Common use of Maintenance and Examination of Records Clause in Contracts

Maintenance and Examination of Records. The MCO and its Subcontractors must maintain records, books, documents, papers, and files that are related to West Virginia’s Medicaid managed care program services and expenditures, including reports to BMS and source information used in preparation of these reports. These reports include but are not limited to financial statements, records relating to quality of care, and medical records. In addition, the MCO must provide, and cause its Subcontractors to provide, at no cost to BMS or a designee, prompt, reasonable, and adequate access to any records, books, documents, papers, and files that are related to performance under the Contract. The MCO and its Subcontractors agrees to permit inspection of its records, books, documents, papers, and files which will be conducted in accordance with Federal and State laws and regulations regarding confidentiality. The MCO and its Subcontractors are required to submit information to BMS or to a designee in a manner that maintains the confidentiality of involved parties (e.g., blacking out enrollees’ and providers’ names). The MCO must comply with the record retention requirements of Title 45, Sections 74.21 through 74.23 (45 CFR 74.21 through 74.23). Such records, with the exception of medical records and enrollee and provider quality assurance and quality improvement records when confidentiality is protected by law, are the property of BMS. The Secretary, DHHS and BMS or a designee have the right to audit and inspect any books or records of the MCO or its Subcontractors pertaining to the ability of the MCO to bear the risk of financial losses and services performed or payable amounts under the Contract. Upon non-renewal or termination of this Contract, the MCO must turn over, and cause its Subcontractors to turn over, to BMS or to a designee of BMS all records, books, documents, papers and files that are related to persons receiving services and to the administration of this Contract that BMS may request. The MCO must provide, and cause its Subcontractors to provide, BMS and its authorized agents with reasonable access to any records, books, documents, papers, and files the MCO and its Subcontractors maintain for the purposes of this Contract. BMS and its authorized agents will request access in writing except in cases of suspected fraud, waste, and abuse. The MCO and its Subcontractors must make all requested medical records available within ten (10) business days of BMS’ request. Any Subcontract with an approved MCO Subcontractor must include a provision specifically authorizing maintenance and examination of records in accordance with the terms set forth in this Section.

Maintenance and Examination of Records. The MCO and its Subcontractors must maintain records, books, documents, papers, papers and files that are related to West Virginia’s Medicaid managed care program services and expenditures, including reports to BMS and source information used in preparation of these reports. These reports include but are not limited to financial statements, records relating to quality of care, and medical records. In addition, the MCO must provide, and cause its Subcontractors to provide, at no cost to BMS or a designee, prompt, reasonable, and adequate access to any records, books, documents, papers, papers and files that are related to performance under the Contract. The MCO and its Subcontractors agrees to permit inspection of its records, books, documents, papers, papers and files which will be conducted in accordance with Federal and State laws and regulations regarding confidentiality. The MCO and its Subcontractors are required to submit information to BMS or to a designee in a manner that maintains the confidentiality of involved parties (e.g., blacking out enrolleesmembers’ and providers’ names). The MCO must comply with the record retention requirements of Title 45, Sections 74.21 through 74.23 (45 CFR 74.21 through 74.23). Such records, with the exception of medical records and enrollee member and provider quality assurance and quality improvement records when confidentiality is protected by law, are the property of BMS. The Secretary, DHHS and BMS or a designee have the right to audit and inspect any books or records of the MCO or its Subcontractors pertaining to the ability of the MCO to bear the risk of financial losses and services performed or payable amounts under the Contract. Upon non-renewal or termination of this Contract, the MCO must turn over, and cause its Subcontractors to turn over, to BMS or to a designee of BMS all records, books, documents, papers and files that are related to persons receiving services and to the administration of this Contract that BMS may request. The MCO must provide, and cause its Subcontractors to provide, BMS and its authorized agents with reasonable access to any records, books, documents, papers, papers and files the MCO and its Subcontractors maintain for the purposes of this Contract. BMS and its authorized agents will request access in writing except in cases of suspected fraud, waste, fraud and abuse. The MCO and its Subcontractors must make all requested medical records available within ten (10) business working days of BMS’ request. Any Subcontract with an approved MCO Subcontractor must include a provision specifically authorizing maintenance and examination of records in accordance with the terms set forth in this Section.

