Common use of Reporting Fraud Clause in Contracts

Reporting Fraud. 12 Provider shall comply with RCW 48.135 concerning Insurance Fraud Reporting and shall 13 notify North Sound BH-ASO Compliance Department of all incidents or occasions of 14 suspected fraud, waste, or abuse involving Services provided to an individual. Provider 15 shall report a suspected incident of fraud, waste or abuse, including a credible allegation 16 of fraud, within five (5) business days of the date Provider first becomes aware of, or is on 17 notice of, such activity. The obligation to report suspected fraud, waste, or abuse shall 18 apply if the suspected conduct was perpetrated by Provider, Provider’s employee, agent, 19 subcontractor, or individual. Provider shall establish P&P’s for identifying, investigating, 20 and taking appropriate corrective action against suspected fraud, waste, or abuse. 21 Detailed information provided to employees and subcontractors regarding fraud and 22 abuse P&P’s and the false Claims Act and the Washington false claims statutes RCW 23 Chapter 74.66 and 74.09.210. Upon request by North Sound BH-ASO, and/or HCA, 24 Provider shall confer with the appropriate State agency prior to or during any investigation 25 into suspected fraud, waste, or abuse.

Reporting Fraud. 12 43 Provider shall comply with RCW 48.135 concerning Insurance Fraud Reporting and 44 shall 13 notify North Sound BH-ASO Compliance Department of all incidents or occasions 1 of 14 suspected fraud, waste, or abuse involving Services provided to an individual. 2 Provider 15 shall report a suspected incident of fraud, waste or abuse, including a credible 3 allegation 16 of fraud, within five (5) business days of the date Provider first becomes 4 aware of, or is on 17 notice of, such activity. The obligation to report suspected fraud, 5 waste, or abuse shall 18 apply if the suspected conduct was perpetrated by Provider, 6 Provider’s employee, agent, 19 subcontractor, or individual. Provider shall establish 7 P&P’s for identifying, investigating, 20 and taking appropriate corrective action against 8 suspected fraud, waste, or abuse. 21 Detailed information provided to employees and 9 subcontractors regarding fraud and 22 abuse P&P’s and the false Claims Act and the 10 Washington false claims statutes RCW 23 Chapter 74.66 and 74.09.210. Upon request by 11 North Sound BH-ASO, and/or HCADOC, 24 Provider shall confer with the appropriate State 12 agency prior to or during any investigation 25 into suspected fraud, waste, or abuse.

Reporting Fraud. 12 Provider shall comply with chapter 48.135 RCW 48.135 concerning Insurance Fraud 13 Reporting and shall 13 notify North Sound BH-ASO Compliance Department of all 14 incidents or occasions of 14 suspected fraud, waste, or abuse involving Services 15 provided to an individual. Provider 15 shall report a suspected incident of fraud, waste waste, 16 or abuse, including a credible allegation 16 of fraud, within five (5) standard business 17 days (Monday-Friday) of the date Provider first becomes aware of, or is on 17 notice of, 18 such activity. The obligation to report suspected fraud, waste, or abuse shall 18 apply 19 if the suspected conduct was perpetrated by Provider, Provider’s employee, agent, 19 subcontractor, 20 or individual. Provider shall establish P&P’s policies and procedures for identifying, investigating, 20 21 investigating and taking appropriate corrective action against suspected fraud, 22 waste, or abuse. 21 Detailed information provided to employees and subcontractors regarding fraud and 22 23 abuse P&P’s policies and procedures and the false False Claims Act and the Washington false 24 claims statutes RCW 23 Chapter 74.66 and 74.09.210. Upon request by North Sound 25 BH-ASO, ASO and/or HCA, 24 Provider shall confer with the appropriate State agency prior 26 to or during any investigation 25 into suspected fraud, waste, or abuse.

Reporting Fraud. 12 43 Provider shall comply with RCW 48.135 concerning Insurance Fraud Reporting and 44 shall 13 notify North Sound BH-ASO Compliance Department of all incidents or occasions 1 of 14 suspected fraud, waste, or abuse involving Services provided to an individual. 2 Provider 15 shall report a suspected incident of fraud, waste or abuse, including a credible 3 allegation 16 of fraud, within five (5) business days of the date Provider first becomes 4 aware of, or is on 17 notice of, such activity. The obligation to report suspected fraud, 5 waste, or abuse shall 18 apply if the suspected conduct was perpetrated by Provider, 6 Provider’s employee, agent, 19 subcontractor, or individual. Provider shall establish 7 P&P’s for identifying, investigating, 20 and taking appropriate corrective action against 8 suspected fraud, waste, or abuse. 21 Detailed information provided to employees and 9 subcontractors regarding fraud and 22 abuse P&P’s and the false Claims Act and the 10 Washington false claims statutes RCW 23 Chapter 74.66 and 74.09.210. Upon request by 11 North Sound BH-ASO, and/or HCA, 24 Provider shall confer with the appropriate State 12 agency prior to or during any investigation 25 into suspected fraud, waste, or abuse.

