Notice of Audit. (1) Subject to subclauses (2) and (3), the DHB will give the PHO at least 30 Business Days' notice of the DHB's intention to carry out an Audit, except that the DHB and PHO may agree that the Audit will be carried out on a day that is less than 30 Business Days from the date of notice. (2) The DHB may give the PHO less than 30 Business Days' notice or no notice of the DHB's intention to carry out an Audit, provided that: (a) the amount of notice given by the DHB is reasonable in the circumstances; and (b) the DHB has reasonable grounds to believe that: (i) there has been a material breach of this Agreement; (ii) a delay of 30 Business Days would unreasonably prejudice the integrity of the Audit; or (iii) a delay of 30 Business Days would unreasonably prejudice the interests of any Eligible Person. (3) If the DHB reasonably suspects that fraudulent claiming has occurred, the DHB may enter the PHO's or any Contracted Provider’s Premises and conduct an Audit without giving notice. (4) The notice of Audit will include: (a) the anticipated scope of the Audit; (b) the name of the Auditor or Auditors; (c) the Auditor's or Auditors' qualifications (if any); and (d) a declaration from the Auditor or Auditors of any conflicts or potential conflicts of interest. (5) The DHB will ensure: (a) that any Auditor it appoints is suitably experienced, competent, has an appropriate background given the nature of the Services Provided and the type of Audit being conducted, and carries out his, her, or its work in a professional manner; and (b) that if the content of clinical records is being audited for clinically-related matters, the Auditor or member of the Audit team who Audits the clinical records is a suitably qualified clinician. (6) If the PHO has any reasonable concerns about the scope of an Audit or any person or agency appointed as an Auditor, except in relation to an Audit conducted in accordance with subclause (2) or (3), the PHO may bring those concerns to the DHB's attention in writing within 10 Business Days after receiving the notice of Audit, and the DHB will discuss those concerns with the PHO and respond to it in writing before commencing the Audit.
Appears in 9 contracts
Samples: Pho Services Agreement, Pho Services Agreement, Pho Services Agreement
Notice of Audit. (1) Subject to subclauses (2) and (3), the DHB will give the PHO at least 30 Business Days' notice of the DHB's intention to carry out an Audit, except that the DHB and PHO may agree that the Audit will be carried out on a day that is less than 30 Business Days from the date of notice.
(2) . The DHB may give the PHO less than 30 Business Days' notice or no notice of the DHB's intention to carry out an Audit, provided that:
(a) : the amount of notice given by the DHB is reasonable in the circumstances; and
(b) and the DHB has reasonable grounds to believe that:
(i) : there has been a material breach of this Agreement;
(ii) ; a delay of 30 Business Days would unreasonably prejudice the integrity of the Audit; or
(iii) or a delay of 30 Business Days would unreasonably prejudice the interests of any Eligible Person.
(3) . If the DHB reasonably suspects that fraudulent claiming has occurred, the DHB may enter the PHO's or any Contracted Provider’s Premises and conduct an Audit without giving notice.
(4) . The notice of Audit will include:
(a) : the anticipated scope of the Audit;
(b) ; the name of the Auditor or Auditors;
(c) ; the Auditor's or Auditors' qualifications (if any); and
(d) and a declaration from the Auditor or Auditors of any conflicts or potential conflicts of interest.
(5) . The DHB will ensure:
(a) : that any Auditor it appoints is suitably experienced, competent, has an appropriate background given the nature of the Services Provided and the type of Audit being conducted, and carries out his, her, or its work in a professional manner; and
(b) and that if the content of clinical records is being audited for clinically-related matters, the Auditor or member of the Audit team who Audits the clinical records is a suitably qualified clinician.
