{"component": "clause", "props": {"groups": [{"size": 22, "snippet": "See Recital A. ---------------------", "snippet_links": [], "samples": [{"hash": "lCMNdlEtDmw", "uri": "/contracts/lCMNdlEtDmw#provider-subcontracts", "label": "Dental Group Management Agreement (Gentle Dental Service Corp)", "score": 18.0, "published": true}, {"hash": "iraN3vMol6O", "uri": "/contracts/iraN3vMol6O#provider-subcontracts", "label": "Dental Group Management Agreement (Gentle Dental Service Corp)", "score": 18.0, "published": true}, {"hash": "gGyHQj6UJx3", "uri": "/contracts/gGyHQj6UJx3#provider-subcontracts", "label": "Dental Group Management Agreement (Gentle Dental Service Corp)", "score": 18.0, "published": true}], "hash": "704e58974f54fddcd525d248c2184496", "id": 1}, {"size": 6, "snippet": "Provider shall obtain CMHSP\u2019s prior written approval before subcontracting any or all of Provider\u2019s obligations hereunder. Furthermore, any subcontract shall:\nA. Be in writing and include a full specification of the subcontracted supports/services.\nB. Contain a provision stating this Agreement is incorporated by reference into the subcontract and made a part thereof, and as such, is subject to the terms and conditions of this Agreement.\nC. Not terminate the legal responsibility of Provider to ensure that supports/services required of Provider hereunder are fulfilled.\nD. Provide, prior to execution of any such subcontract, commercially reasonable efforts to furnish CMHSP with notice verifying that subcontractor and its professional staff, if any, maintain all approvals, licenses, certifications, registrations, accreditations, and authorizations required by Federal, State, and local laws, ordinances, rules, and regulations to perform the subcontracted supports/services pursuant to the subcontract.\nE. Allow for the audit and inspection of records and premises by CMHSP, LRE, the Office of Inspector General, or any State of Federal government agency, or their representatives, or any other authorized body, at any time, including but not limited to, access to inspect, review, copy, and/or audit all financial records, licenses, accreditation, certification, and program reports pertaining to the performance of obligations under this Agreement, to the full extent permitted by applicable State and Federal law.\nF. Provide, prior to execution of any such subcontract, assurance that the subcontractor:\n1. Is not listed by MDHHS or another agency of the Federal government or State of Michigan as being suspended from participation in Medicaid or Medicare programs.\n2. Is not listed by MDHHS or any other agency of the State of Michigan in its registry for unfair labor practices.\n3. Is not listed by the U.S. General Services Administration in its \u201cExcluded Parties List\u201d as to Federal funding.\n4. Maintains workers\u2019 compensation and unemployment insurance coverage for its employees, as required by law.\n5. Maintains liability insurance coverages required by CMHSP or LRE, as the case may be, for all contracted services,", "snippet_links": [{"key": "provider-shall", "type": "clause", "offset": [0, 14]}, {"key": "prior-written-approval", "type": "definition", "offset": [30, 52]}, {"key": "in-writing", "type": "clause", "offset": [165, 175]}, {"key": "incorporated-by-reference", "type": "clause", "offset": [298, 323]}, {"key": "terms-and-conditions-of-this-agreement", "type": "clause", "offset": [401, 439]}, {"key": "responsibility-of-provider", "type": "clause", "offset": [468, 494]}, {"key": "to-ensure", "type": "clause", "offset": [495, 504]}, {"key": "services-required", "type": "definition", "offset": [519, 536]}, {"key": "prior-to", "type": "definition", "offset": [586, 594]}, {"key": "commercially-reasonable-efforts", "type": "definition", "offset": [630, 661]}, {"key": "with-notice", "type": "clause", "offset": [679, 690]}, {"key": "professional-staff", "type": "definition", "offset": [728, 746]}, {"key": "all-approvals", "type": "clause", "offset": [765, 778]}, {"key": "authorizations-required", "type": "clause", "offset": [841, 864]}, {"key": "local-laws", "type": "definition", "offset": [888, 898]}, {"key": "and-regulations", "type": "clause", "offset": [919, 934]}, {"key": "pursuant-to-the", "type": "clause", "offset": [982, 