Common use of Access to Provider Records Clause in Contracts

Access to Provider Records. The Provider agrees to provide at no cost to the following entities or their designees with prompt, reasonable, and adequate access to the PIHP and Provider Contract/Agreement and any records, books, documents, and papers that relate to the PIHP and Provider Contract/Agreement and/or the Provider’s performance of its responsibilities under this contract for purposes of examination, audit, investigation, contract administration, the making of copies, excerpts or transcripts, or any other purpose NC DHHS deems necessary for contract enforcement or to perform its regulatory functions: The United States Department of Health and Human Services or its designee; The Comptroller General of the United States or its designee; The North Carolina Department of Health and Human Services (NC DHHS), its Medicaid Managed Care program personnel, or its designee The Office of Inspector General North Carolina Department of Justice Medicaid Investigations Division Any independent verification and validation contractor, audit firm, or quality assurance contractor acting on behalf of NC DHHS; The North Carolina Office of State Auditor, or its designee A state or federal law enforcement agency. And any other state or federal entity identified by NC DHHS, or any other entity engaged by NC DHHS. The Provider shall cooperate with all announced and unannounced site visits, audits, investigations, post-payment reviews, or other Program Integrity activities conducted by the NC Department of Health and Human Services. Nothing in this section shall be construed to limit the ability of the federal government, the Centers for Medicare and Medicaid Services, the U.S. Department of Health and Human Services Office of Inspector General, the U.S. Department of Justice, or any of the foregoing entities' contractors or agents, to enforce federal requirements for the submission of documentation in response to an audit or investigation. (Attachment X.x.xx p. 323)

Access to Provider Records. The Provider agrees to provide at no cost to the following entities or their designees with prompt, reasonable, and adequate access to the PIHP and Provider Contract/Agreement and any records, books, documents, and papers that relate to the PIHP and Provider Contract/Agreement and/or the Provider’s performance of its responsibilities under this contract the Agreement for purposes of examination, audit, investigation, contract administration, the making of copies, excerpts or transcripts, or any other purpose NC DHHS Department deems necessary for contract enforcement or to perform its regulatory functions: : i) The United States Department of Health and Human Services or its designee; itsdesignee; ii) The Comptroller General of the United States or its designee; The North Carolina Department of Health and Human Services (NC DHHS)itsdesignee; iii) Department, its Medicaid Managed Care managed care program personnel, or its designee itsdesignee; iv) The Office of Inspector General General; v) North Carolina Department of Justice Medicaid Investigations Division Division; vi) Any independent verification and validation contractor, audit firm, or quality assurance contractor acting on behalf of NC DHHS; Department; vii) The North Carolina Office of State Auditor, or its designee itsdesignee; viii) A state or federal law enforcement agency. ; ix) And any other state or federal entity identified by NC DHHSDepartment, or any other entity engaged by NC DHHSDepartment. The Provider shall cooperate with all announced and unannounced site visits, audits, investigations, post-payment reviews, or other Program Integrity program integrity activities conducted by the NC Department of Health and Human ServicesDepartment. Nothing in this section Provision shall be construed to limit the ability of the federal government, the Centers for Medicare and Medicaid Services, the U.S. Department of Health and Human Services Office of Inspector General, the U.S. Department of Justice, or any of the foregoing entities' contractors or agents, to enforce federal requirements for the submission of documentation in response to an audit or investigation. (Attachment X.x.xx p. 323)Provider shall make copies of medical records available to United and the Department in conjunction with its regulation of United. The records shall be made available and furnished immediately upon request in either paper or electronic form, at no cost to the requesting party.

Access to Provider Records. The Provider agrees to provide at no cost to the following entities or their designees with prompt, reasonable, and adequate access to the PIHP and Provider Contract/Agreement Contract and any records, books, documents, papers, and papers video recordings that relate to the PIHP and Provider Contract/Agreement Contract and/or the Provider’s performance of its responsibilities under this contract Contract for purposes of examination, audit, investigation, contract administration, the making of copies, excerpts or transcripts, or any other purpose NC DHHS deems necessary for contract enforcement or to perform its regulatory functions: : i. The United States Department of Health and Human Services or its designee; ; ii. The Comptroller General of the United States or its designee; ; iii. The North Carolina Department of Health and Human Services (NC DHHS), its Medicaid Managed Care program personnel, or its designee designee; iv. The Office of Inspector General General; v. North Carolina Department of Justice Medicaid Investigations Division Division; vi. Any independent verification and validation contractor, audit firm, or quality assurance contractor acting on behalf of NC DHHS; ; vii. The North Carolina Office of State Auditor, or its designee designee; viii. A state or federal law enforcement agency. ix. And any other state or federal entity identified by NC DHHS, or any other entity engaged by NC DHHS. The Provider shall cooperate with all announced and unannounced site visits, audits, investigations, post-post- payment reviews, or other Program Integrity activities conducted by the NC Department of Health and Human Services. Nothing in this section Attachment shall be construed to limit the ability of the federal government, the Centers for Medicare and Medicaid Services, the U.S. Department of Health and Human Services Office of Inspector General, the U.S. Department of Justice, or any of the foregoing entities' contractors or agents, to enforce federal requirements for the submission of documentation in response to an audit or investigation. (Attachment X.x.xx p. 323).

Access to Provider Records. The Provider agrees to provide at no cost to the following entities or their designees with prompt, reasonable, and adequate access to the PIHP and Provider Contract/Agreement and any records, books, documents, and papers that relate to the PIHP and Provider Contract/Agreement and/or the Provider’s performance of its responsibilities under this contract the Agreement for purposes of examination, audit, investigation, contract administration, the making of copies, excerpts or transcripts, or any other purpose NC DHHS Department deems necessary for contract enforcement or to perform its regulatory functions: : i) The United States Department of Health and Human Services or its designee; ; ii) The Comptroller General of the United States or its designee; The North Carolina Department of Health and Human Services (NC DHHS); iii) Department, its Medicaid Managed Care managed care program personnel, or its designee designee; iv) The Office of Inspector General General; v) North Carolina Department of Justice Medicaid Investigations Division Division; vi) Any independent verification and validation contractor, audit firm, or quality assurance contractor acting on behalf of NC DHHS; Department; vii) The North Carolina Office of State Auditor, or its designee designee; viii) A state or federal law enforcement agency. ; ix) And any other state or federal entity identified by NC DHHSDepartment, or any other entity engaged by NC DHHSDepartment. The Provider shall cooperate with all announced and unannounced site visits, audits, investigations, post-payment reviews, or other Program Integrity program integrity activities conducted by the NC Department of Health and Human ServicesDepartment. Nothing in this section Provision shall be construed to limit the ability of the federal government, the Centers for Medicare and Medicaid Services, the U.S. Department of Health and Human Services Office of Inspector General, the U.S. Department of Justice, or any of the foregoing entities' contractors or agents, to enforce federal requirements for the submission of documentation in response to an audit or investigation. (Attachment X.x.xx p. 323)Provider shall make copies of medical records available to United and the Department in conjunction with its regulation of United. The records shall be made available and furnished immediately upon request in either paper or electronic form, at no cost to the requesting party.