(6) . If the PHO has any reasonable concerns about the scope of an Audit or any person or agency appointed as an Auditor, except in relation to an Audit conducted in accordance with subclause (2) or (3), the PHO may bring those concerns to the DHB's attention in writing within 10 Business Days after receiving the notice of Audit, and the DHB will discuss those concerns with the PHO and respond to it in writing before commencing the Audit. An Audit may involve a variety of activities including, without limitation, conducting investigations or on-site audits at the PHO's or a Contracted Provider’s Premises, and surveying Service Users and Contracted Providers. The DHB will ensure that an Audit is carried out in a way that: minimises disruption to the Services; takes into account relevant safety considerations; and displays appropriate sensitivity to the privacy and dignity of Service Users seen in the course of an onsite audit. The PHO and each Contracted Provider who is a subject of an Audit will co-operate with the DHB for the purposes of, and during the course of, the Audit and will allow or arrange for the Auditor to have access to: the PHO's and Contracted Provider’s Premises, including to observe the provision of the Services; Records and any other information (including Health Information), in whatever form, that relate to the Services and this Agreement, the Service Users and their representatives (if relevant); and the PHO and Contracted Provider's Staff. The PHO and its Contracted Providers will take reasonable steps to ensure that the Auditor has access to Service Users and their representatives (if relevant), for interviews about the Services. In respect of onsite audits at the PHO or a Contracted Provider's Premises, we agree that: the Auditor may visit the Premises and have access to the Records at any time during Regular Hours, or any other time agreed by the PHO or Contracted Provider; unless an exception described in clauses B.29(2) and B.29(3) applies, the onsite audit will be undertaken at a time that is reasonably convenient for the PHO and Contracted Provider; and the PHO and the Contracted Provider may have a person present during an onsite audit. The DHB may make copies of any Record for the purposes of an Audit, except to the extent that it is prohibited from doing so by law. The DHB will provide the PHO with a draft and a final Audit report in accordance with the relevant Audit Protocol. If an Audit results in recommendations, we will each take reasonable steps to implement the recommendations and any agreed follow-up processes. The DHB may conduct an Audit after this Agreement has terminated, but only to the extent that it is relevant to the period during which this Agreement was in force. We acknowledge and agree that the purpose of a PHO financial Audit is to: monitor the use of public funding paid to the PHO, including funding paid for Services Provided under this Agreement; confirm that the PHO is and will continue to be a Not for Profit organisation; and identify whether the PHO is solvent. If the DHB has a concern regarding the PHO's use of funding, whether the PHO is a Not for Profit organisation, or solvency, the DHB may request by notice to the PHO, and the PHO must provide to the DHB within 20 Business Days after receipt of the notice, a certificate from a suitably qualified person certifying information about the PHO's use of funding, the PHO's solvency, or whether the PHO is a Not for Profit organisation. From time to time the DHB may appoint, at its cost, a suitably independent financial analyst as an Auditor to determine or assess: the correctness of the financial information the PHO provides about its use of public funding; any other matters relevant to assessing whether the PHO is a Not for Profit organisation; and whether the PHO is solvent.
Appears in 1 contract
Samples: Pho Services Agreement
Notice of Audit. (1) Subject to subclauses (2) and (3), the DHB will give the PHO at least 30 Business Days' notice of the DHB's intention to carry out an Audit, except that the DHB and PHO may agree that the Audit will be carried out on a day that is less than 30 Business Days from f rom the date of notice.
(2) The DHB may give the PHO less than 30 Business Days' notice or no notice of the DHB's intention to carry out an Audit, provided that:
(a) the amount of notice given by the DHB is reasonable in the circumstances; and
(b) the DHB has reasonable grounds to believe that:
(i) there has been a material breach of this Agreement;
(ii) a delay of 30 Business Days would unreasonably prejudice the integrity of the Audit; or
(iii) a delay of 30 Business Days would unreasonably prejudice the interests of any Eligible Person.
(3) If the DHB reasonably suspects that fraudulent f raudulent claiming has occurred, the DHB may enter the PHO's or any Contracted Provider’s Premises and conduct an Audit without giving notice.
(4) The notice of Audit will include:
(a) the anticipated scope of the Audit;
(b) the name of the Auditor or Auditors;
(c) the Auditor's or Auditors' qualifications (if any); and
(d) a declaration from f rom the Auditor or Auditors of any conflicts or potential conflicts of interest.
