Common use of Allocation; Performance; Reduction in Funding; Termination Clause in Contracts

Allocation; Performance; Reduction in Funding; Termination. A. The amount of payment actually due to Contractor will be determined by an allocation formula. The allocation formula includes the following factors: the amount of funds available to each region of the State and the amount of service provided by the contractor in each region of the State. Contractor will be notified of the allocation amount quarterly and will not be compensated in excess of that amount. A portion of the amount paid the provider will be based on the provider's performance. Provider performance measures are set forth in the document titled Performance Measures Definitions which is located at xxxx.xxxx.xx.xxx/XXXXXX/xxxxXxxxxxxxx.xxxx. Detailed information on the payment procedures is contained in the DARMHA Manuals. Further detail of the compensation process is contained in the terms of this Contract. B. The State may conduct periodic reviews of the utilization of funds paid under this Contract. When requested, the contractor must present documentation to support utilization of funds applicable to the population for which the funds were allocated. The documentation may include staff salaries and other operating costs expended to support the population in question. Underutilization by the Contractor of such funds, reallocation of such funds, or a decision by the State to discontinue purchasing the delivery of care, may result in reduced funding under this Contract. The State will make allocation decisions in its sole discretion. The State makes no representation, covenant or warranty that it will allocate any specified amount of dollars to any particular region of the State. Other than changes in allocation, for which no advance notification shall be made, the State shall give ten (10) days written notice of any decision to reduce the funding of this Contract, which notice shall include a statement of reasons for such reduction. The Contractor may, within the ten (10) day period, appeal to the Commissioner of the Department of Administration pursuant to the Dispute Resolution clause of this Contract. C. No costs may be incurred against this Contract by the Contractor after the end of the term of this Contract. All claims shall be submitted to the State within sixty (60) days of the date of service delivery, or the State may elect to deny payment. D. The State may reduce the funding levels and amounts stated in this Contract. This may prevent the Contractor from receiving further funds under the terms of this Contract. The Contractor remains responsible for the assurance and delivery of the full clinically appropriate Continuum of Care through June 30, 2021, to those individuals registered in DARMHA. E. As authorized by IC 12-21-2-7, IC 12-21-2-8, and 440 IAC 9-2-1(b), the State may reduce funding or terminate this Contract, or terminate the Contractor’s State certification if the Contractor fails to comply with all of the terms and conditions of (1) this Contract and (2) 440 IAC 9. F. The State shall make available written instructions to the Contractor regarding any procedures and/or assessments, DARMHA processing, or instructions with which the Contractor must comply as a precondition for payment under the terms of this Contract. G. The Contractor may, upon written demand by the State, be required to repay the State all sums paid by the State to the Contractor for which adequate fiscal and/or care delivery documentation is not available for the time period audited. The Contractor agrees to assist the State, or its authorized representatives, in any audit in connection with the Contract. The Contractor further agrees that the State shall have the right to enter the premises of the Contractor, and/or its subcontractors, and review records and property maintained by the Contractor in connection with this Contract. If such an audit of the Contractor results in an audit exception, the State shall have the right to offset such amount against current or future allowable claims, demand a cash payback, or withhold payment of current claims in a like amount, pending resolution between the parties of any disputed amount. H. Medicaid Rehabilitation Option (MRO) reconciliation payments are to be paid in full to DMHA no later than 30 days after the Contractor is notified of the additional match owed. If the Contractor disputes such amount, and the dispute is related to the Department of Child Services (DCS) MRO referrals, the Contractor must not reduce the amount of the match owed to DMHA by the disputed amount. The Contractor is obligated to resolve its dispute with DCS. If the resolution between DCS and the Contractor results in a finding that the amount of match owed should be reduced, the State will generate new reports, which will reflect the change.