997]}, {"key": "records-and-premises", "type": "clause", "offset": [1052, 1072]}, {"key": "the-office-of-inspector-general", "type": "clause", "offset": [1088, 1119]}, {"key": "any-state", "type": "definition", "offset": [1124, 1133]}, {"key": "federal-government-agency", "type": "definition", "offset": [1137, 1162]}, {"key": "at-any-time", "type": "clause", "offset": [1220, 1231]}, {"key": "not-limited", "type": "clause", "offset": [1247, 1258]}, {"key": "access-to-inspect", "type": "clause", "offset": [1263, 1280]}, {"key": "financial-records", "type": "definition", "offset": [1313, 1330]}, {"key": "program-reports", "type": "definition", "offset": [1376, 1391]}, {"key": "pertaining-to", "type": "definition", "offset": [1392, 1405]}, {"key": "obligations-under-this-agreement", "type": "clause", "offset": [1425, 1457]}, {"key": "state-and-federal-law", "type": "clause", "offset": [1502, 1523]}, {"key": "the-subcontractor", "type": "clause", "offset": [1596, 1613]}, {"key": "the-federal-government", "type": "clause", "offset": [1662, 1684]}, {"key": "state-of-michigan", "type": "clause", "offset": [1688, 1705]}, {"key": "agency-of-the-state", "type": "definition", "offset": [1817, 1836]}, {"key": "unfair-labor-practices", "type": "definition", "offset": [1869, 1891]}, {"key": "the-us", "type": "clause", "offset": [1913, 1920]}, {"key": "general-services-administration", "type": "clause", "offset": [1922, 1953]}, {"key": "excluded-parties-list", "type": "clause", "offset": [1962, 1983]}, {"key": "federal-funding", "type": "definition", "offset": [1991, 2006]}, {"key": "compensation-and", "type": "clause", "offset": [2030, 2046]}, {"key": "coverage-for", "type": "clause", "offset": [2070, 2082]}, {"key": "as-required-by-law", "type": "clause", "offset": [2098, 2116]}, {"key": "coverages-required", "type": "clause", "offset": [2151, 2169]}, {"key": "the-case", "type": "definition", "offset": [2190, 2198]}, {"key": "contracted-services", "type": "definition", "offset": [2215, 2234]}], "samples": [{"hash": "aOGJPpYxv7U", "uri": "/contracts/aOGJPpYxv7U#provider-subcontracts", "label": "Provider Service Agreement", "score": 32.5414010538, "published": true}], "hash": "aaa9443707090acfe97fc2d79282ef31", "id": 2}, {"size": 2, "snippet": "(a) If Provider, with CMHSP\u2019s prior written consent, subcontracts any supports/services required of Provider under this Agreement, any such subcontract shall:\n(1) Be in writing and include a full specification of the subcontracted supports/services;\n(2) Contain a provision stating that this Agreement is incorporated by reference into the subcontract and made a part thereof; and\n(3) Contain a provision stating that the subcontract is subject to the terms and conditions of this Agreement. Any such subcontract shall not terminate the legal responsibility of Provider to ensure that supports/services required of Provider hereunder are fulfilled.\n(b) Prior to the execution of any such subcontract, Provider shall use commercially reasonable efforts to furnish CMHSP with notice verifying that:\n(1) The subcontractor and its professional staff, if any, maintain all approvals, licenses, certifications, registrations, accreditations, and authorizations required by Federal, State and local laws, ordinances, rules and regulations to perform the subcontracted supports/services for Covered Persons.\n(2) The subcontractor is not listed by a MDHHS or agency of the Federal government or the State of Michigan as being suspended from participation in Medicaid or Medicare Programs;\n(3) The subcontractor is not listed by a MDHHS or agency of the State of Michigan in its registry for unfair labor practices;\n(4) The subcontractor is not listed by the U.S. General Services Administration in its\n(5) The subcontractor maintains workers\u2019 compensation and unemployment insurance coverage for its employees; and\n(6) The subcontractor maintains liability insurance coverages required by CMHSP, LRE or Administrator for all contracted services. Provider shall immediately notify CMHSP in writing if, subsequent to execution of any such subcontract, Provider discovers that any of the above cited verifications are no longer true.