Common use of ITP Clause in Contracts

ITP. All Service Provider Agencies must complete, sign, and submit the Service Provider Roster. The CDSA may remove an employee / subcontractor of the Service Provider Agency from the Service Provider Roster for failing to fulfill obligations under this Attachment 1 without terminating the Provider Agreement with the Service Provider Agency. A Change Request Form found in Appendix A of Attachment 1 must be submitted to the CDSA detailing any changes to the Service Provider Roster or any agency details. Service Provider Agencies, who have employees / subcontractors who provide services to infants and toddlers referred to or enrolled in the N.C. ITP, shall conduct a criminal background record check on all such employees / subcontractors. The record check shall occur: (a) within ten (10) business days of the hiring of the employee or subcontractor; (b) within ten (10) business days of signing the Provider Agreement; or, (c) prior to the Service Provider Agency being added to the Service Provider Roster. Following the completion of the background check, the Service Provider Agency must submit to the CDSA a signed, notarized copy of the Verification of Acceptable Criminal Record Check form found in Appendix A of Attachment 1. The Service Provider Agency is not required to submit the actual background check for its employees / subcontractors but must retain copies of criminal record investigation reports in their records prior to the provision of any direct early intervention services. Independent practitioners who enroll as a Service Provider (i.e., individuals who enroll as providers) and agency owners who provide direct services, shall submit a current (i.e. obtained within 6 months) North Carolina Statewide criminal record check report. In addition, any Service Provider remains under the obligation to report any criminal violation, be it a felony or a misdemeanor, within five (5) business days of such occurrence, during the period of time in which this Provider Agreement is in effect. Additionally, all Service Providers are subject to an annual, mandatory review against the OIG List of Excluded Individuals/Entities (“LEIE”) Database for OIG exclusion verification. Service Providers shall adhere to the confidentiality requirements of the Individuals with Disabilities Education Act (IDEA), Family Educational Rights and Privacy Act (FERPA), Health Insurance Portability and Accountability Act (HIPAA), and all corresponding federal rules and regulations implementing these statutes and N.C. ITP policies. All direct Service Providers performing under Attachment 1 shall sign and adhere to the terms of the N.C. ITP Confidentiality Agreement found in Appendix A of Attachment 1 and submit an executed Confidentiality Agreement to the CDSA (or CDSAs) within two (2) business days of the commencement of employment. Service Providers shall comply with the Medicaid False Claims Act (31 U.S.C. § 3729) and shall be required to ▇▇▇▇ both public and private insurance with parent consent. Service Providers shall abide by all enrollment agreements and state/federal laws that apply to Service Providers who deliver services to Medicaid beneficiaries Families have the exclusive right to deny billing of private or public insurance. Billing shall be consistent with N.C. ITP’s “Fees, Billing and Reimbursement Policy.” Any Service Provider that refuses to apply the same billing procedures to both public and private insurance entities, with parent consent, shall be referred to the appropriate entity for consideration of further appropriate action, which may include legal action. Failure to accept public and private insurance clients may be cause for termination of this Provider Agreement. All services under Attachment 1, shall be authorized solely through an IFSP that is developed by the infant or toddler’s IFSP Team through the CDSA. Services on an IFSP to which the family has consented and for which the family has declined billing insurance (public or private) shall be billed to the family based on a sliding fee scale as set forth in N.C. ITP policies (see N.C. ITP website at: ▇▇▇▇▇://▇▇▇▇▇▇▇.▇▇.▇▇▇). Families have the exclusive right to accept and/or decline services, and this right extends to accepting or declining less than all recommended services. Families also have the exclusive right to consent or not to consent to the method, length, frequency, and intensity of services. All services provided pursuant to this Provider Agreement shall be authorized solely through an IFSP that is developed by the infant or toddler’s IFSP Team through the CDSA. Services on an IFSP shall not be modified or ended except through the CDSA’s Service Coordinator and through an IFSP review meeting that is scheduled with appropriate prior notice and includes the family and other appropriate members of the IFSP Team. All IFSPs meetings require prior written notice (at least ten (10) days, unless waived by the parent), which includes both initial and any subsequent review IFSP meetings. No service can be modified (i.e., lengthened, shortened, terminated) absent a properly convened IFSP meeting. Evaluations and assessments and the development or review of an IFSP shall be at no cost to the family. Service Providers may pursue payment for evaluations in accordance with N.C. ITP’s “Fees, Billing, and Reimbursement Policy.” Service Providers may pursue payment for IFSP review meetings through the N.C. ITP as Case Consultation and Education (CC & E). Service Providers may receive N.C. ITP funds, depending on availability, for services that are duly authorized and provided, as long as the receipt(s) for those services are consistent with the N.C. ITP “Fees, Billing, and Reimbursement Policy.” If they receive N.C. ITP funds, Service Providers shall ensure that those funds are not used to satisfy a financial commitment for services that would otherwise have been paid for from another public or private source. Regardless of who bills for the service, if compliance with documentation requirements is not provided to support reimbursed early intervention services or if the Service Provider receives overpayment for a claim, then the Service Provider shall refund the funding source (i.e. family, public or private insurance, or the N.C. ITP) the amount previously paid or the amount overpaid for that service. During the term of the Provider Agreement, the Service Provider shall maintain complete and professionally adequate medical records consistent with the standards of practice set by their North Carolina Licensing Board or other relevant certifying entity. The Service Provider shall prepare and preserve as required, all reports, notes, forms, claims and correspondence that are necessary and appropriate to their professional services. The Service Provider shall further maintain these records in accordance with the record retention requirements specified in the “Oversight” section of the Provider Agreement. The CDSA shall have the right and authority to conduct an on-site audit of the Service Provider. The CDSA shall give Service Providers three (3) business days’ notice prior to conducting an on-site visit. Service Providers shall provide all requested documentation, including but not limited to: (a) licensure or certification; (b) procedures and policies for billing and collecting family fees; (c) proof of insurance; (d) criminal background verification; (e) financial records needed by the Office of Inspector General (“OIG”), the Office of the Attorney General, the North Carolina State Auditor or the North Carolina Early Intervention Branch staff; and (f) any other reasonably requested records. The N.C. ITP retains the right to monitor all Service Providers. Such monitoring may take place in a variety of ways, including but not limited to: review of notes, plans of care, billing notes, family pay records and other receipts for services, direct observation of service provision, and review of licensure and/or certification. Service Providers shall make available, within ten (10) business days of a request from the CDSA or any N.C. ITP staff, any and all records generated by the provider for any infant, toddler, or family served in the N.C. ITP Program. Service Providers shall ensure that all health and safety codes are followed, and that infants and toddlers being evaluated for eligibility or enrolled in the N.C. ITP are not at risk of sustaining harm or injury. This includes compliance with all state laws concerning the reporting of suspected or observed abuse and/or neglect. Service Providers shall observe and adhere to all professional licensure and/or certification requirements and standards.