(5) The DHB will ensure:
(a) that any Auditor it appoints is suitably experienced, competent, has an appropriate background given the nature of the Services Provided and the type of Audit being conducted, and carries out his, her, or its work in a professional manner; and
(b) that if the content of clinical records is being audited for clinically-related matters, the Auditor or member of the Audit team who Audits the clinical records is a suitably qualified clinician.
(6) If the PHO has any reasonable concerns about the scope of an Audit or any person or agency appointed as an Auditor, except in relation to an Audit conducted in accordance with subclause (2) or (3), the PHO may bring those concerns to the DHB's attention in writing within 10 Business Days after af ter receiving the notice of Audit, and the DHB will discuss those concerns with the PHO and respond to it in writing before commencing the Audit.
Appears in 1 contract
Samples: Pho Services Agreement
Notice of Audit. (1) Subject to subclauses (2) and (3), the DHB will give the PHO at least 30 Business Days' Days notice of the DHB's its intention to carry out an Audit, except that the DHB and PHO may agree that the Audit will be carried out on a day that is less than 30 Business Days from the date of notice.
(2) The DHB may give the PHO a reduced notice period that is reasonable in the circumstances (and may include less than 30 Business Days' 24 hours notice or no notice of the DHB's intention to carry out an Audit, provided that:
(ain some circumstances) the amount of notice given by the DHB is reasonable in the circumstances; and
(b) if the DHB has reasonable grounds to believe that:
(ia) there has been a material breach of this Agreement;
(iib) a delay of 30 Business Days would unreasonably prejudice the integrity of the Audit; or
(iiic) a delay of 30 Business Days would unreasonably prejudice the interests of any Eligible Person.
(3) If the DHB reasonably suspects that fraudulent claiming has occurred, the DHB may enter the PHO's or any Contracted Provider’s Premises and conduct an Audit at any time without giving prior notice.
(4) The notice Notice of Audit will include:
(a) the anticipated scope of the Audit;
(b) the name identity of the Auditor or Auditorsperson appointed as Auditor;
(c) the Auditor's or Auditors' qualifications (if any); and
(d) a declaration from the Auditor or Auditors of any conflicts of interest he or potential conflicts of interestshe may have.
(5) The DHB will ensure:
(a) that any Auditor it appoints is suitably experienced, competent, has an appropriate background given the nature of the Services Provided and the type of Audit being conducted, and carries out his, her, or its work in a professional manner; and
(b) that if the content of clinical records is being audited for clinically-related matters, the Auditor or member of the Audit team who Audits the clinical records is a suitably qualified clinician.
(6) If the PHO has any reasonable concerns about the scope focus of an any Audit or any person or agency appointed by the DHB as an Auditor, except in relation to an Audit conducted in accordance with subclause (2) or (3), the PHO may will bring those concerns to the DHB's attention in writing within 10 Business Days after of receiving the notice of intention to Audit. Subject to time constraints when the DHB is conducting an urgent Audit in the situations described in subclause (2), and the DHB will discuss those concerns with the PHO and respond to it in writing before regarding its concerns prior to commencing the Audit.
Appears in 1 contract
Samples: Pho Services Agreement
Notice of Audit. (1) Subject to subclauses (2) and (3), the DHB will give the PHO at least 30 Business Days' notice of the DHB's intention to carry out an Audit, except that the DHB and PHO may agree that the Audit will be carried out on a day that is less than 30 Business Days from the date of notice.
(2) . The DHB may give the PHO less than 30 Business Days' notice or no notice of the DHB's intention to carry out an Audit, provided that:
(a) : the amount of notice given by the DHB is reasonable in the circumstances; and
(b) and the DHB has reasonable grounds to believe that:
(i) : there has been a material breach of this Agreement;
(ii) ; a delay of 30 Business Days would unreasonably prejudice the integrity of the Audit; or
(iii) or a delay of 30 Business Days would unreasonably prejudice the interests of any Eligible Person.
(3) If the DHB reasonably suspects that fraudulent claiming has occurred, the DHB may enter the PHO's or any Contracted Provider’s Premises and conduct an Audit without giving notice.
