Common use of RECORDS AND AUDIT PROVISIONS Clause in Contracts

RECORDS AND AUDIT PROVISIONS. 5.1 ON-SITE AND OFF-SITE REVIEWS/AUDITS The OTP grants the Director, DHA [or authorized representative(s)], the right to conduct on-site or off-site reviews or accounting audits with full access to patients and records. The audits may be conducted on a scheduled or unscheduled (unannounced) basis. This right to audit/review includes, but is not limited to, the right to: (a) Examine fiscal and all other records of the OTP which would confirm compliance with this agreement and designation as an authorized OTP provider. (b) Conduct audits of OTP records including clinical, financial, and census records to determine the nature of the services being provided, and the basis for charges and claims against the United States for services provided to beneficiaries. The Director, DHA, or a designee shall have full access to records of both TRICARE and non-TRICARE patients. Note: In most cases, only TRICARE patients’ records will be audited. Examples of situations where non-TRICARE patient records would be requested may be in situations of differential quality of care assessments or to identify systemic quality or safety concerns. (c) Examine reports of evaluations and inspections conducted by federal, state, local government, and private agencies and organizations. (d) Conduct on-site inspections of the facilities of the OTP and interview employees, members of the staff, contractors, board members, volunteers, and patients, as may be required. (e) Release copies of final review reports (including reports of on-site reviews) under the Freedom of Information Act (FOIA).

RECORDS AND AUDIT PROVISIONS. 5.1 ‌‌ 5.1‌‌ ON-SITE AND OFF-SITE REVIEWS/AUDITS The OTP IOP grants the Director, DHA [or authorized representative(s)], the right to conduct on-site or off-site reviews or accounting audits with full access to patients and records. The audits may will be conducted on a scheduled or unscheduled (unannounced) basis. This right to audit/review includes, but is not limited to, the right to: to:‌ (a) a)‌ Examine fiscal and all other records of the OTP IOP which would confirm compliance with this agreement and designation as an authorized OTP IOP provider. (b) b)‌ Conduct audits of OTP IOP records including clinical, financial, and census records to determine the nature of the services being provided, and the basis for charges and claims against the United States for services provided to beneficiaries. The Director, DHA, or a designee shall have full access to records of both TRICARE and non-TRICARE patients. Note: In most cases, only TRICARE patients’ records will be audited. Examples of situations where non-TRICARE patient records would be requested may be in situations of differential quality of care assessments or to identify systemic quality or and safety concerns. (c) c)‌ Examine reports of evaluations and inspections conducted by federal, state, local government, and private agencies and organizations. (d) d)‌ Conduct on-site inspections of the facilities of the OTP IOP and interview employees, members of the staff, contractors, board members, volunteers, and patients, as may be required. (e) e)‌ Release copies of final review reports (including reports of on-site reviews) under the Freedom of Information Act (FOIA).

RECORDS AND AUDIT PROVISIONS. 5.1 ON-SITE AND OFF-SITE REVIEWS/AUDITS The OTP SUDRF grants the Director, DHA [or authorized representative(s)]designee, the right to conduct on-site or off-site reviews or accounting audits with full access to patients and records. The audits may will be conducted on a scheduled or unscheduled (unannounced) basis. This right to audit/review includes, but is not limited to, to the right to: (a) Examine fiscal and all other records of the OTP which SUDRF that would confirm compliance with this agreement and designation as an a TRICARE-authorized OTP provider. (b) Conduct audits of OTP records SUDRF records, including clinical, financial, and census records to determine the nature of the services being provided, provided and the basis for charges and claims against the United States U.S. for services provided to TRICARE beneficiaries. The Director, DHA, DHA or a designee shall have full access to records of both TRICARE and non-TRICARE patients. Note: In most cases, only TRICARE patients’ records will be audited. Examples of situations where non-TRICARE patient records would be requested may be in situations of differential quality of care assessments or to identify systemic quality or safety concerns. (c) Examine reports of evaluations and inspections conducted by federal, state, local governmentGovernment, and private agencies and organizations. (d) Conduct on-site inspections of the facilities of the OTP SUDRF and interview interviewing employees, members of the staff, contractors, board members, volunteers, and patients, as may be required. (e) Release copies of final review reports (including reports of on-site reviews) if requested under the Freedom of Information Act (FOIA)Act.

RECORDS AND AUDIT PROVISIONS. 5.1 6.1 ON-SITE AND OFF-SITE REVIEWS/AUDITS The OTP PHP grants the Director, DHA [or authorized representative(s)]designee, the right to conduct on-site or off-site reviews or accounting audits with full access to patients and records. The audits may be conducted on a scheduled or unscheduled (unannounced) basis. This right to audit/review includes, but is not limited to, the right to: (a) Examine fiscal and all other records of the OTP PHP which would confirm compliance with this agreement and designation as an authorized OTP PHP provider. (b) Conduct audits of OTP PHP records including clinical, financial, and census records to determine the nature of the services being provided, and the basis for charges and claims against the United States U.S. for services provided to beneficiaries. The Director, DHA, or a designee designee, shall have full access to records of both TRICARE and non-TRICARE patients. Note: In most cases, only TRICARE patients’ records will be audited. Examples of situations where non-TRICARE patient records would be requested may be in situations of differential quality of care assessments or to identify systemic quality or safety concerns. (c) Examine reports of evaluations and inspections conducted by federal, state, local governmentGovernment, and private agencies and organizations. (d) Conduct on-site inspections of the facilities of the OTP PHP and interview employees, members of the staff, contractors, board members, volunteers, and patients, as may be required. (e) Release copies of final review reports (including reports of on-site reviews) under the Freedom of Information Act (FOIA).

RECORDS AND AUDIT PROVISIONS. 5.1 ON-SITE AND OFF-SITE REVIEWS/AUDITS The OTP IOP grants the Director, DHA [or authorized representative(s)], the right to conduct on-site or off-site reviews or accounting audits with full access to patients and records. The audits may will be conducted on a scheduled or unscheduled (unannounced) basis. This right to audit/review includes, but is not limited to, the right to: (a) Examine fiscal and all other records of the OTP IOP which would confirm compliance with this agreement and designation as an authorized OTP IOP provider. (b) Conduct audits of OTP IOP records including clinical, financial, and census records to determine the nature of the services being provided, and the basis for charges and claims against the United States for services provided to beneficiaries. The Director, DHA, or a designee shall have full access to records of both TRICARE and non-TRICARE patients. Note: In most cases, only TRICARE patients’ records will be audited. Examples of situations where non-TRICARE patient records would be requested may be in situations of differential quality of care assessments or to identify systemic quality or and safety concerns. (c) Examine reports of evaluations and inspections conducted by federal, state, local government, and private agencies and organizations. (d) Conduct on-site inspections of the facilities of the OTP IOP and interview employees, members of the staff, contractors, board members, volunteers, and patients, as may be required. (e) Release copies of final review reports (including reports of on-site reviews) under the Freedom of Information Act (FOIA).