Inspection and Audit of Financial Records. The state and DHHS may inspect and audit any financial records of the plan or its subcontractors. Pursuant to section 1903(m)(4)(A) of the Social Security Act and State Medicaid Manual 2087.6(A-B), non-federally qualified plans must report to the state, upon request, and to the Secretary and the Inspector General of DHHS, a description of certain transactions with parties of interest as defined in section 1318(b) of the Social Security Act.

Inspection and Audit of Financial Records. The CONTRACTOR shall meet all State and federal requirements with respect to inspection and auditing of financial records. The CONTRACTOR shall also cooperate with HCA or its designee and provide all financial records required by HCA or its designee so that they may inspect and audit the CONTRACTOR’s financial records at least annually or at HCA’s discretion. The CONTRACTOR shall secure and maintain during the life of this Agreement a blanket fidelity bond from a company doing business in the State of New Mexico on all personnel in its employment. The bond shall be issued in the amount of at least one million dollars ($1,000,000) per occurrence. Said bond shall protect HCA from any losses sustained through any fraudulent or dishonest act or acts committed by any employees of the CONTRACTOR or its Subcontractors or Major Subcontractors. The CONTRACTOR shall submit proof of coverage to HCA within sixty (60) Calendar Days after the execution of this Agreement or date designated by HCA.

Inspection and Audit of Financial Records. The state, CMS, and DHHS may inspect and audit any financial records of the Health Plan or its subcontractors. Pursuant to s. 1903(m)(4)(A) of the Social Security Act and state Medicaid Manual 2087.6(A-B), non-federally qualified Health Plans shall report to the state, upon request, and to the Secretary and the Inspector General of DHHS, a description of certain transactions with parties of interest as defined in s. 1318(b) of the Social Security Act. G. Physician Incentive Plans 1. Physician incentive plans shall comply with 42 CFR 417.479, 42 CFR 438.6(h), 42 CFR 422.208 and 42 CFR 422.210 and shall not contain provisions that provide incentives for withholding medically necessary care. HealthEase of Florida, Inc. Medicaid HMO Non-Reform Contract 2 The Health Plan shall disclose information on physician incentive plans listed in 42 CFR 417.479(h)(1) and 42 CFR 417.479(i) at the times indicated in 42 CFR 417.479(d)-(g). All such arrangements shall be submitted to BMHC for approval, in writing, prior to use. If any other type of withhold arrangement currently exists, it must be omitted from all provider contracts.

Inspection and Audit of Financial Records. The state and DHHS may inspect and audit any financial records of the PDHP or its subcontractors. In accordance with Section 1903(m)(4)(A) of the Social Security Act and State Medicaid Manual 2087.6(A-B), non-federally qualified PDHPs must report to the state, upon request, and to the Secretary and the Inspector General of DHHS, a description of certain transactions with parties of interest as defined in Section 1318(b) of the Social Security Act.

Inspection and Audit of Financial Records. (A) The Department and the federal government may inspect and audit any books and/or records of the Contractor or its Participating Providers that pertain to: (1) the ability of the Contractor to bear the risk of potential financial losses, or (2) to services performed or determinations of amounts payable under the Contract, or (3) for any other audit allowed by state or federal law. (B) The Contractor shall make available to the Department, the federal government, independent quality review examiners, and other Utah state agencies as allowed by law any of the Contractor’s records that may reasonably be requested to conduct the audit. (C) The Contractor shall, in accordance with 45 CFR 74.48, allow the HHS awarding agency, the U.S. Comptroller General, or any of their duly authorized representatives, to access to any books, documents, papers, and records of the Contractor which are directly pertinent to a specific program for the purpose of making audits, examinations, excerpts, and transcriptions.

Inspection and Audit of Financial Records. Contractor must ensure that the State agency and CMS may inspect and audit any financial records of the entity or its Subcontractors. Contractor shall provide the State or Federal government access to any books, documents, papers, and records of the Contractor that are directly pertinent to this contract, for the purpose of making an audit, examination, excerpt, or transcription. There shall be no restrictions on the right of the State or Federal government to conduct whatever inspections and audits are necessary to assure quality, appropriateness or timeliness of services and reasonableness of their costs.

Inspection and Audit of Financial Records. (A) The Department and the federal government may inspect and audit any books and/or records of the Contractor or its Participating Providers that pertain to: (1) the ability of the Contractor to bear the risk of potential financial losses, or (2) to services performed or determinations of amounts payable under the Contract, or (3) for any other audit allowed by state or federal law. (B) The Contractor shall make available to the Department, the federal government, independent quality review examiners, and other Utah state agencies as allowed by law any of the Contractor’s records that may reasonably be requested to conduct the audit. (C) The Contractor shall, in accordance with 45 CFR 74.48 (and except for contracts less than the simplified acquisition threshold), allow the HHS awarding agency, the U.S. Comptroller General, or any of their duly authorized representatives, to access to any books, documents, papers, and records of the Contractor which are directly pertinent to a specific program for the purpose of making audits, examinations, excerpts, and transcriptions.

Inspection and Audit of Financial Records Sample Clauses

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