Maintenance and Examination of Records. The MCO and its Subcontractors must maintain records, books, documents, papers, and files that are related to West Virginia’s Medicaid managed care program services and expenditures, including reports to BMS DHHR and source information used in preparation of these reports. These reports include but are not limited to financial statements, records relating to quality of care, and medical records. In addition, the MCO must provide, and cause its Subcontractors to provide, at no cost to BMS DHHR or a designee, prompt, reasonable, and adequate access to any records, books, documents, papers, and files that are related to performance under the Contract. The MCO and its Subcontractors agrees to permit inspection of its records, books, documents, papers, and files which will be conducted in accordance with Federal and State laws and regulations regarding confidentiality. The MCO and its Subcontractors are required to submit information to BMS DHHR or to a designee in a manner that maintains the confidentiality of involved parties (e.g., blacking out enrollees’ and providers’ names). The MCO must comply with the record retention requirements of Title 45, Sections 74.21 through 74.23 (45 CFR §74.21 through §74.23)) and FISMA. Such records, with the exception of medical records and enrollee and provider quality assurance and quality improvement records when confidentiality is protected by law, are the property of BMSDHHR. The CMS, the Office of Inspector General, the Comptroller General, the Secretary, DHHS and BMS DHHR or a designee their designees have the right to audit and inspect any books or records of the MCO or its Subcontractors pertaining to the ability of the MCO to bear the risk of financial losses and services performed or payable amounts under the Contract. Upon non-renewal or termination of this Contract, the MCO must turn over, and cause its Subcontractors to turn over, to BMS DHHR or to a designee of BMS DHHR all records, books, documents, papers and files that are related to persons receiving services and to the administration of this Contract that BMS DHHR may request. The MCO must provide, and cause its Subcontractors to provide, BMS CMS, OIG, the Comptroller General, the DHHR and its authorized agents with reasonable access to any records, books, documents, papers, and files the MCO and its Subcontractors maintain for the purposes of this Contract. BMS DHHR and its authorized agents will request access in writing except in cases of suspected fraud, waste, and abuse. The MCO and its Subcontractors must make all requested medical records available within ten (10) business days of BMS’ DHHR’s request. Any Subcontract with an approved MCO Subcontractor must include a provision specifically authorizing maintenance and examination of records in accordance with the terms set forth in this Sectionsection.

Maintenance and Examination of Records. The MCO and its Subcontractors must maintain records, books, documents, papers, papers and files that are related to West Virginia’s Medicaid managed care program services and expenditures, including reports to BMS and source information used in preparation of these reports. These reports include but are not limited to financial statements, records relating to quality of care, and medical records. In addition, the MCO must provide, and cause its Subcontractors to provide, at no cost to BMS or a designee, prompt, reasonable, and adequate access to any records, books, documents, papers, papers and files that are related to performance under the Contract. The MCO and its Subcontractors agrees to permit inspection of its records, books, documents, papers, papers and files which will be conducted in accordance with Federal and State laws and regulations regarding confidentiality. The MCO and its Subcontractors are required to submit information to BMS or to a designee in a manner that maintains the confidentiality of involved parties (e.g., blacking out enrollees’ and providers’ names). The MCO must comply with the record retention requirements of Title 45, Sections 74.21 through 74.23 (45 CFR 74.21 through 74.23). Such records, with the exception of medical records and enrollee and provider quality assurance and quality improvement records when confidentiality is protected by law, are the property of BMS. The Secretary, DHHS and BMS or a designee have the right to audit and inspect any books or records of the MCO or its Subcontractors pertaining to the ability of the MCO to bear the risk of financial losses and services performed or payable amounts under the Contract. Upon non-renewal or termination of this Contract, the MCO must turn over, and cause its Subcontractors to turn over, to BMS or to a designee of BMS all records, books, documents, papers and files that are related to persons receiving services and to the administration of this Contract that BMS may request. The MCO must provide, and cause its Subcontractors to provide, BMS and its authorized agents with reasonable access to any records, books, documents, papers, papers and files the MCO and its Subcontractors maintain for the purposes of this Contract. BMS and its authorized agents will request access in writing except in cases of suspected fraud, waste, and abuse. The MCO and its Subcontractors must make all requested medical records available within ten (10) business days of BMS’ request. Any Subcontract with an approved MCO Subcontractor must include a provision specifically authorizing maintenance and examination of records in accordance with the terms set forth in this Section.

