Common use of Audit/Inspection Clause in Contracts

Audit/Inspection. 6.1 As required under 42 CFR 431.107, Provider shall keep such records as are necessary to disclose fully the extent of services provided to Members and shall furnish records and information regarding any claim for providing such service to OHCA, the Oklahoma Attorney General’s Medicaid Fraud Control Unit (hereinafter MFCU), and the U.S. Secretary of Health and Human Services (hereinafter Secretary). Provider agrees to keep records to disclose the services it provides for seven years from the date of service. Provider shall not destroy or dispose of records, which are under audit, review or investigation when the seven-year limitation is met. Provider shall maintain such records until informed in writing by the auditing, reviewing or investigating agency that the audit, review or investigation is complete. 6.2 Authorized representatives of OHCA, MFCU, and the Secretary shall have the right to make physical inspection of Provider’s place of business and to examine records relating to financial statements or claims submitted by Provider under this Agreement and to audit Provider’s financial records as provided by 42 CFR 431.107. If Provider fails to submit records to OHCA or its agent within reasonable specified timeframes, all SoonerCare payments to Provider may be suspended until records are submitted. 6.3 Pursuant to 74 Okla. Stat. 85.41, OHCA and the Oklahoma State Auditor and Inspector shall have the right to examine Provider’s books, records, documents, accounting procedures, practices, or any other items relevant to this Agreement. 6.4 Provider shall submit, within thirty-five days of a request by OHCA, MFCU, or the Secretary, all documents, as defined by 12 Okla. Stat. 3234, in its possession, custody, or control concerning (i) the ownership of any subcontractor with whom Provider has had business transactions totaling more than twenty five thousand dollars during the twelve months preceding the date of the request, or (ii) any significant business transactions between Provider and any wholly owned supplier or between Provider and any subcontractor during the five years preceding the date of the request. 6.5 If Provider is an entity other than an individual person, Provider shall provide OHCA with information concerning Provider’s ownership in accordance with 42 CFR 455.100 et seq. Provider agrees to update its Provider Information within twenty (20) days of any change in ownership. Ownership information is critical for determining whether a person with an ownership interest has been convicted of a program crime under Titles V, XVIII, XIX, XX and XXI of the federal Social Security Act, 42 USC 301 et seq. Provider shall also furnish ownership information to OHCA upon further request.

Audit/Inspection. 6.1 As required under 42 CFR 431.107by federal and state law, Provider shall keep such records as are necessary to disclose fully the extent of services provided to Members and shall furnish records and information regarding any claim for providing such service to OHCA, the Oklahoma Attorney General’s Medicaid Fraud Control Unit (hereinafter MFCU), and the U.S. Secretary of Health and Human Services (hereinafter Secretary). Provider agrees to keep records to disclose the services it provides for seven years from the date of service. Provider shall not destroy or dispose of records, which are under audit, review or investigation when the seven-year limitation is met. Provider shall maintain such records until informed in writing by the auditing, reviewing or investigating agency that the audit, review or investigation is complete. 6.2 Authorized representatives of OHCA, MFCU, and the Secretary shall have the right to make physical inspection of Provider’s place of business and to examine records relating to financial statements or claims submitted by Provider under this Agreement and to audit Provider’s financial records as provided by 42 CFR 431.107. If Provider fails to submit records to OHCA or its agent within reasonable specified timeframes, all SoonerCare payments to Provider may be suspended until records are submitted. 6.3 Pursuant to 74 Okla. Stat. 85.41, OHCA and the Oklahoma State Auditor and Inspector shall have the right to examine Provider’s books, records, documents, accounting procedures, practices, or any other items relevant to this Agreement. 6.4 Provider shall submit, within thirty-five days of a request by OHCA, MFCU, or the Secretary, all documents, as defined by 12 Okla. Stat. 3234, in its possession, custody, or control concerning (i) the ownership of any subcontractor with whom Provider has had business transactions totaling more than twenty five thousand dollars during the twelve months preceding the date of the request, or (ii) any significant business transactions between Provider and any wholly owned supplier or between Provider and any subcontractor during the five years preceding the date of the request. 6.5 If Provider is an entity other than an individual person, Provider shall provide OHCA with information concerning Provider’s ownership in accordance with 42 CFR 455.100 et seq. Provider agrees to update its Provider Information within twenty (20) days of any change in ownership. Ownership information is critical for determining whether a person with an ownership interest has been convicted of a program crime under Titles V, XVIII, XIX, XX and XXI of the federal Social Security Act, 42 USC 301 et seq. Provider shall also furnish ownership information to OHCA upon further request.