\n(c) Any subcontractor shall ensure, as applicable, that its professional staff, if any, meet CMHSP\u2019s, LRE\u2019s or Administrator\u2019s, as the case may be, credentialing and privileging requirements, including privileging and competency standards and/or that its nonprofessional staff meets the CMHSP\u2019s or LRE\u2019s, as the case may be, requirements for qualifications and competency standards, necessary to perform the subcontracted Supports/Services.", "snippet_links": [{"key": "prior-written-consent", "type": "clause", "offset": [30, 51]}, {"key": "services-required", "type": "definition", "offset": [79, 96]}, {"key": "in-writing", "type": "clause", "offset": [166, 176]}, {"key": "incorporated-by-reference", "type": "clause", "offset": [305, 330]}, {"key": "terms-and-conditions-of-this-agreement", "type": "clause", "offset": [452, 490]}, {"key": "responsibility-of-provider", "type": "clause", "offset": [543, 569]}, {"key": "to-ensure", "type": "clause", "offset": [570, 579]}, {"key": "the-execution", "type": "clause", "offset": [662, 675]}, {"key": "provider-shall", "type": "clause", "offset": [701, 715]}, {"key": "use-commercially-reasonable-efforts", "type": "clause", "offset": [716, 751]}, {"key": "with-notice", "type": "clause", "offset": [769, 780]}, {"key": "the-subcontractor", "type": "clause", "offset": [801, 818]}, {"key": "professional-staff", "type": "definition", "offset": [827, 845]}, {"key": "all-approvals", "type": "clause", "offset": [864, 877]}, {"key": "required-by", "type": "definition", "offset": [955, 966]}, {"key": "state-and-local-laws", "type": "clause", "offset": [976, 996]}, {"key": "rules-and-regulations", "type": "definition", "offset": [1010, 1031]}, {"key": "services-for", "type": "clause", "offset": [1070, 1082]}, {"key": "covered-persons", "type": "definition", "offset": [1083, 1098]}, {"key": "the-federal-government", "type": "clause", "offset": [1160, 1182]}, {"key": "state-of-michigan", "type": "clause", "offset": [1190, 1207]}, {"key": "agency-of-the-state", "type": "definition", "offset": [1330, 1349]}, {"key": "unfair-labor-practices", "type": "definition", "offset": [1382, 1404]}, {"key": "the-us", "type": "clause", "offset": [1445, 1452]}, {"key": "general-services-administration", "type": "clause", "offset": [1454, 1485]}, {"key": "compensation-and", "type": "clause", "offset": [1534, 1550]}, {"key": "coverage-for", "type": "clause", "offset": [1574, 1586]}, {"key": "coverages-required", "type": "clause", "offset": [1658, 1676]}, {"key": "contracted-services", "type": "definition", "offset": [1716, 1735]}, {"key": "subcontractor-shall", "type": "clause", "offset": [1930, 1949]}, {"key": "the-case", "type": "definition", "offset": [2053, 2061]}, {"key": "credentialing-and-privileging", "type": "clause", "offset": [2070, 2099]}, {"key": "competency-standards", "type": "clause", "offset": [2140, 2160]}, {"key": "requirements-for", "type": "clause", "offset": [2247, 2263]}], "samples": [{"hash": "dJGRdC1nBGW", "uri": "/contracts/dJGRdC1nBGW#provider-subcontracts", "label": "Provider Service Agreement", "score": 23.8583162218, "published": true}], "hash": "e6a7638b2c720dab16d52c4ea49cef0b", "id": 3}, {"size": 1, "snippet": "If Provider, with CMHSP\u2019s prior written consent, subcontracts any supports/services required of Provider under this Agreement, any such subcontract shall:", "snippet_links": [{"key": "prior-written-consent", "type": "clause", "offset": [26, 47]}, {"key": "services-required", "type": "definition", "offset": [75, 92]}, {"key": "this-agreement", "type": "clause", "offset": [111, 125]}], "samples": [{"hash": "h8KUFzKCF80", "uri": "/contracts/h8KUFzKCF80#provider-subcontracts", "label": "Service Agreement", "score": 25.0164271047, "published": true}], "hash": "d4b2c18a7f7cdeebe1a5c271ffd16be6", "id": 4}, {"size": 1, "snippet": "(a) Generally. CONTRACTOR must enter into written contracts with properly credentialed health care service providers, licensed in Texas, either directly or through intermediaries, such as Independent Practice Associations (IPAs). CONTRACTOR must have its own credentialing process to review, approve, and periodically re-certify the credentials of all participating providers in compliance with 28 T.A.C. Section 11.1902. CONTRACTOR may delegate credentialing in accordance with TDI regulations.