Allocation; Performance; Reduction in Funding; Termination. A. The amount of payment actually due to Contractor will be determined by an allocation formula. The allocation formula includes the following factors: the amount of funds available to each region of the State and the amount of service provided by the contractor in each region of the State. Contractor will be notified of the allocation amount quarterly and will not be compensated in excess of that amount. A portion of the amount paid the provider will be based on the provider's performance. Provider performance measures are set forth in the document titled Performance Measures Definitions which is located at xxxx.xxxx.xx.xxx/XXXXXX/xxxxXxxxxxxxx.xxxx. Detailed information on the payment procedures is contained in the DARMHA Manuals. Further detail of the compensation process is contained in the terms of this Contract. B. The State may conduct periodic reviews of the utilization of funds paid under this Contract. When requested, the contractor must present documentation to support utilization of funds applicable to the population for which the funds were allocated. The documentation may include staff salaries and other operating costs expended to support the population in question. Underutilization by the Contractor of such funds, reallocation of such funds, or a decision by the State to discontinue purchasing the delivery of care, may result in reduced funding under this Contract. The State will make allocation decisions in its sole discretion. The State makes no representation, covenant or warranty that it will allocate any specified amount of dollars to any particular region of the State. Other than changes in allocation, for which no advance notification shall be made, the State shall give ten (10) days written notice of any decision to reduce the funding of this Contract, which notice shall include a statement of reasons for such reduction. The Contractor may, within the ten (10) day period, appeal to the Commissioner of the Department of Administration pursuant to the Dispute Resolution clause of this Contract. C. No costs may be incurred against this Contract by the Contractor after the end of the term of this Contract. All claims shall be submitted to the State within sixty (60) days of the date of service delivery, or the State may elect to deny payment. D. The State may reduce the funding levels and amounts stated in this Contract. This may prevent the Contractor from receiving further funds under the terms of this Contract. The Contractor remains responsible for the assurance and delivery of the full clinically appropriate Continuum of Care through June 30, 20212020, to those individuals registered in DARMHA. E. As authorized by IC 12-21-2-7, IC 12-21-2-8, and 440 IAC 9-2-1(b), the State may reduce funding or terminate this Contract, or terminate the Contractor’s State certification if the Contractor fails to comply with all of the terms and conditions of (1) this Contract and (2) 440 IAC 9. F. The State shall make available written instructions to the Contractor regarding any procedures and/or assessments, DARMHA processing, or instructions with which the Contractor must comply as a precondition for payment under the terms of this Contract. G. The Contractor may, upon written demand by the State, be required to repay the State all sums paid by the State to the Contractor for which adequate fiscal and/or care delivery documentation is not available for the time period audited. The Contractor agrees to assist the State, or its authorized representatives, in any audit in connection with the Contract. The Contractor further agrees that the State shall have the right to enter the premises of the Contractor, and/or its subcontractors, and review records and property maintained by the Contractor in connection with this Contract. If such an audit of the Contractor results in an audit exception, the State shall have the right to offset such amount against current or future allowable claims, demand a cash payback, or withhold payment of current claims in a like amount, pending resolution between the parties of any disputed amount. H. Medicaid Rehabilitation Option (MRO) reconciliation payments are to be paid in full to DMHA no later than 30 days after the Contractor is notified of the additional match owed. If the Contractor disputes such amount, and the dispute is related to the Department of Child Services (DCS) MRO referrals, the Contractor must not reduce the amount of the match owed to DMHA by the disputed amount. The Contractor is obligated to resolve its dispute with DCS. If the resolution between DCS and the Contractor results in a finding that the amount of match owed should be reduced, the State will generate new reports, which will reflect the change.

Allocation; Performance; Reduction in Funding; Termination. A. The amount of payment actually due to Contractor will be determined by an allocation formula. The allocation formula includes the following factors: the amount of funds available to each region of the State and the amount of service provided by the contractor in each region of the State. Contractor will be notified of the allocation amount quarterly and will not be compensated in excess of that amount. A portion of the amount paid the provider will be based on the provider's performance. Provider performance measures are set forth in the document titled Performance Measures Definitions which is located at xxxx.xxxx.xx.xxx/XXXXXX/xxxxXxxxxxxxx.xxxx. Detailed information on the payment procedures is contained in the DARMHA Manuals. Further detail of the compensation process is contained in the terms of this Contract. B. The State may conduct periodic reviews of the utilization of funds paid under this Contract. When requested, the contractor must present documentation to support utilization of funds applicable to the population for which the funds were allocated. The documentation