Covered Person Records Sample Clauses

Covered Person Records. Preferred Provider and Provider shall prepare and maintain, and protect the confidentiality, security, accuracy, completeness and integrity of, all appropriate medical and other records related to the provision of Medicare covered services to Attributed Lives (including, but not limited to, medical, encounter, financial, accounting, administrative and billing records) in accordance with: (i) applicable state and federal laws and regulations including, but not limited to, applicable confidentiality requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”); and (ii) ACO and CMS billing, reimbursement, and administrative requirements. Such records shall include such documentation as may be necessary to monitor and evaluate the quality of care and to conduct medical or other health care evaluations and audits to determine, on a concurrent or retrospective basis, the medical necessity and appropriateness of care provided to Attributed Lives. Subject to applicable laws regarding confidentiality, Preferred Provider and Providers hereby authorize ACO to release any and all information, records, summaries of records and statistical reports specific to Preferred Provider, or Providers, including but not limited to utilization profiles, encounter data, treatment plans, outcome data and other information pertinent to Preferred Provider’s, or Providers’ performance of services and professional qualifications to federal or state governmental authority(ies) with jurisdiction, or any of their authorized agents, and accreditation agencies, without receiving Preferred Provider’s, or Providers’ prior consent.