\n(b) Subcontract terms. CONTRACTOR must ensure that, as part of its contract with the provider, or in its intermediary's contract with the actual provider of health services, in addition to any requirements imposed by state insurance law or TDI regulation, the following requirements are included:\n(1) A statement to the effect that the provider is subject to all state and federal laws, rules and regulations that apply to all persons or entities receiving state and federal funds, including provisions of the Clean Air Act and the Federal Water Pollution Control Act, as amended, found at 42 C.F.R. 7401, et seq. and 33 U.S.C. 1251, et seq., respectively; the exclusion, debarment, and suspension provisions of Section 1128(a) or (b) of the Social Security Act (42 USC Section 1320 a-7), or Executive Order 12549; the provisions of the Byrd Anti-Lobbying Amendment, found at 31 U.S.C. 1352, rel\u2587\u2587\u2587\u2587g to use of federal funds for lobbying for or obtaining federal contracts; Health and Safety Code, Chapter 85, Subchapter E, relating to the Duties of State Agencies and State Contractors for the confidentiality of AIDS and HIV-related medical information and an anti-discrimination policy for employees and Members with communicable diseases; confidentiality provisions relating to Member information (cite); Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990, and all requirements imposed by the regulations implementing these acts and all amendments to the laws and regulations; the provisions of Executive Order 11246, as amended by 11375, relating to Equal Employment Opportunity; Texas Government Code, Title 10, Subtitle D, Chapter 2161 and 1 TAC Section 111.11(b) and 111.13(c)(7) relating to the good faith effort to use Historically Underutilized Businesses (HUBs); section 9-7.06 of article IX of the General Appropriations Act of 1999 regarding \"Buy Texas\"; Texas Family Code Section 231.006 regarding child support payments; and chapter 552 of the Texas Government Code regarding the release of public information;\n(2) A statement that the provider understands and agrees that CONTRACTOR has the sole responsibility for payment of covered services rendered by the provider under CONTRACTOR/provider contract and a statement that in the event that CONTRACTOR becomes insolvent or ceases operations, the provider's sole recourse is against CONTRACTOR through CONTRACTOR's bankruptcy, conservatorship, or receivership estate;\n(3) A statement that CONTRACTOR will initiate and maintain any action necessary to stop a health care provider or employee, agent, assign, trustee, or successor-in-interest from maintaining an action against HHSC or any Member to collect payment from HHSC or any Members over and above allowable copayments or deductibles, excluding payment for services not covered under CHIP;\n(4) A statement that CONTRACTOR must defend, indemnify and hold harmless Members and HHSC against any and all claims, costs, damages, or expenses (including attorney's fees) of any type or nature arising from the failure, inability, or refusal of CONTRACTOR to pay health care providers for covered services or supplies;\n(5) CONTRACTOR must ensure that each health care provider contract prohibits the provider from engaging in direct marketing to Members that is designed to increase enrollment in a particular health plan. This prohibition should not constrain providers from engaging in permissible marketing activities consistent with broad outreach objectives and application assistance;\n(6) A statement that the provider is subject to all state and federal laws and regulations relating to fraud and abuse in health care and CHIP. The provider must cooperate and assist HHSC and any state or federal agency that has the duty of identifying, investigating, sanctioning or prosecuting suspected fraud and abuse. The provider must provide originals and/or copies of all records and information requested and allow access to premises and provide records to HHSC or its authorized agent(s), HCFA, the U.S. Department of Health and Human Services (DHHS), FBI, TDI, or other unit of state government. The provider must provide all copies of records free of charge; and\n(7) A requirement that the provider is responsible for collecting at the time of the