Reporting Fraud. 12 Provider shall comply with RCW 48.135 concerning Insurance Fraud Reporting and shall 13 notify North Sound BH-ASO Compliance Department of all incidents or occasions of 14 suspected fraud, waste, or abuse involving Services provided to an individual. Provider 15 shall report a suspected incident of fraud, waste waste, or abuse, including a credible allegation 16 of fraud, within five (5) business days of the date Provider first becomes aware of, or is on 17 notice of, such activity. The obligation to report suspected fraud, waste, or abuse shall 18 apply if the suspected conduct was perpetrated by Provider, Provider’s employee, agent, 19 subcontractor, or individual. Provider shall establish P&P’s for identifying, investigating, investigating 20 and taking appropriate corrective action against suspected fraud, waste, or abuse. 21 Detailed information provided to employees and subcontractors regarding fraud and 22 abuse P&P’s and the false Claims Act and the Washington false claims statutes RCW 23 Chapter 74.66 and 74.09.210. Upon request by North Sound BH-ASO, ASO and/or HCA, Provider 24 Provider shall confer with the appropriate State agency prior to or during any investigation into 25 into suspected fraud, waste, or abuse.

Reporting Fraud. 12 29 Provider shall comply with RCW 48.135 concerning Insurance Fraud 30 Reporting and shall 13 notify North Sound BH-ASO Compliance Department of all 31 incidents or occasions of 14 suspected fraud, waste, or abuse involving Services 32 provided to an individual. Provider 15 shall report a suspected incident of fraud, 33 waste or abuse, including a credible allegation 16 of fraud, within five (5) 34 business days of the date Provider first becomes aware of, or is on 17 notice of, 35 such activity. The obligation to report suspected fraud, waste, or abuse shall 18 36 apply if the suspected conduct was perpetrated by Provider, Provider’s 37 employee, agent, 19 subcontractor, or individual. Provider shall establish P&P’s 38 for identifying, investigating, 20 and taking appropriate corrective action against 39 suspected fraud, waste, or abuse. 21 Detailed information provided to 40 employees and subcontractors regarding fraud and 22 abuse P&P’s and the false 41 Claims Act and the Washington false claims statutes RCW 23 Chapter 74.66 and 74.09.21000 00.00.000. Upon request by North Sound BH-ASO, and/or HCA, 24 Provider shall 43 confer with the appropriate State agency prior to or during any investigation 25 44 into suspected fraud, waste, or abuse.

Reporting Fraud. 12 26 Provider shall comply with RCW 48.135 concerning Insurance Fraud Reporting and shall 13 27 notify North Sound BH-ASO Compliance Department of all incidents or occasions of 14 28 suspected fraud, waste, or abuse involving Services provided to an individual. Provider 15 29 shall report a suspected incident of fraud, waste or abuse, including a credible allegation 16 30 of fraud, within five (5) business days of the date Provider first becomes aware of, or is on 17 31 notice of, such activity. The obligation to report suspected fraud, waste, or abuse shall 18 32 apply if the suspected conduct was perpetrated by Provider, Provider’s employee, agent, 19 33 subcontractor, or individual. Provider shall establish P&P’s for identifying, investigating, 20 34 and taking appropriate corrective action against suspected fraud, waste, or abuse. 21 35 Detailed information provided to employees and subcontractors regarding fraud and 22 36 abuse P&P’s and the false Claims Act and the Washington false claims statutes RCW 23 37 Chapter 74.66 and 74.09.210. Upon request by North Sound BH-ASO, and/or HCA, 24 38 Provider shall confer with the appropriate State agency prior to or during any investigation 25 39 into suspected fraud, waste, or abuse.. 41 2.12 PROVIDER TRAINING AND EDUCATION‌ 42 Upon the request of North Sound BH-ASO, the Provider shall participate in training when 43 required by the North Sound BH-ASO and/or HCA. 44 45