may include staff salaries and other operating costs expended to support the population in question. Underutilization by the Contractor of such funds, reallocation of such funds, or a decision by the State to discontinue purchasing the delivery of care, may result in reduced funding under this Contract. The State will make allocation decisions in its sole discretion. The State makes no representation, covenant or warranty that it will allocate any specified amount of dollars to any particular region of the State. Other than changes in allocation, for which no advance notification shall be made, the State shall give ten (10) days written notice of any decision to reduce the funding of this Contract, which notice shall include a statement of reasons for such reduction. The Contractor may, within the ten (10) day period, appeal to the Commissioner of the Department of Administration pursuant to the Dispute Resolution clause of this Contract. C. No costs may be incurred against this Contract by the Contractor after the end of the term of this Contract. All claims shall be submitted to the State within sixty (60) days of the date of service delivery, or the State may elect to deny payment. D. The State may reduce the funding levels and amounts stated in this Contract. This may prevent the Contractor from receiving further funds under the terms of this Contract. The Contractor remains responsible for the assurance and delivery of the full clinically appropriate Continuum of Care through June 30, 20212019, to those individuals registered in DARMHA. E. As authorized by IC 12-21-2-7, IC 12-21-2-8, and 440 IAC 9-2-1(b), the State may reduce funding or terminate this Contract, or terminate the Contractor’s State certification if the Contractor fails to comply with all of the terms and conditions of (1) this Contract and (2) 440 IAC 9. F. The State shall make available written instructions to the Contractor regarding any procedures and/or assessments, DARMHA processing, or instructions with which the Contractor must comply as a precondition for payment under the terms of this Contract. G. The Contractor may, upon written demand by the State, be required to repay the State all sums paid by the State to the Contractor for which adequate fiscal and/or care delivery documentation is not available for the time period audited. The Contractor agrees to assist the State, or its authorized representatives, in any audit in connection with the Contract. The Contractor further agrees that the State shall have the right to enter the premises of the Contractor, and/or its subcontractors, and review records and property maintained by the Contractor in connection with this Contract. If such an audit of the Contractor results in an audit exception, the State shall have the right to offset such amount against current or future allowable claims, demand a cash payback, or withhold payment of current claims in a like amount, pending resolution between the parties of any disputed amount. H. Medicaid Rehabilitation Option (MRO) reconciliation payments are to be paid in full to DMHA no later than 30 days after the Contractor is notified of the additional match owed. If the Contractor disputes such amount, and the dispute is related to the Department of Child Services (DCS) MRO referrals, the Contractor must not reduce the amount of the match owed to DMHA by the disputed amount. The Contractor is obligated to resolve its dispute with DCS. If the resolution between DCS and the Contractor results in a finding that the amount of match owed should be reduced, the State will generate new reports, which will reflect the change.

Allocation; Performance; Reduction in Funding; Termination. A. a. The amount of payment actually due to Contractor will be determined by an allocation formula. The allocation formula includes the following factors: the amount of funds available to each region of the State and the amount of service provided by the contractor in each region of the State. Contractor will be notified of the allocation amount quarterly and will not be compensated in excess of that amount. A portion of the amount paid the provider will be based on the provider's performance. Provider performance measures are set forth in the document titled Performance Measures Definitions which is located at xxxx.xxxx.xx.xxx/XXXXXX/xxxxXxxxxxxxx.xxxx. Detailed information on the payment procedures is contained in the DARMHA Manuals. Further detail of the compensation process is contained in the terms of this Contract. B. b. The State may conduct periodic reviews of the utilization of funds paid under this Contract. When requested, the contractor must present documentation to support utilization of funds applicable to the population for which the funds were allocated. The documentation may include staff salaries and other operating costs expended to support the population in question. Underutilization by the Contractor of such funds, reallocation of such funds, or a decision by the State to discontinue purchasing the delivery of care, may result in reduced funding under this Contract. The State will make allocation decisions in its sole discretion. The State makes no representation, covenant or warranty that it will allocate any specified amount of dollars to any particular region of the State. Other than changes in allocation, for which no advance notification shall be made, the State shall give ten (10) days written notice of any decision to reduce the funding of this Contract, which notice shall include a statement of reasons for such reduction. The Contractor may, within the ten (10) day period, appeal to the Commissioner of the Department of Administration pursuant to the Dispute Resolution clause of this Contract. C. c. No costs may be incurred against this Contract by the Contractor after the end of the term of this Contract. All claims shall be submitted to the State within sixty (60) days of the