service any applicable CHIP copayments or deductibles given the limitations on those copayments and deductibles as set out in section 11.06 of this Agreement. CONTRACTOR must require, through contractual provisions or provider manual, providers to create and keep medical records in compliance with the medical records standards contained in the Standards for Quality Improvement Programs in Appendix F. All medical records must be kept for at least five (5) years, except for records of rural health clinics, which must be kept for a period of six (6) years from the date of service. THE CONTRACTOR REMAINS RESPONSIBLE FOR PERFORMING AND FOR ANY FAILURE TO PERFORM ALL DUTIES, RESPONSIBILITIES AND SERVICES UNDER THIS AGREEMENT REGARDLESS OF WHETHER THE DUTY, RESPONSIBILITY OR SERVICE IS CONTRACTED TO ANOTHER FOR ACTUAL PERFORMANCE.", "snippet_links": [{"key": "contractor-must", "type": "clause", "offset": [15, 30]}, {"key": "contracts-with", "type": "clause", "offset": [50, 64]}, {"key": "service-providers", "type": "clause", "offset": [99, 116]}, {"key": "in-texas", "type": "definition", "offset": [127, 135]}, {"key": "independent-practice", "type": "clause", "offset": [188, 208]}, {"key": "credentialing-process", "type": "definition", "offset": [259, 280]}, {"key": "participating-providers", "type": "definition", "offset": [352, 375]}, {"key": "in-compliance-with", "type": "definition", "offset": [376, 394]}, {"key": "in-accordance-with", "type": "definition", "offset": [460, 478]}, {"key": "subcontract-terms", "type": "clause", "offset": [500, 517]}, {"key": "provider-of-health-services", "type": "definition", "offset": [641, 668]}, {"key": "in-addition-to", "type": "clause", "offset": [670, 684]}, {"key": "insurance-law", "type": "clause", "offset": [719, 732]}, {"key": "subject-to", "type": "definition", "offset": [844, 854]}, {"key": "rules-and-regulations", "type": "definition", "offset": [883, 904]}, {"key": "state-and-federal-funds", "type": "clause", "offset": [953, 976]}, {"key": "clean-air-act-and-the-federal-water-pollution-control-act", "type": "clause", "offset": [1006, 1063]}, {"key": "as-amended", "type": "definition", "offset": [1065, 1075]}, {"key": "suspension-provisions", "type": "clause", "offset": [1183, 1204]}, {"key": "social-security-act", "type": "clause", "offset": [1238, 1257]}, {"key": "section-1320", "type": "clause", "offset": [1266, 1278]}, {"key": "the-provisions-of-the", "type": "clause", "offset": [1311, 1332]}, {"key": "lobbying-amendment", "type": "clause", "offset": [1343, 1361]}, {"key": "use-of-federal-funds", "type": "clause", "offset": [1400, 1420]}, {"key": "federal-contracts", "type": "definition", "offset": [1451, 1468]}, {"key": "health-and-safety-code", "type": "definition", "offset": [1470, 1492]}, {"key": "state-agencies", "type": "clause", "offset": [1546, 1560]}, {"key": "aids-and-hiv", "type": "clause", "offset": [1610, 1622]}, {"key": "medical-information", "type": "definition", "offset": [1631, 1650]}, {"key": "for-employees", "type": "clause", "offset": [1685, 1698]}, {"key": "communicable-diseases", "type": "clause", "offset": [1716, 1737]}, {"key": "provisions-relating-to", "type": "clause", "offset": [1755, 1777]}, {"key": "member-information", "type": "definition", "offset": [1778, 1796]}, {"key": "title-vi-of-the-civil-rights-act-of-1964", "type": "definition", "offset": [1805, 1845]}, {"key": "section-504-of-the-rehabilitation-act-of-1973", "type": "definition", "offset": [1847, 1892]}, {"key": "americans-with-disabilities-act-of-1990", "type": "definition", "offset": [1898, 1937]}, {"key": "all-requirements", "type": "clause", "offset": [1943, 1959]}, {"key": "the-regulations", "type": "clause", "offset": [1971, 1986]}, {"key": "the-laws", "type": "definition", "offset": [2033, 2041]}, {"key": "executive-order-11246", "type": "clause", "offset": [2077, 2098]}, {"key": "equal-employment-opportunity", "type": "definition", "offset": [2133, 2161]}, {"key": "texas-government-code", "type": "clause", "offset": [2163, 2184]}, {"key": "title-10", "type": "definition", "offset": [2186, 2194]}, {"key": "good-faith-effort", "type": "definition", "offset": [2282, 2299]}, {"key": "historically-underutilized-businesses", "type": "clause", "offset": [2307, 