Common use of Program Integrity and Data Usage Clause in Contracts

Program Integrity and Data Usage. The PIHP shall establish written policies, procedures, and standards of conduct that articulate the organization's commitment to comply with all applicable data processing and safeguarding requirements and standards under the contract, and all applicable Federal and state requirements. This documentation must be kept current and be provided to the department upon request. a. This requirement extends to all subcontractors to the extent that the subcontractor is delegated responsibility by the PIHP. The PIHP is responsible for ensuring that data usage agreements and procedures are in place with providers and contractors that facilitate complete, accurate and timely encounter submissions to the Department. b. The Department retains the right to analyze encounter data and use it for any purpose it deems necessary. The Department will ensure that the analysis does not violate the integrity of the reported data submitted by the PIHP.