date of service delivery, or the State may elect to deny payment. D. d. The State may reduce the funding levels and amounts stated in this Contract. This may prevent the Contractor from receiving further funds under the terms of this Contract. The Contractor remains responsible for the assurance and delivery of the full clinically appropriate Continuum of Care through June 30, 20212024, to those individuals registered in DARMHA. E. e. As authorized by IC 12-21-2-7, IC 12-21-2-8, and 440 IAC 9-2-1(b), the State may reduce funding or terminate this Contract, or terminate the Contractor’s State certification if the Contractor fails to comply with all of the terms and conditions of (1) this Contract and (2) 440 IAC 9. F. f. The State shall make available written instructions to the Contractor regarding any procedures and/or assessments, DARMHA processing, or instructions with which the Contractor must comply as a precondition for payment under the terms of this Contract. G. g. The Contractor may, upon written demand by the State, be required to repay the State all sums paid by the State to the Contractor for which adequate fiscal and/or care delivery documentation is not available for the time period audited. The Contractor agrees to assist the State, or its authorized representatives, in any audit in connection with the Contract. The Contractor further agrees that the State shall have the right to enter the premises of the Contractor, and/or its subcontractors, and review records and property maintained by the Contractor in connection with this Contract. If such an audit of the Contractor results in an audit exception, the State shall have the right to offset such amount against current or future allowable claims, demand a cash payback, or withhold payment of current claims in a like amount, pending resolution between the parties of any disputed amount. H. Medicaid Rehabilitation Option (MRO) reconciliation payments are to be paid in full to DMHA no later than 30 days after . In conjunction with the services provided by the Contractor is notified of pursuant to this agreement, Contractor hereby agrees to provide information supplied by the additional match owed. If State to families served by the Contractor disputes such amountregarding Hoosier Healthwise, and Indiana’s Children’s Health Insurance Program (S-CHIP), as required by IC 12-17.6-5-4. Further, if families served by the dispute is related to the Department of Child Services (DCS) MRO referralsContractor specify health care for their children as a particularly important need, the Contractor must not reduce agrees to refer the amount of family to the match owed to DMHA by the disputed amount. The Contractor is obligated to resolve its dispute with DCS. If the resolution between DCS and the Contractor results in a finding that the amount of match owed should be reducedHoosier Healthwise Helpline, the State will generate new reports, which will reflect the change1-800-889- 9949.

Allocation; Performance; Reduction in Funding; Termination. A. The amount of payment actually due to Contractor will be determined by an allocation formula. The allocation formula includes the following factors: the amount of funds available to each region of the State and the amount of service provided by the contractor in each region of the State. Contractor will be notified of the allocation amount quarterly and will not be compensated in excess of that amount. A portion of the amount paid the provider will be based on the provider's performance. Provider performance measures are set forth in the document titled Performance Measures Definitions which is located at xxxx.xxxx.xx.xxx/XXXXXX/xxxxXxxxxxxxx.xxxx. Detailed information on the payment procedures is contained in the DARMHA Manuals. Further detail of the compensation process is contained in the terms of this Contract. B. The State may conduct periodic reviews of the utilization of funds paid under this Contract. When requested, the contractor must present documentation to support utilization of funds applicable to the population for which the funds were allocated. The documentation may include staff salaries and other operating costs expended to support the population in question. Underutilization by the Contractor of such funds, reallocation of such funds, or a decision by the State to discontinue purchasing the delivery of care, may result in reduced funding under this Contract. The State will make allocation decisions in its sole discretion. The State makes no representation, covenant or warranty that it will allocate any specified amount of dollars to any particular region of the State. Other than changes in allocation, for which no advance notification shall be made, the State shall give ten (10) days written notice of any decision to reduce the funding of this Contract, which notice shall include a statement of reasons for such reduction. The Contractor may, within the ten (10) day period, appeal to the Commissioner of the Department of Administration pursuant to the Dispute Resolution clause of this Contract. C. No costs may be incurred against this Contract by the Contractor after the end of the term of this Contract. All claims shall be submitted to the State within sixty (60) days of the date of service delivery, or the State may elect to deny payment. D. The State may reduce the funding levels and amounts stated in this Contract. This may prevent the Contractor from receiving further funds under the terms of this Contract. The Contractor remains responsible for the assurance and delivery of the full clinically appropriate Continuum of Care through June 30, 20212022, to those individuals registered in DARMHA. E. As authorized by IC 12-21-2-7, IC 12-21-2-8, and 440 IAC 9-2-1(b), the State may reduce funding or terminate this Contract, or terminate the Contractor’s State certification if the Contractor fails to comply with all of the terms and conditions of (1) this Contract and (2) 440 IAC 9. F. The State shall make available written instructions to the Contractor regarding any procedures and/or assessments, DARMHA processing, or instructions with which the Contractor must comply as a precondition for payment under the terms of this Contract. G. The Contractor may, upon written demand by the State, be required to repay the State all sums paid by the State to the Contractor for which adequate fiscal and/or care delivery documentation is not available for the time period audited. The Contractor agrees to assist the State, or its authorized representatives, in any audit in connection with the Contract. The Contractor further agrees that the State shall have the right to enter the premises of the Contractor, and/or its subcontractors, and review records and property maintained by the Contractor in connection with this Contract. If such an audit of the Contractor results in an audit exception, the State shall have the right to offset such amount against current or future allowable claims, demand a cash payback, or withhold payment of current claims in a like amount, pending resolution between the parties of any disputed amount. H. Medicaid Rehabilitation Option (MRO) reconciliation payments are to be paid in full to DMHA no later than 30 days after the Contractor is notified of the additional match owed. If the Contractor disputes such amount, and the dispute is related to the Department of Child Services (DCS) MRO referrals, the Contractor must not reduce the amount of the match owed to DMHA by the disputed amount. The Contractor is obligated to resolve its dispute with DCS. If the resolution between DCS and the Contractor results in a finding that the amount of match owed should be reduced, the State will generate new reports, which will reflect the change.

Allocation; Performance; Reduction in Funding; Termination. A. The amount of payment actually due to Contractor will be determined by an allocation formula. The allocation formula includes the following factors: the amount of funds available to each region of the State and the amount of service provided by the contractor in each region of the State. Contractor will be notified of the allocation amount quarterly and will not be compensated in excess of that amount. A portion of the amount paid the provider will be based on the provider's performance. Provider performance measures are set forth in the document titled Performance Measures Definitions which is located at xxxx.xxxx.xx.xxx/XXXXXX/xxxxXxxxxxxxx.xxxx. Detailed information on the payment procedures is contained in the DARMHA Manuals. Further detail of the compensation process is contained in the terms of this Contract. B. The State may conduct periodic reviews of the utilization of funds paid under this Contract. When requested, the contractor must present documentation to support utilization of funds applicable to the population for which the funds were allocated. The documentation may include staff salaries and other operating costs expended to support the population in question. Underutilization by the Contractor of such funds, reallocation of such funds, or a decision by the State to discontinue purchasing the delivery of care, may result in reduced funding under this Contract. The State will make allocation decisions in its sole discretion. The State makes mak es no representation, covenant or warranty that it will allocate any specified amount of dollars to any particular region of the State. Other than changes in allocation, for which no advance notification shall be made, the State shall give ten (10) days written notice of any decision to reduce the funding of this Contract, which notice shall include a statement of reasons for such reduction. The Contractor may, within the ten (10) day period, appeal to the Commissioner of the Department of Administration pursuant to the Dispute Resolution clause of this Contract. C. No costs may be incurred against this Contract by the Contractor after the end of the term of this Contract. All claims shall be submitted to the State within sixty (60) days of the date of service delivery, or the State may elect to deny payment. D. The State may reduce the funding levels and amounts stated in this Contract. This may prevent the Contractor from receiving further funds under the terms of this Contract. The Contractor remains responsible for the assurance and delivery of the full clinically appropriate Continuum of Care through June 30, 20212025, to those individuals registered in DARMHA. E. As authorized by IC 12-21-2-7, IC 12-21-2-8, and 440 IAC 9-2-1(b), the State may reduce funding or terminate this Contract, or terminate the Contractor’s State certification if the Contractor fails to comply with all of the terms and conditions of of (1) this Contract and (2) 440 IAC 9. F. The State shall make available written instructions to the Contractor regarding any procedures and/or assessments, DARMHA processing, or instructions with which the Contractor must comply as a precondition for payment under the terms of this Contract. G. The Contractor may, upon written demand by the State, be required to repay the State all sums paid by the State to the Contractor for which adequate fiscal and/or care delivery documentation is not available for the time period audited. The Contractor agrees to assist the State, or its authorized representatives, in any audit in connection with the Contract. The Contractor further agrees that the State shall have the right to enter the premises of the Contractor, and/or its subcontractors, and review records and property maintained by the Contractor in connection with this Contract. If such an audit of the Contractor results in an audit exception, the State shall have the right to offset such amount against current or future allowable claims, demand a cash payback, or withhold payment of current claims in a like amount, pending resolution between the parties of any disputed amount. H. Medicaid Rehabilitation Option (MRO) reconciliation payments are to be paid in full to DMHA no later than 30 days after the Contractor is notified of the additional match owed. If the Contractor disputes such amount, and the dispute is related to the Department of Child Services (DCS) MRO referrals, the Contractor must not reduce the amount of the match owed to DMHA by the disputed amount. The Contractor is obligated to resolve its dispute with DCS. If the resolution between DCS and the Contractor results in a finding that the amount of match owed should be reduced, the State will generate new reports, which will reflect the change.The

