": "clause", "offset": [6328, 6335]}], "snippet": "1. The parties agree that Defendants shall retain the services of a Data Validator for purposes of verifying and reporting on a semi-annual basis Defendants\u2019 compliance with the exit criteria identified in this Agreement. The Data Validator shall be a third party contractor of the State of Missouri that has had prior experience conducting data validation services for state child welfare agencies. The Plaintiffs agree and understand that the services of a Data Validator will have to be retained in compliance with federal and state law governing procurement of contracts. Defendants will make best efforts to complete this process within four months from the date of this Agreement.\n2. The Data Validator shall issue written reports pursuant to the schedule set forth below. The reports shall describe the measurable progress made by Defendants in relation to each of the exit criteria and reportable data elements contained in this Agreement for each six-month reporting period, as well as any issues or challenges encountered or observed by the Data Validator regarding the collection of performance data or its application to the exit criteria and data elements.\n3. Sampling, data, and data analysis will be subject to review and approval by the Data Validator. Promptly after the Data Validator is retained, the parties shall work with the Data Validator to determine the appropriate means for measuring and reporting performance on each of the exit criteria and data sharing items, including ensuring that any case reviews conducted for purposes of measuring performance are based on a statistically valid, representative, random sample of Class Members. Data will be provided from the data source identified in Exhibit B. The sample files shall be drawn, without replacement, from Class Members (as opposed to all children in CD custody). The parties agree that a sample is representative if, given the population size, the case review delivers a measurement with a 5% margin of error at the 90% confidence level. A non-exclusive example of a collection or measurement issue the parties must address and resolve with the Data Validator is excluding or limiting the use of Children or employees who \u201cstraddle\u201d relevant time periods.\n4. The Data Validator shall prepare and provide to the parties an agreed upon template that provides the format for data elements and reporting at the close of each Reporting Period on: (a) Defendants\u2019 performance on each exit criterion and (b) Defendants\u2019 performance on all data elements specified in this Agreement.\n5. Once the parties and the Data Validator have completed the requirements of paragraphs 3 and 4 above, the parties and the Data Validator shall establish the beginning date for the commencement of the first six-month Reporting Period.\n6. As specified in Exhibit B, the parties have agreed to percentage-based ranges for measuring compliance with exit criteria. Upon conclusion of the first Reporting Period, performance data on all of the Exit Criteria and Data Sharing items, using the methodology set forth by the Data Validator as described in Section IV.A.3, shall be provided to the Data Validator for purposes of setting the current baseline for performance in each area. The Data Validator shall prepare a report for the first Reporting Period that sets forth these baselines.\n7. Upon receipt of the baseline performance data for all of the Exit Criteria and Data Sharing items, the parties shall work with the Data Validator to try to reach agreement on the ultimate percentage for each exit criterion within each range specified in this Agreement. If the parties cannot reach agreement on the ultimate percentage for any exit criterion within 60 days, the Data Validator shall issue a report and specify the percentage within the agreed upon percentage-based ranges.