Maintenance and Examination of Records. The MCO and its Subcontractors must maintain records, books, documents, papers, and files that are related to West Virginia’s Medicaid Medicaid/WVCHIP managed care program services and expenditures, including reports to BMS and source information used in preparation of these reports. These reports include but are not limited to financial statements, records relating to quality of care, and medical records. In addition, the MCO must provide, and cause its Subcontractors to provide, at no cost to BMS or a designee, prompt, reasonable, and adequate access to any records, books, documents, papers, and files that are related to performance under the Contract. The MCO and its Subcontractors agrees to permit inspection of its records, books, documents, papers, and files which will be conducted in accordance with Federal and State laws and regulations regarding confidentiality. The MCO and its Subcontractors are required to submit information to BMS or to a designee in a manner that maintains the confidentiality of involved parties (e.g., blacking out enrollees’ and providers’ names). The MCO must comply with the record retention requirements of Title 45, Sections 74.21 through 74.23 (45 CFR 74.21 through 74.23). Such records, with the exception of medical records and enrollee and provider quality assurance and quality improvement records when confidentiality is protected by law, are the property of BMS. The Secretary, DHHS and BMS or a designee have the right to audit and inspect any books or records of the MCO or its Subcontractors pertaining to the ability of the MCO to bear the risk of financial losses and services performed or payable amounts under the Contract. Upon non-renewal or termination of this Contract, the MCO must turn over, and cause its Subcontractors to turn over, to BMS or to a designee of BMS all records, books, documents, papers and files that are related to persons receiving services and to the administration of this Contract that BMS may request. The MCO must provide, and cause its Subcontractors to provide, BMS and its authorized agents with reasonable access to any records, books, documents, papers, and files the MCO and its Subcontractors maintain for the purposes of this Contract. BMS and its authorized agents will request access in writing except in cases of suspected fraud, waste, and abuse. The MCO and its Subcontractors must make all requested medical records available within ten (10) business days of BMS’ request. Any Subcontract with an approved MCO Subcontractor must include a provision specifically authorizing maintenance and examination of records in accordance with the terms set forth in this Section.