Audit/Inspection. 6.1 As required under 42 CFR 431.107by federal and state law, Provider shall keep such records as are necessary to disclose fully the extent of services provided to Members and shall furnish records and information regarding any claim for providing such service to OHCA, the Oklahoma Attorney General’s Medicaid Fraud Control Unit (hereinafter “MFCU”), and the U.S. Secretary of Health and Human Services (hereinafter “Secretary”). Provider agrees to keep records to disclose the services it provides for seven years from the date of service. Provider shall not destroy or dispose of records, which are under audit, review or investigation when the seven-year limitation is met. Provider shall maintain such records until informed in writing by the auditing, reviewing or investigating agency that the audit, review or investigation is complete. 6.2 Authorized representatives of OHCA, MFCU, and the Secretary shall have the right to make physical inspection of Provider’s place of business and to examine records relating to financial statements or claims submitted by Provider under this Agreement and to audit Provider’s financial records as provided by 42 CFR 431.107. If Provider fails to submit records to OHCA or its agent within reasonable specified timeframes, all SoonerCare payments to Provider may be suspended until records are submitted. 6.3 Pursuant to 74 Okla. Stat. 85.41, OHCA and the Oklahoma State Auditor and Inspector shall have the right to examine Provider’s books, records, documents, accounting procedures, practices, or any other items relevant to this Agreement. 6.4 Provider shall submit, within thirty-five days of a request by OHCA, MFCU, or the Secretary, all documents, as defined by 12 Okla. Stat. 3234, in its possession, custody, or control concerning (i) the ownership of any subcontractor with whom Provider has had business transactions totaling more than twenty five thousand dollars during the twelve months preceding the date of the request, or (ii) any significant business transactions between Provider and any wholly owned supplier or between Provider and any subcontractor during the five years preceding the date of the request. 6.5 If Provider is an entity other than an individual person, Provider shall provide OHCA with information concerning Provider’s ownership in accordance with 42 CFR 455.100 et seq. Provider agrees to update its Provider Information within twenty (20) days of any change in ownership. Ownership information is critical for determining whether a person with an ownership interest has been convicted of a program crime under Titles V, XVIII, XIX, XX and XXI of the federal Social Security Act, 42 USC 301 et seq. Provider shall also furnish ownership information to OHCA upon further request.