\n8. Within 60 days of the end of each Reporting Period, Defendants shall provide to the Data Validator all data, reports, and other information that the Data Validator deems necessary to verify the measure of the agency\u2019s performance on each of the exit criteria and reportable data elements in this Agreement. The Data Validator and Defendants may communicate regarding the data and information to be furnished. The parties shall have access, through the Data Validator, to all information made available by Defendants to the Data Validator under the terms of this Agreement.\n9. Should the Data Validator need additional documents or information to verify Defendants\u2019 performance in any Reporting Period, it shall send a letter to Defendants requesting such documents or information, and the Data Validator shall provide a copy of the request to Plaintiffs\u2019 Counsel.\n10. Should the Data Validator encounter or identify any issues regarding the collection or measurement of performance data that might bear on Defendants\u2019 statistical ability to achieve the performance standard set forth for any of the exit criteria, the Data Validator shall bring the matter to the parties\u2019 attention for discussion. If necessary, the matter shall be resolved pursuant to the Dispute Resolution processes set forth in Sections IV.B.1-4.\n11. The Data Validator shall issue a draft report setting forth Defendants\u2019 progress in relation to each of the exit criteria and identified data elements within four months of the close of the reporting period. The Data Validator may request an extension of time to complete the report, which shall not be unreasonably denied. After receipt of the draft report, the parties shall have 21 days to submit comments to the Data Validator on its findings. Thereafter, within 30 days, the Data Validator shall issue a final report, which shall be a public document, subject to the provisions of Section IV.A.12, below.\n12. All non-public information obtained by the Data Validator shall be maintained in a confidential manner. The Data Validator\u2019s reports shall be public documents, except that any individually-identifying information and other confidential information protected from disclosure shall be redacted from any public report in accordance with the Confidentiality Order entered by the Court. The Data Validator\u2019s redacted reports shall be published on Defendants\u2019 website.\n13. The Data Validator shall be permitted to speak separately with all parties.\n14. The cost of the Data Validator shall be borne by Defendants.", "samples": [{"hash": "kp6DaUUHsr7", "uri": "/contracts/kp6DaUUHsr7#data-validation", "label": "Joint Settlement Agreement", "score": 30.4220199585, "published": true}, {"hash": "1KPXeZOmRoO", "uri": "/contracts/1KPXeZOmRoO#data-validation", "label": "Joint Settlement Agreement", "score": 30.4120461812, "published": true}, {"hash": "lLdUX6vY2A3", "uri": "/contracts/lLdUX6vY2A3#data-validation", "label": "Joint Settlement Agreement", "score": 30.2340774536, "published": true}], "size": 4, "hash": "afbfdd0243c3ae03456279dd248614a1", "id": 3}, {"snippet_links": [{"key": "encounter-data", "type": "definition", "offset": [0, 14]}, {"key": "claims-for-payments", "type": "clause", "offset": [61, 80]}, {"key": "edits-and-audits", "type": "clause", "offset": [145, 161]}, {"key": "to-ensure", "type": "clause", "offset": [162, 171]}, {"key": "will-be-rejected", "type": "clause", "offset": [268, 284]}, {"key": "claims-data", "type": "clause", "offset": [311, 322]}, {"key": "consistent-with-the", "type": "clause", "offset": [361, 380]}, {"key": "transaction-standards", "type": "clause", "offset": [387, 408]}, {"key": "in-place", "type": "definition", "offset": [409, 417]}, {"key": "date-of-service", "type": "definition", "offset": [425, 440]}, {"key": "services-provided", "type": "clause", "offset": [464, 481]}, {"key": "commitment-to", "type": "clause", "offset": [492, 505]}, {"key": "random-sample", "type": "definition", "offset": [577, 590]}, {"key": "access-to", "type": "definition", "offset": [674, 683]}, {"key": "information-systems", "type": "definition", "offset": [688, 707]}], "snippet": "Encounter data is currently defined by AHS as a \u201cclaim\u201d. All claims for payments are currently submitted to HP and undergo a series of automated edits and audits to ensure accuracy, timeliness, correctness, logic, consistency and completeness. Any claim failing