Maintenance and Examination of Records. The MCO and its Subcontractors must maintain records, books, documents, papers, papers and files that are related to West Virginia’s Medicaid managed care program services and expenditures, including reports to BMS DHHR and source information used in preparation of these reports. These reports include but are not limited to financial statements, records relating to quality of care, and medical records. In addition, the MCO must provide, and cause its Subcontractors to provide, at no cost to BMS DHHR or a designee, prompt, reasonable, and adequate access to any records, books, documents, papers, papers and files that are related to performance under the Contract. The MCO and its Subcontractors agrees to permit inspection of its records, books, documents, papers, papers and files which will be conducted in accordance with Federal and State laws and regulations regarding confidentiality. The MCO and its Subcontractors are required to submit information to BMS DHHR or to a designee in a manner that maintains the confidentiality of involved parties (e.g., blacking out enrollees’ and providers’ names). The MCO must comply with the record retention requirements of Title 45, Sections 74.21 through 74.23 (45 CFR 74.21 through 74.23)) and FISMA. Such records, with the exception of medical records and enrollee and provider quality assurance and quality improvement records when confidentiality is protected by law, are the property of BMSDHHR. The CMS, the Office of Inspector General, the Comptroller General, the Secretary, DHHS and BMS DHHR or a designee their designees have the right to audit and inspect any books or records of the MCO or its Subcontractors pertaining to the ability of the MCO to bear the risk of financial losses and services performed or payable amounts under the Contract. Upon non-renewal or termination of this Contract, the MCO must turn over, and cause its Subcontractors to turn over, to BMS DHHR or to a designee of BMS DHHR all records, books, documents, papers and files that are related to persons receiving services and to the administration of this Contract that BMS DHHR may request. The MCO must provide, and cause its Subcontractors to provide, BMS CMS, OIG, the Comptroller General, the DHHR and its authorized agents with reasonable access to any records, books, documents, papers, papers and files the MCO and its Subcontractors maintain for the purposes of this Contract. BMS DHHR and its authorized agents will request access in writing except in cases of suspected fraud, waste, and abuse. The MCO and its Subcontractors must make all requested medical records available within ten (10) business days of BMS’ DHHR’s request. Any Subcontract with an approved MCO Subcontractor must include a provision specifically authorizing maintenance and examination of records in accordance with the terms set forth in this Section.

Maintenance and Examination of Records. The MCO and its Subcontractors must maintain records, books, documents, papers, papers and files that are related to West Virginia’s Medicaid managed care program services and expenditures, including reports to BMS DHHR and source information used in preparation of these reports. These reports include but are not limited to financial statements, records relating to quality of care, and medical records. In addition, the MCO must provide, and cause its Subcontractors to provide, at no cost to BMS DHHR or a designee, prompt, reasonable, and adequate access to any records, books, documents, papers, papers and files that are related to performance under the Contract. The MCO and its Subcontractors agrees to permit inspection of its records, books, documents, papers, papers and files which will be conducted in accordance with Federal and State laws and regulations regarding confidentiality. The MCO and its Subcontractors are required to submit information to BMS DHHR or to a designee in a manner that maintains the confidentiality of involved parties (e.g., blacking out enrolleesmembers’ and providers’ names). The MCO must comply with the record retention requirements of Title 45, Sections 74.21 through 74.23 (45 CFR 74.21 through 74.23). Such records, with the exception of medical records and enrollee member and provider quality assurance and quality improvement records when confidentiality is protected by law, are the property of BMSDHHR. The Secretary, DHHS and BMS DHHR or a designee have the right to audit and inspect any books or records of the MCO or its Subcontractors pertaining to the ability of the MCO to bear the risk of financial losses and services performed or payable amounts under the Contract. Upon non-renewal or termination of this Contract, the MCO must turn over, and cause its Subcontractors to turn over, to BMS DHHR or to a designee of BMS DHHR all records, books, documents, papers and files that are related to persons receiving services and to the administration of this Contract that BMS DHHR may request. The MCO must provide, and cause its Subcontractors to provide, BMS DHHR and its authorized agents with reasonable access to any records, books, documents, papers, papers and files the MCO and its Subcontractors maintain for the purposes of this Contract. BMS DHHR and its authorized agents will request access in writing except in cases of suspected fraud, waste, fraud and abuse. The MCO and its Subcontractors must make all requested medical records available within ten (10) business days of BMS’ DHHR’s request. Any Subcontract with an approved MCO Subcontractor must include a provision specifically authorizing maintenance and examination of records in accordance with the terms set forth in this Section.