Audit/Inspection. 6.1 As required under 42 CFR 431.107, Provider PROVIDER shall keep such records as are necessary to disclose fully the extent of services provided to Members and shall furnish records and information regarding any claim for providing such service to OHCA, the Oklahoma Attorney General’s Medicaid Fraud Control Unit (hereinafter MFCUMFCU hereafter), and the U.S. Secretary of Health and Human Services (hereinafter SecretarySecretary hereafter). Provider PROVIDER agrees to keep records to disclose the services it provides for seven years from the date of service. Provider PROVIDER shall not destroy or dispose of records, which are under audit, review or investigation when the seven-year limitation is met. Provider PROVIDER shall maintain such records until informed in writing by the auditing, reviewing or investigating agency that the audit, review or investigation is complete. 6.2 Authorized representatives of OHCA, MFCU, and the Secretary shall have the right to make physical inspection of ProviderPROVIDER’s place of business and to examine records relating to financial statements or claims submitted by Provider under this Agreement and to audit Provider’s financial records as provided by 42 CFR 431.107. If Provider fails to submit records to OHCA or its agent within reasonable specified timeframes, all SoonerCare payments to Provider may be suspended until records are submitted.records 6.3 Pursuant to 74 Okla. Stat. 85.41, OHCA and the Oklahoma State Auditor and Inspector shall have the right to examine ProviderPROVIDER’s books, records, documents, accounting procedures, practices, or any other items relevant to this Agreement. 6.4 Provider PROVIDER shall submit, within thirty-five days of a request by OHCA, MFCU, or the Secretary, all documents, as defined by 12 Okla. Stat. 3234, in its possession, custody, or control concerning (i) the ownership of any subcontractor with whom Provider PROVIDER has had business transactions totaling more than twenty twenty-five thousand dollars during the twelve months preceding the date of the request, or (ii) any significant business transactions between Provider PROVIDER and any wholly owned supplier or between Provider PROVIDER and any subcontractor during the five years preceding the date of the request. 6.5 If Provider PROVIDER is an entity other than an individual person, Provider PROVIDER shall provide OHCA with information concerning ProviderPROVIDER’s ownership in accordance with 42 CFR 455.100 et seq. Provider PROVIDER agrees to update its Provider Information within twenty (20) days of any change in ownership. Ownership information is critical for determining whether a person with an ownership interest has been convicted of a program crime under Titles V, XVIII, XIX, XX and XXI of the federal Social Security Act, 42 USC 301 et seq. Provider shall also furnish ownership information to OHCA upon further request.twenty

Audit/Inspection. 6.1 As required under 42 CFR 431.107, Provider PROVIDER shall keep such records as are necessary to disclose fully the extent of services provided to Members and shall furnish records and information regarding any claim for providing such service to OHCA, the Oklahoma Attorney General’s Medicaid Fraud Control Unit (hereinafter MFCUMFCU hereafter), and the U.S. Secretary of Health and Human Services (hereinafter SecretarySecretary hereafter). Provider PROVIDER agrees to keep records to disclose the services it provides for seven years from the date of service. Provider PROVIDER shall not destroy or dispose of records, which are under audit, review or investigation when the seven-year limitation is met. Provider PROVIDER shall maintain such records until informed in writing by the auditing, reviewing or investigating agency that the audit, review or investigation is complete. 6.2 Authorized representatives of OHCA, MFCU, and the Secretary shall have the right to make physical inspection of ProviderPROVIDER’s place of business and to examine records relating to financial statements or claims submitted by Provider PROVIDER under this Agreement and to audit ProviderPROVIDER’s financial records as provided by 42 CFR 431.107. If Provider PROVIDER fails to submit records to OHCA or its agent within reasonable specified timeframes, all SoonerCare payments to Provider PROVIDER may be suspended until records are submitted. 6.3 Pursuant to 74 Okla. Stat. 85.41, OHCA and the Oklahoma State Auditor and Inspector shall have the right to examine ProviderPROVIDER’s books, records, documents, accounting procedures, practices, or any other items relevant to this Agreement. 6.4 Provider PROVIDER shall submit, within thirty-five days of a request by OHCA, MFCU, or the Secretary, all documents, as defined by 12 Okla. Stat. 3234, in its possession, custody, or control concerning (i) the ownership of any subcontractor with whom Provider PROVIDER has had business transactions totaling more than twenty twenty-five thousand dollars during the twelve months preceding the date of the request, or (ii) any significant business transactions between Provider PROVIDER and any wholly owned supplier or between Provider PROVIDER and any subcontractor during the five years preceding the date of the request. 6.5 If Provider PROVIDER is an entity other than an individual person, Provider PROVIDER shall provide OHCA with information concerning ProviderPROVIDER’s ownership in accordance with 42 CFR 455.100 et seq. Provider PROVIDER agrees to update its Provider Information within twenty (20) days of any change in ownership. Ownership information is critical for determining whether a person with an ownership interest has been convicted of a program crime under Titles V, XVIII, XIX, XX and XXI of the federal Social Security Act, 42 USC 301 et seq. Provider shall also furnish ownership information to OHCA upon further request.twenty