(4) . The notice of Audit will include:
(a) : the anticipated scope of the Audit;
(b) ; the name of the Auditor or Auditors;
(c) ; the Auditor's or Auditors' qualifications (if any); and
(d) and a declaration from the Auditor or Auditors of any conflicts or potential conflicts of interest.
(5) . The DHB will ensure:
(a) : that any Auditor it appoints is suitably experienced, competent, has an appropriate background given the nature of the Services Provided and the type of Audit being conducted, and carries out his, her, or its work in a professional manner; and
(b) and that if the content of clinical records is being audited for clinically-related matters, the Auditor or member of the Audit team who Audits the clinical records is a suitably qualified clinician.
(6) . If the PHO has any reasonable concerns about the scope of an Audit or any person or agency appointed as an Auditor, except in relation to an Audit conducted in accordance with subclause (2) or (3), the PHO may bring those concerns to the DHB's attention in writing within 10 Business Days after receiving the notice of Audit, and the DHB will discuss those concerns with the PHO and respond to it in writing before commencing the Audit. An Audit may involve a variety of activities including, without limitation, conducting investigations or on-site audits at the PHO's or a Contracted Provider’s Premises, and surveying Service Users and Contracted Providers. The DHB will ensure that an Audit is carried out in a way that: minimises disruption to the Services; takes into account relevant safety considerations; and displays appropriate sensitivity to the privacy and dignity of Service Users seen in the course of an onsite audit. The PHO and each Contracted Provider who is a subject of an Audit will co-operate with the DHB for the purposes of, and during the course of, the Audit and will allow or arrange for the Auditor to have access to: the PHO's and Contracted Provider’s Premises, including to observe the provision of the Services; Records and any other information (including Health Information), in whatever form, that relate to the Services and this Agreement, the Service Users and their representatives (if relevant); and the PHO and Contracted Provider's Staff. The PHO and its Contracted Providers will take reasonable steps to ensure that the Auditor has access to Service Users and their representatives (if relevant), for interviews about the Services. In respect of onsite audits at the PHO or a Contracted Provider's Premises, we agree that: the Auditor may visit the Premises and have access to the Records at any time during Regular Hours, or any other time agreed by the PHO or Contracted Provider; unless an exception described in clauses B.29(2) and B.29(3) applies, the onsite audit will be undertaken at a time that is reasonably convenient for the PHO and Contracted Provider; and the PHO and the Contracted Provider may have a person present during an onsite audit. The DHB may make copies of any Record for the purposes of an Audit, except to the extent that it is prohibited from doing so by law. The DHB will provide the PHO with a draft and a final Audit report in accordance with the relevant Audit Protocol. If an Audit results in recommendations, we will each take reasonable steps to implement the recommendations and any agreed follow-up processes. The DHB may conduct an Audit after this Agreement has terminated, but only to the extent that it is relevant to the period during which this Agreement was in force. We acknowledge and agree that the purpose of a PHO financial Audit is to: monitor the use of public funding paid to the PHO, including funding paid for Services Provided under this Agreement; confirm that the PHO is and will continue to be a Not for Profit organisation; and identify whether the PHO is solvent. If the DHB has a concern regarding the PHO's use of funding, whether the PHO is a Not for Profit organisation, or solvency, the DHB may request by notice to the PHO, and the PHO must provide to the DHB within 20 Business Days after receipt of the notice, a certificate from a suitably qualified person certifying information about the PHO's use of funding, the PHO's solvency, or whether the PHO is a Not for Profit organisation. From time to time the DHB may appoint, at its cost, a suitably independent financial analyst as an Auditor to determine or assess: the correctness of the financial information the PHO provides about its use of public funding; whether the PHO is solvent. The PHO is responsible for auditing the performance of its Contracted Providers. Without limiting the generality of this clause, in particular the PHO is responsible for: auditing the enrolment of persons on the NES by its Contracted Providers; auditing the information that its Contracted Providers are required to provide to the DHB, through the PHO; and carrying out clinical audits of its Contracted Providers.
Appears in 1 contract
Samples: Pho Services Agreement