2344]}, {"key": "section-9", "type": "clause", "offset": [2353, 2362]}, {"key": "article-ix", "type": "clause", "offset": [2371, 2381]}, {"key": "act-of-1999", "type": "definition", "offset": [2412, 2423]}, {"key": "buy-texas", "type": "clause", "offset": [2435, 2444]}, {"key": "code-section", "type": "definition", "offset": [2460, 2472]}, {"key": "child-support-payments", "type": "clause", "offset": [2491, 2513]}, {"key": "release-of", "type": "clause", "offset": [2574, 2584]}, {"key": "public-information", "type": "clause", "offset": [2585, 2603]}, {"key": "payment-of", "type": "definition", "offset": [2710, 2720]}, {"key": "services-rendered", "type": "definition", "offset": [2729, 2746]}, {"key": "by-the-provider", "type": "clause", "offset": [2747, 2762]}, {"key": "provider-contract", "type": "clause", "offset": [2780, 2797]}, {"key": "in-the-event", "type": "clause", "offset": [2819, 2831]}, {"key": "ceases-operations", "type": "definition", "offset": [2869, 2886]}, {"key": "sole-recourse", "type": "clause", "offset": [2903, 2916]}, {"key": "receivership-estate", "type": "definition", "offset": [2992, 3011]}, {"key": "contractor-will", "type": "clause", "offset": [3034, 3049]}, {"key": "any-action", "type": "definition", "offset": [3072, 3082]}, {"key": "a-health-care", "type": "clause", "offset": [3101, 3114]}, {"key": "action-against", "type": "clause", "offset": [3206, 3220]}, {"key": "services-not-covered", "type": "clause", "offset": [3358, 3378]}, {"key": "indemnify-and-hold-harmless", "type": "clause", "offset": [3436, 3463]}, {"key": "all-claims", "type": "clause", "offset": [3497, 3507]}, {"key": "to-pay", "type": "clause", "offset": [3649, 3655]}, {"key": "health-care-providers", "type": "definition", "offset": [3656, 3677]}, {"key": "covered-services-or-supplies", "type": "clause", "offset": [3682, 3710]}, {"key": "engaging-in", "type": "definition", "offset": [3807, 3818]}, {"key": "direct-marketing", "type": "definition", "offset": [3819, 3835]}, {"key": "to-members", "type": "clause", "offset": [3836, 3846]}, {"key": "health-plan", "type": "definition", "offset": [3903, 3914]}, {"key": "marketing-activities", "type": "clause", "offset": [3993, 4013]}, {"key": "consistent-with", "type": "clause", "offset": [4014, 4029]}, 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not, without prior approval from MCNA, enter into any subcontract or other agreement for any of the work contemplated under this Agreement without receiving approval from MCNA. In the event Provider secures prior approval and enters into any subcontract agreement with another provider to provide Covered Services to Covered Persons, such agreement shall meet all requirements of the Agreement.", "snippet_links": [{"key": "provider-shall", "type": "clause", "offset": [0, 14]}, {"key": "prior-approval", "type": "definition", "offset": [28, 42]}, {"key": "agreement-for", "type": "clause", "offset": [90, 103]}, {"key": "of-the-work", "type": "clause", "offset": [108, 119]}, {"key": "this-agreement", "type": "clause", "offset": [139, 153]}, {"key": "event-provider", "type": "definition", "offset": [199, 213]}, {"key": "subcontract-agreement", "type": "definition", "offset": [257, 278]}, {"key": "provide-covered-services", "type": "clause", "offset": [304, 328]}, {"key": "covered-persons", "type": "definition", "offset": [332, 347]}, {"key": "the-agreement", "type": "clause", "offset": [395, 408]}], "samples": [{"hash": "6HDPyn6cJXM", "uri": "/contracts/6HDPyn6cJXM#provider-subcontracts", "label": "Product Attachment to Master Dental Provider Agreement", "score": 24.8206707734, "published": true}], "hash": "1d7fa24b3877d4291b4266a2a2094981", "id": 6}, {"size": 1, "snippet": "See Recital B.", "snippet_links": [], "samples": [{"hash": "65hWdcapeI8", "uri": "/contracts/65hWdcapeI8#provider-subcontracts", "label": "Dental Group Management Agreement (Gentle Dental Service Corp)", "score": 18.0, "published": true}], "hash": "400c67b8c0b29efd437f421dd4474fbb", "id": 7}, {"size": 1, "snippet": "50 ------------- (a) Generally............................................................................................51 (b) Subcontract terms...................................................................................51 SECTION 15.02 PROVIDER