Allocation; Performance; Reduction in Funding; Termination. A. The amount of payment actually due to Contractor will be determined by an allocation formula. The allocation formula includes the following factors: the amount of funds available to each region of the State and the amount of service provided by the contractor in each region of the State. Contractor will be notified of the allocation amount quarterly and will not be compensated in excess of that amount. A portion of the amount paid the provider will be based on the provider's performance. Provider performance measures are set forth in the document titled Performance Measures Definitions which is located at xxxx.xxxx.xx.xxx/XXXXXX/xxxxXxxxxxxxx.xxxx. Detailed information on the payment procedures is contained in the DARMHA Manuals. Further detail of the compensation process is contained in the terms of this Contract. B. The State may conduct periodic reviews of the utilization of funds paid under this Contract. When requested, the contractor must present documentation to support utilization of funds applicable to the population for which the funds were allocated. The documentation may include staff salaries and other operating costs expended to support the population in question. Underutilization by the Contractor of such funds, reallocation of such funds, or a decision by the State to discontinue purchasing the delivery of care, may result in reduced funding under this Contract. The State will make allocation decisions in its sole discretion. The State makes no representation, covenant or warranty that it will allocate any specified amount of dollars to any particular region of the State. Other than changes in allocation, for which no advance notification shall be made, the State shall give ten (10) days written notice of any decision to reduce the funding of this Contract, which notice shall include a statement of reasons for such reduction. The Contractor may, within the ten (10) day period, appeal to the Commissioner of the Department of Administration pursuant to the Dispute Resolution clause of this Contract. C. No costs may be incurred against this Contract by the Contractor after the end of the term of this Contract. All claims shall be submitted to the State within sixty (60) days of the date of service delivery, or the State may elect to deny payment. D. The State may reduce the funding levels and amounts stated in this Contract. This may prevent the Contractor from receiving further funds under the terms of this Contract. The Contractor remains responsible for the assurance and delivery of the full clinically appropriate Continuum of Care through June 30, 20212023, to those individuals registered in DARMHA. E. As authorized by IC 12-21-2-7, IC 12-21-2-8, and 440 IAC 9-2-1(b), the State may reduce funding or terminate this Contract, or terminate the Contractor’s State certification if the Contractor fails to comply with all of the terms and conditions of of (1) this Contract and (2) 440 IAC 9. F. The State shall make available written instructions to the Contractor regarding any procedures and/or assessments, DARMHA processing, or instructions with which the Contractor must comply as a precondition for payment under the terms of this Contract. G. The Contractor may, upon written demand by the State, be required to repay the State all sums paid by the State to the Contractor for which adequate fiscal and/or care delivery documentation is not available for the time period audited. The Contractor agrees to assist the State, or its authorized representatives, in any audit in connection with the Contract. The Contractor further agrees that the State shall have the right to enter the premises of the Contractor, and/or its subcontractors, and review records and property maintained by the Contractor in connection with this Contract. If such an audit of the Contractor results in an audit exception, the State shall have the right to offset such amount against current or future allowable claims, demand a cash payback, or withhold payment of current claims in a like amount, pending resolution between the parties of any disputed amount. H. Medicaid Rehabilitation Option (MRO) reconciliation payments are to be paid in full to DMHA no later than 30 days after . In conjunction with the services provided by the Contractor is notified of pursuant to this agreement, Contractor hereby agrees to provide information supplied by the additional match owed. If State to families served by the Contractor disputes such amountregarding Hoosier Healthwise, and Indiana’s Children’s Health Ins urance Program (S-CHIP), as required by IC 12-17.6-5-4. Further, if families served by the dispute is related to the Department of Child Services (DCS) MRO referralsContractor specify health care for their children as a particularly important need, the Contractor must not reduce agrees to refer the amount of family to the match owed to DMHA by the disputed amount. The Contractor is obligated to resolve its dispute with DCS. If the resolution between DCS and the Contractor results in a finding that the amount of match owed should be reducedHoosier Healthwise Helpline, the State will generate new reports, which will reflect the change1-800-889- 9949.