edits will be rejected and must be re-submitted. Claims data will be collected in a format that is consistent with the HIPAA transaction standards in place on the date of service. Claims must represent services provided to Global Commitment to Health Demonstration enrollees only. DVHA will perform validation on a random sample of all claims to ensure that services were actually provided. AHS will have direct access to all information systems.", "samples": [{"hash": "4lXmEoBoyDn", "uri": "/contracts/4lXmEoBoyDn#data-validation", "label": "Intergovernmental Agreement", "score": 27.6666736603, "published": true}, {"hash": "hRY5WEpVrRk", "uri": "/contracts/hRY5WEpVrRk#data-validation", "label": "Intergovernmental Agreement", "score": 26.4084568024, "published": true}], "size": 3, "hash": "89b39164eb4137a39764571cc84ad888", "id": 7}, {"snippet_links": [{"key": "completion-of", "type": "clause", "offset": [9, 22]}, {"key": "to-validate", "type": "definition", "offset": [41, 52]}, {"key": "the-meter", "type": "definition", "offset": [120, 129]}, {"key": "in-the-field", "type": "clause", "offset": [146, 158]}, {"key": "representative-sample", "type": "definition", "offset": [160, 181]}, {"key": "confidence-level", "type": "definition", "offset": [213, 229]}], "snippet": "1.2.3.1. Completion of sampling exercise to validate data delivered over network compared to date read from the face of the meter while installed in the field. Representative sample to be taken by FPL to meet *** confidence level +/- *** confidence interval that the readings correlate (n=***) (same exercise as 1.1.3).", "samples": [{"hash": "kamuNUeEHAp", "uri": "/contracts/kamuNUeEHAp#data-validation", "label": "Master Services and Software License Agreement (Silver Spring Networks Inc)", "score": 22.7768650055, "published": true}, {"hash": "eORkFWr1rmI", "uri": "/contracts/eORkFWr1rmI#data-validation", "label": "Master Services and Software License Agreement (Silver Spring Networks Inc)", "score": 22.5441474915, "published": true}], "size": 4, "hash": "7139eb202a8926f950dd907114546fa3", "id": 4}, {"snippet_links": [{"key": "the-network", "type": "definition", "offset": [100, 111]}], "snippet": "1.5.3.1. Validation of sample of meters to occur for which outage indication has been provided over the network.\n1.5.3.1.1. No more than *** of investigated meters are to be categorized as \u201cfalse positives\u201d meaning there is no explainable reason for the outage message to be produced.", "samples": [{"hash": "kamuNUeEHAp", "uri": "/contracts/kamuNUeEHAp#data-validation", "label": "Master Services and Software License Agreement (Silver Spring Networks Inc)", "score": 22.7768650055, "published": true}, {"hash": "eORkFWr1rmI", "uri": "/contracts/eORkFWr1rmI#data-validation", "label": "Master Services and Software License Agreement (Silver Spring Networks Inc)", "score": 22.5441474915, "published": true}], "size": 4, "hash": "461063a1a845930f4cd529b754afa817", "id": 5}, {"snippet_links": [{"key": "texas-health-steps", "type": "definition", "offset": [25, 43]}, {"key": "to-submit", "type": "definition", "offset": [54, 63]}, {"key": "for-services", "type": "clause", "offset": [71, 83]}, {"key": "the-cms", "type": "clause", "offset": [141, 148]}, {"key": "claim-form", "type": "definition", "offset": [154, 164]}, {"key": "hipaa-compliant", "type": "definition", "offset": [177, 192]}, {"key": "code-set", "type": "definition", "offset": [193, 201]}, {"key": "required-by", "type": "definition", "offset": [202, 213]}, {"key": "encounter-data", "type": "definition", "offset": [220, 234]}, {"key": "review-of", "type": "clause", "offset": [262, 271]}, {"key": "random-sample", "type": "definition", "offset": [274, 287]}, {"key": "eligible-enrollees", "type": "clause", "offset": [310, 328]}, {"key": "to-validate", "type": "definition", "offset": [429, 440]}, {"key": "reported-data", "type": "definition", "offset": [507, 520]}, {"key": "network-providers", "type": "clause", "offset": [642, 659]}, {"key": "notice-to-the", "type": "clause", "offset": [724, 737]}, {"key": "the-provider", "type": "definition", "offset": [745, 757]}], "snippet": "The HMO must require all Texas Health