ACCESSIBILITY..........................................................................52 ------------- SECTION", "snippet_links": [{"key": "subcontract-terms", "type": "clause", "offset": [129, 146]}, {"key": "provider-accessibility", "type": "clause", "offset": [246, 268]}], "samples": [{"hash": "8N2f169wWN4", "uri": "/contracts/8N2f169wWN4#provider-subcontracts", "label": "Children's Health Insurance Program Agreement (Amerigroup Corp)", "score": 18.0, "published": true}], "hash": "46d46127fe81fb7b437b97a498dc1e3c", "id": 8}, {"size": 1, "snippet": "The Contractor\u2019s Subcontracts shall contain the following provisions:\n9.5.1 A statement that Subcontractors receiving GFS or FBG funds shall cooperate with the Contractor or HCA-sponsored Quality Improvement (QI) activities.\n9.5.2 A means to keep records necessary to adequately document services provided to Consumers for all delegated activities including QI, Utilization Management, and Consumer Rights and Protections.", "snippet_links": [{"key": "the-contractor", "type": "clause", "offset": [0, 14]}, {"key": "cooperate-with", "type": "clause", "offset": [141, 155]}, {"key": "quality-improvement", "type": "definition", "offset": [188, 207]}, {"key": "keep-records", "type": "clause", "offset": [242, 254]}, {"key": "services-provided", "type": "definition", "offset": [288, 305]}, {"key": "delegated-activities", "type": "clause", "offset": [327, 347]}, {"key": "utilization-management", "type": "clause", "offset": [362, 384]}, {"key": "rights-and-protections", "type": "clause", "offset": [399, 421]}], "samples": [{"hash": "i5qPvZ2PhHS", "uri": "/contracts/i5qPvZ2PhHS#provider-subcontracts", "label": "Behavioral Health Administrative Services Organization Contract", "score": 24.6030116359, "published": true}], "hash": "ede0f02f02e81962c789dc6445bb1c68", "id": 9}, {"size": 1, "snippet": "The Contractor\u2019s Subcontracts shall contain the following provisions:\n9.5.1 A statement that Subcontractors receiving GFS or FBG funds shall cooperate with the Contractor or HCA-sponsored Quality Improvement (QI) activities.\n9.5.2 A means to keep records necessary to adequately document services provided to Individuals for all delegated activities including QI, Utilization Management, and Individual Rights and Protections.\n9.5.3 For providers, a requirement to provide discharge planning services which shall, at a minimum:\n9.5.3.1 Coordinate a community-based discharge plan for each Individual served under this Contract beginning at intake. Discharge planning shall apply to all Individuals regardless of length of stay or whether they complete treatment.\n9.5.3.2 Coordinate exchange of assessment, admission, treatment progress, and continuing care information with the referring entity. Contact with the referral agency shall be made within the first week of residential treatment.\n9.5.3.3 Establish referral relationships with assessment entities, outpatient providers, vocational or employment services, and courts which specify aftercare expectations and services, including procedure for involvement of entities making referrals in treatment activities;\n9.5.3.4 Coordinate, as needed, with DBHR prevention services, vocational services, housing services and supports, and other community resources and services that may be appropriate, including the DCYF, and the DSHS Economic Services Administration including Community Service Offices (CSOs).\n9.5.3.5 Coordinate services to financially-eligible Individuals who are in need of medical services.\n9.5.4 A requirement that residential treatment providers ensure that priority admission is given to the populations identified in this contract.\n9.5.5 Requirements for information and data sharing to support Care Coordination consistent with this Contract.\n9.5.6 A requirement to implement a Grievance process that complies with WAC 182-538C- 110 and as described in the Grievance System Section of this Contract.\n9.5.7 A requirement that termination of a Subcontract shall not be grounds for an appeal, Administrative Hearing, or a Grievance for the Individual if similar services are immediately available in the service area.\n9.5.8 Requirements for how Individuals will be informed of their right to a Grievance or Appeal in the case of:\n9.5.8.1 Denial or termination of service related to medical necessity determinations.