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Common use of FISCAL PROVISIONS Clause in Contracts

FISCAL PROVISIONS. Reimbursement under this Agreement shall be made in the following manner: A. Upon the Provider’s compliance with all provisions pursuant to W&I Code section 14105.94 and this Agreement, and upon the submission of a cost report and claim form based on valid and substantiated information, the State agrees to process the cost report and claim form for reimbursement. B. Transfer of funds is contingent upon the availability of federal financial participation. If, in the event federal financial participation funds for a service period are not available for all of the supplemental amounts payable to GEMT providers due to the application of a federal limit or for any other reason, both of the following shall apply: 1) The total amounts payable to GEMT providers for the service period shall be reduced to reflect the amounts for which federal financial participation is available. 2) The amounts payable to each GEMT provider for the service period shall be equal to the amounts computed under Article 3 multiplied by the ratio of the total amounts for which federal financial participation is available. C. Provider shall certify the certified public expenditure from the Provider’s General Fund, or from any other funds allowed under federal law and regulation, for Title XIX funds claimed for reimbursement pursuant to W&I Code section 14105.94. The State shall deny payment of any invoice submitted under this Agreement, if it determines that the certification is not adequately supported for purposes of FFP. The following certification statement shall be made on each Summary Invoice submitted to the State for payment for the performance of services: “I, certify under penalty of perjury as follows: Public funds for services provided have been expended as necessary for federal financial participation, pursuant to the requirements of Section 1903(w) of the Social Security Act and 42 C.F.R. § 433.50, et seq. for allowable costs. The expenditures claimed have not previously been, nor will be, claimed at any other time to receive federal funds under Medicaid or any other program. The provider acknowledges that the information is to be used for claiming federal funds and understands that misrepresentation of information constitutes a violation of federal and State law. The provider acknowledges that all funds expended pursuant to W&I Code section 14105.94 are subject to review and audit by the Department of Health Care Services. The provider acknowledges that it understands that DHCS must deny payments for any claim submitted under W&I Code section 14105.94, if it determines that the certification is not adequately supported for purposes of federal financial participation. That I am the responsible person of the subject fire department / agency and am duly authorized to sign this certification and that, to the best of my knowledge and information, each statement and amount in the accompanying schedules are to be true, correct, and in compliance with section 14105.94 of the California Welfare and Institutions Code.”

Appears in 3 contracts

Samples: Provider Participation Agreement, Provider Participation Agreement, Provider Participation Agreement

FISCAL PROVISIONS. Reimbursement under this Agreement shall be made in the following manner: A. Upon the Provider’s compliance with all provisions pursuant to W&I Code section 14105.94 14105.96 and this Agreement, and upon the submission of a cost report and claim form based on valid and substantiated information, the State agrees to process the cost report and claim form for reimbursement. B. Transfer of funds is contingent upon the availability of federal financial participation. If, in the event federal financial participation funds for a service period are not available for all of the supplemental amounts payable to GEMT Public Hospital Outpatient Services Supplemental Reimbursement Program providers due to the application of a federal limit or for any other reason, both of the following shall apply: 1) The total amounts payable to GEMT Public Hospital Outpatient Services Supplemental Reimbursement Program providers for the service period shall be reduced to reflect the amounts for which federal financial participation is available. 2) The amounts payable to each GEMT Public Hospital Outpatient Services Supplemental Reimbursement Program provider for the service period shall be equal to the amounts computed under Article 3 multiplied by the ratio of the total amounts for which federal financial participation is available. C. Provider shall certify the certified public expenditure from the Provider’s General Fund, or from any other funds allowed under federal law and regulation, for Title XIX funds claimed for reimbursement pursuant to W&I Code section 14105.9414105.96. The State shall deny payment of any invoice submitted under this Agreement, if it determines that the certification is not adequately supported for purposes of FFP. The following certification statement shall be made on each Summary Invoice submitted to the State for payment for the performance of services: “I, certify under penalty of perjury as follows: Public funds for services provided have been expended as necessary for federal financial participation, pursuant to the requirements of Section 1903(w) of the Social Security Act and 42 C.F.R. § 433.50, et seq. for allowable costs. The expenditures claimed have not previously been, nor will be, claimed at any other time to receive federal funds under Medicaid or any other program. The provider acknowledges that the information is to be used for claiming federal funds and understands that misrepresentation of information constitutes a violation of federal and State law. The provider acknowledges that all funds expended pursuant to W&I Code section 14105.94 14105.96 are subject to review and audit by the Department of Health Care Services. The provider acknowledges that it understands that DHCS must deny payments for any claim submitted under W&I Code section 14105.9414105.96, if it determines that the certification is not adequately supported for purposes of federal financial participation. That I am the responsible person of the subject fire department / agency and am duly authorized to sign this certification and that, to the best of my knowledge and information, each statement and amount in the accompanying schedules are to be true, correct, and in compliance with section 14105.94 14105.96 of the California Welfare and Institutions Code.”

Appears in 1 contract

Samples: Provider Participation Agreement