Steps Providers to submit claims for services paid (either on a capitated or fee-for service basis) on the CMS 1500 claim form and use the HIPAA compliant code set required by HHSC. Encounter Data will be validated by chart review of a random sample of Texas Health Steps eligible enrollees against monthly Encounter Data reported by the HMO. HHSC or its designee will conduct chart reviews to validate that all screens are performed when due and as reported, and that reported data is accurate and timely. Substantial deviation between reported and charted Encounter Data could result in the HMO and/or Network Providers being investigated for potential Fraud, Abuse, or Waste without notice to the HMO or the Provider.", "samples": [{"hash": "eF48zrTfEj4", "uri": "/contracts/eF48zrTfEj4#data-validation", "label": "Contract Amendment (Centene Corp)", "score": 23.138261795, "published": true}, {"hash": "1RxcOFq9fQ1", "uri": "/contracts/1RxcOFq9fQ1#data-validation", "label": "Contract Amendment (Centene Corp)", "score": 22.8124580383, "published": true}, {"hash": "iQnXnxhuFhA", "uri": "/contracts/iQnXnxhuFhA#data-validation", "label": "Contract Amendment (Centene Corp)", "score": 22.3141689301, "published": true}], "size": 3, "hash": "2cdd5401ff89bdc5cfb43ef684be6b63", "id": 6}, {"snippet_links": [{"key": "completion-of", "type": "clause", "offset": [8, 21]}, {"key": "alternate-method", "type": "definition", "offset": [48, 64]}, {"key": "data-capture", "type": "definition", "offset": [85, 97]}, {"key": "the-meter", "type": "definition", "offset": [101, 110]}, {"key": "data-collected", "type": "clause", "offset": [132, 146]}, {"key": "the-network", "type": "definition", "offset": [165, 176]}], "snippet": "1.3.3.1 Completion of dual metering exercise or alternate method to compare interval data capture at the meter and compare to meter data collected and provided over the network. Method TBD.", "samples": [{"hash": "kamuNUeEHAp", "uri": "/contracts/kamuNUeEHAp#data-validation", "label": "Master Services and Software License Agreement (Silver Spring Networks Inc)", "score": 22.7768650055, "published": true}, {"hash": "eORkFWr1rmI", "uri": "/contracts/eORkFWr1rmI#data-validation", "label": "Master Services and Software License Agreement (Silver Spring Networks Inc)", "score": 22.5441474915, "published": true}], "size": 2, "hash": "ead0e238188efc17ceb5a33adaaea123", "id": 8}, {"snippet_links": [{"key": "in-general", "type": "definition", "offset": [0, 10]}, {"key": "measurement-data", "type": "definition", "offset": [46, 62]}, {"key": "the-data", "type": "clause", "offset": [66, 74]}, {"key": "supporting-evidence", "type": "clause", "offset": [159, 178]}, {"key": "temperature-sensor", "type": "definition", "offset": [228, 246]}, {"key": "system-installation", "type": "definition", "offset": [308, 327]}, {"key": "testing-or-maintenance", "type": "definition", "offset": [329, 351]}, {"key": "data-acquisition", "type": "clause", "offset": [664, 680]}, {"key": "data-sets", "type": "clause", "offset": [831, 840]}, {"key": "flagged-data", "type": "definition", "offset": [875, 887]}, {"key": "hours-of", "type": "clause", "offset": [1067, 1075]}], "snippet": "In general, the NAEMS researchers invalidated measurement data if the data values were: \u2022 Unreasonably low or high when compared to normal ranges if there was supporting evidence that the data value is not correct (e.g., lagoon temperature sensor producing a reading of less than -40 \u00b0 C). \u2022 Obtained during system installation, testing or maintenance during which uncorrectable errors might be introduced. \u2022 Obtained when a sensor or instrument was proven to be malfunctioning (e.g., unstable). \u2022 Obtained during calibration or precision check of a sensor or instrument and before the sensor or instrument reached equilibrium after the check. \u2022 Obtained when the data acquisition and control hardware and/or software were not functioning correctly. Data that the NAEMS researchers deemed invalid were retained in the preprocessed data sets. However, the EPA did not use the flagged data to calculate pollutant emissions rates. 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