\n9.5.8.2 Failure to act upon a request for services with reasonable promptness.\n9.5.9 A requirement that the Subcontractor shall comply with Chapter 71.32 RCW (Mental Health Advance Directives).\n9.5.10 A requirement to provide Individuals access to translated information and interpreter services as described in the Materials and Information Section of this Contract.\n9.5.11 A requirement for adherence to established protocols for determining eligibility for services consistent with this Contract.\n9.5.12 A requirement to use the Integrated Co-Occurring Disorder Screening Tool (GAIN-SS found at \u2587\u2587\u2587\u2587\u2587://\u2587\u2587\u2587.\u2587\u2587\u2587.\u2587\u2587.\u2587\u2587\u2587/billers-providers-partners/behavioral-health- recovery/gain-ss). The Contractor shall include requirements for training staff that will be using the tool(s) to address the screening and assessment process, the tool and quadrant placement as well as requirements for corrective action if the process is not implemented and maintained throughout the Contract\u2019s period of performance.\n9.5.13 A requirement for subcontracted staff to participate in training when requested by HCA. Exceptions must be in writing and include a plan for how the required information shall be provided to them.\n9.5.14 A requirement to conduct criminal background checks and maintain related policies and procedures and personnel files consistent with requirements in Chapter 43.43 RCW and, Chapter 246-341 WAC.\n9.5.15 Requirements for nondiscrimination in employment and Individual services.\n9.5.16 Protocols for screening for debarment and suspension of certification.\n9.5.17 Requirements to identify funding sources consistent with the Payments and Sanctions Section of this Contract, FBG reporting requirements and the rules for payer responsibility found in the table \u201cHow do providers identify the correct payer\u201d within the Apple Health Mental Health Services Billing Guide.\n9.5.18 A requirement to participate in the peer review process when requested by HCA. (42 U.S.C. 300x-53(a) and 45 C.F.R. 96.136). The MHBG and SABG Block Grant requires an annual peer review by individuals with expertise in the field of drug abuse treatment (for SABG) and individuals with expertise in the field of mental health treatment consisting (for MHBG). At least five percent (5%) of treatment providers will be reviewed.\n9.5.19 The Contractor shall ensure that the Charitable Choice Requirements of 42 CFR Part 54 are followed and that Faith-Based Organizations (FBO) are provided opportunities to compete with traditional alcohol/drug abuse treatment providers for funding.\n9.5.20 If the Contractor Subcontracts with FBOs, the Contractor shall require the FBO to meet the requirements of 42 C.F.R. Part 54 as follows:\n9.5.20.1 Individuals requesting or receiving SUD services shall be provided with a choice of SUD treatment providers.\n9.5.20.2 The FBO shall facilitate a referral to an alternative provider within a reasonable time frame when requested by the recipient of services.\n9.5.20.3 The FBO shall report to the Contractor all referrals made to alternative providers.\n9.5.20.4 The FBO shall provide Individuals with a notice of their rights.\n9.5.20.5 The FBO provides Individuals with a summary of services that includes any religious activities.\n9.5.20.6 Funds received from the FBO must be segregated in a manner consistent with federal Regulations.\n9.5.20.7 No funds may be expended for religious activities.\n9.5.21 A requirement that the Subcontractor shall respond in a full and timely manner to law enforcement inquiries regarding an individual\u2019s eligibility to possess a firearm under RCW 9.41.040(2)(a)(ii).\n9.5.21.1 The Contractor shall report new commitment data within twenty-four (24) hours. Commitment information under this section does not need to be re- sent if it is already in the possession of HCA. The Contractor and HCA shall be immune from liability related to the sharing of commitment information under this section (RCW 71.05.740).\n9.5.22 Delegated activities are documented and agreed upon between Contractor and Subcontractor. 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