Maintenance and Examination of Records. The MCO and its Subcontractors must maintain records, books, documents, papers, and files that are related to West Virginia’s Medicaid Medicaid/WVCHIP managed care program services and expenditures, including reports to BMS and source information used in preparation of these reports. These reports include but are not limited to financial statements, records relating to quality of care, and medical records. In addition, the MCO must provide, and cause its Subcontractors to provide, at no cost to BMS or a designee, prompt, reasonable, and adequate access to any records, books, documents, papers, and files that are related to performance under the Contract. The MCO and its Subcontractors agrees to permit inspection of its records, books, documents, papers, and files which will be conducted in accordance with Federal and State laws and regulations regarding confidentiality. The MCO and its Subcontractors are required to submit information to BMS or to a designee in a manner that maintains the confidentiality of involved parties (e.g., blacking out enrollees’ and providers’ names). The MCO must comply with the record retention requirements of Title 45, Sections 74.21 through 74.23 (45 CFR 74.21 through 74.23). Such records, with the exception of medical records and enrollee and provider quality assurance and quality improvement records when confidentiality is protected by law, are the property of BMS. The Secretary, DHHS and BMS or a designee have the right to audit and inspect any books or records of the MCO or its Subcontractors pertaining to the ability of the MCO to bear the risk of financial losses and services performed or payable amounts under the Contract. Upon non-renewal or termination of this Contract, the MCO must turn over, and cause its Subcontractors to turn over, to BMS or to a designee of BMS all records, books, documents, papers and files that are related to persons receiving services and to the administration of this Contract that BMS may request. The MCO must provide, and cause its Subcontractors to provide, BMS and its authorized agents with reasonable access to any records, books, documents, papers, and files the MCO and its Subcontractors maintain for the purposes of this Contract. BMS and its authorized agents will request access in writing except in cases of suspected fraud, waste, and abuseFWA. The MCO and its Subcontractors must make all requested medical records available within ten (10) business days of BMS’ request. Any Subcontract with an approved MCO Subcontractor must include a provision specifically authorizing maintenance and examination of records in accordance with the terms set forth in this Section.

Maintenance and Examination of Records. The MCO and its Subcontractors must maintain records, books, documents, papers, papers and files that are related to West Virginia’s Medicaid managed care program services and expenditures, including reports to BMS and source information used in preparation of these reports. These reports include but are not limited to financial statements, records relating to quality of care, and medical records. In addition, the MCO must provide, and cause its Subcontractors to provide, at no cost to BMS or a designee, prompt, reasonable, and adequate access to any records, books, documents, papers, papers and files that are related to performance under the Contract. The MCO and its Subcontractors agrees to permit inspection of its records, books, documents, papers, papers and files which will be conducted in accordance with Federal and State laws and regulations regarding confidentiality. The MCO and its Subcontractors are required to submit information to BMS or to a designee in a manner that maintains the confidentiality of involved parties (e.g., blacking out enrolleesmembers’ and providers’ names). The MCO must comply with the record retention requirements of Title 45, Sections 74.21 through 74.23 (45 CFR 74.21 through 74.23). Such records, with the exception of medical records and enrollee member and provider quality assurance and quality improvement records when confidentiality is protected by law, are the property of BMS. The Secretary, DHHS and BMS or a designee have the right to audit and inspect any books or records of the MCO or its Subcontractors pertaining to the ability of the MCO to bear the risk of financial losses and services performed or payable amounts under the Contract. Upon non-renewal or termination of this Contract, the MCO must turn over, and cause its Subcontractors to turn over, to BMS or to a designee of BMS all records, books, documents, papers and files that are related to persons receiving services and to the administration of this Contract that BMS may request. The MCO must provide, and cause its Subcontractors to provide, BMS and its authorized agents with reasonable access to any records, books, documents, papers, papers and files the MCO and its Subcontractors maintain for the purposes of this Contract. BMS and its authorized agents will request access in writing except in cases of suspected fraud, waste, fraud and abuse. The MCO and its Subcontractors must make all requested medical records available within ten (10) business working days of BMS’ request. Any Subcontract with an approved MCO Subcontractor must include a provision specifically authorizing maintenance and examination of records in accordance with the terms set forth in this Section.