Allocation; Performance; Reduction in Funding; Termination. A. The amount of payment actually due to Contractor will be determined by an allocation formula. The allocation formula includes the following factors: the amount of funds available to each region of the State and the amount of service provided by the contractor in each region of the State. Contractor will be notified of the allocation amount quarterly and will not be compensated in excess of that amount. A portion of the amount paid the provider will be based on the provider's performance. Provider performance measures are set forth in the document titled Performance Measures Definitions which is located at xxxx.xxxx.xx.xxx/XXXXXX/xxxxXxxxxxxxx.xxxx. Detailed information on the payment procedures is contained in the DARMHA Manuals. Further detail of the compensation process is contained in the terms of this Contract. B. The State may conduct periodic reviews of the utilization of funds paid under this Contract. When requested, the contractor must present documentation to support utilization of funds applicable to the population for which the funds were allocated. The documentation may include staff salaries and other operating costs expended to support the population in question. Underutilization by the Contractor of such funds, reallocation of such funds, or a decision by the State to discontinue purchasing the delivery of care, may result in reduced funding under this Contract. The State will make allocation decisions in its sole discretion. The State makes no representation, covenant or warranty that it will allocate any specified amount of dollars to any particular region of the State. Other than changes in allocation, for which no advance notification shall be made, the State shall give ten (10) days written notice of any decision to reduce the funding of this Contract, which notice shall include a statement of reasons for such reduction. The Contractor may, within the ten (10) day period, appeal to the Commissioner of the Department of Administration pursuant to the Dispute Resolution clause of this Contract. C. No costs may be incurred against this Contract by the Contractor after the end of the term of this Contract. All claims shall be submitted to the State within sixty (60) days of the date of service delivery, or the State may elect to deny payment. D. The State may reduce the funding levels and amounts stated in this Contract. This may prevent the Contractor from receiving further funds under the terms of this Contract. The Contractor remains responsible for the assurance and delivery of the full clinically appropriate Continuum of Care through June 30, 20212023, to those individuals registered in DARMHA. E. As authorized by IC 12-21-2-7, IC 12-21-2-8, and 440 IAC 9-2-1(b), the State may reduce funding or terminate this Contract, or terminate the Contractor’s State certification if the Contractor fails to comply with all of the terms and conditions of of (1) this Contract and (2) 440 IAC 9. F. The State shall make available written instructions to the Contractor regarding any procedures and/or assessments, DARMHA processing, or instructions with which the Contractor must comply as a precondition for payment under the terms of this Contract. G. The Contractor may, upon written demand by the State, be required to repay the State all sums paid by the State to the Contractor for which adequate fiscal and/or care delivery documentation is not available for the time period audited. The Contractor agrees to assist the State, or its authorized representatives, in any audit in connection with the Contract. The Contractor further agrees that the State shall have the right to enter the premises of the Contractor, and/or its subcontractors, and review records and property maintained by the Contractor in connection with this Contract. If such an audit of the Contractor results in an audit exception, the State shall have the right to offset such amount against current or future allowable claims, demand a cash payback, or withhold payment of current claims in a like amount, pending resolution between the parties of any disputed amount. H. Medicaid Rehabilitation Option (MRO) reconciliation payments are to be paid in full to DMHA no later than 30 days after . In conjunction with the services provided by the Contractor is notified of pursuant to this agreement, Contractor hereby agrees to provide information supplied by the additional match owed. If State to families served by the Contractor disputes such amountregarding Hoosier Healthwise, and Indiana’s Children’s Health Insurance Program (S-CHIP), as required by IC 12-17.6-5-4. Further, if families served by the dispute is related to the Department of Child Services (DCS) MRO referralsContractor specify health care for their children as a particularly important need, the Contractor must not reduce agrees to refer the amount of family to the match owed to DMHA by the disputed amount. The Contractor is obligated to resolve its dispute with DCS. If the resolution between DCS and the Contractor results in a finding that the amount of match owed should be reducedHoosier Healthwise Helpline, the State will generate new reports, which will reflect the change1-800-889- 9949.