Common use of Timely Response to EOHHS Requests Clause in Contracts

Timely Response to EOHHS Requests. a. The Contractor shall respond to any EOHHS requests for review, analysis, information, or other materials related to the Contractor’s performance of this Contract by the deadlines specified by EOHHS, including but not limited to, for most requests such as those described in this Section, providing a sufficient response within one week of receiving the request. Such requests may include but are not limited to requests for: 1) Records or data to assist the Contractor and EOHHS in identifying and resolving issues and inconsistencies in the Contractor’s data submissions to EOHHS; 2) Analysis of utilization, patterns of care, cost, and other characteristics to identify opportunities to improve the Contractor’s performance on any cost or quality measures related to this Contract; 3) Documentation and information related to the Contractor’s care delivery, Care Management, or Community Partners responsibilities, to assist EOHHS with understanding the Contractor’s activities pursuant to these requirements; 4) Information about the Contractor’s member protections activities, including Grievances; and 5) Cooperation and coordination with EOHHS, the Massachusetts Office of the Attorney General, and the Massachusetts Office of the State Auditor in any Fraud detection and control activities, or other activities as requested by EOHHS; and b. If the Contractor fails to satisfactorily respond within the time requested by EOHHS without prior approval from EOHHS for a late response, EOHHS may invoke the remedies for poor performance described in Section 6.22.

Timely Response to EOHHS Requests. a. The Contractor shall respond to any EOHHS requests for review, analysis, information, or other materials related to the Contractor’s performance of this Contract by the deadlines specified by EOHHS, including but not limited to, for most requests such as those described in this Section, providing a sufficient response within one week of receiving the request. Such requests may include but are not limited to requests for: 1) Records or data to assist the Contractor and EOHHS in identifying and resolving issues and inconsistencies in the Contractor’s data submissions to EOHHS; 2) Analysis of utilization, patterns of care, cost, and other characteristics to identify opportunities to improve the Contractor’s performance on any cost or quality measures related to this Contract; 3) Documentation and information related to the Contractor’s care delivery, Care Management, or Community Partners responsibilities, to assist EOHHS with understanding the Contractor’s activities pursuant to these requirements; 4) Information about the Contractor’s member protections activities, including Grievances; and 5) Cooperation and coordination with EOHHS, the Massachusetts Office of the Attorney General, and the Massachusetts Office of the State Auditor in any Fraud fraud detection and control activities, or other activities as requested by EOHHS; and b. If the Contractor fails to satisfactorily respond within the time requested by EOHHS without prior approval from EOHHS for a late response, EOHHS may invoke take corrective action or impose sanctions in accordance with the remedies for poor performance described in Section 6.22Contract.

Timely Response to EOHHS Requests. a. The Contractor shall respond to any EOHHS requests for review, analysis, information, or other materials related to the Contractor’s performance of this Contract by the deadlines specified by EOHHS, including but not limited to, for most requests such as those described in this Section, providing a sufficient response within one week of receiving the request. Such requests may include but are not limited to requests for: 1) Records from Contractor’s Health Information System, claims processing system, Encounter Data submission process, or data other sources, to assist the Contractor and EOHHS in identifying and resolving issues and inconsistencies in the Contractor’s data submissions to EOHHS; 2) Analysis of utilization, patterns of care, cost, and other characteristics to identify opportunities to improve the Contractor’s performance on any cost or quality measures related to this Contract; 3) Financial and data analytics, such as the Contractor’s payment rates to Network Providers as a percent of MassHealth’s fee schedules; 4) Documentation and information related to the Contractor’s care delivery, Care Management, or Community Partners responsibilities, to assist EOHHS with understanding the Contractor’s activities pursuant to these requirements; 45) Information about the Contractor’s member protections activities, including Grievancessuch as Grievances and Appeals; 6) Documentation and information related to Contractor’s Program Integrity activities as described in Section 2.3.D.3; 7) Documentation, analysis, and detail on the metrics evaluated in the Contractor’s Quality Improvement performance and programming; and 5) 8) Cooperation and coordination with EOHHS, the Massachusetts Office of the Attorney General, and the Massachusetts Office of the State Auditor in any Fraud detection and control activities, or other activities as requested by EOHHS; and. b. If the Contractor fails to satisfactorily respond within the time requested by EOHHS without prior approval from EOHHS for a late response, EOHHS may invoke the remedies for poor performance described take corrective action or impose sanctions in Section 6.22accordance with this Contract.

Timely Response to EOHHS Requests. a. The Contractor shall respond to any EOHHS requests for review, analysis, information, or other materials related to the Contractor’s performance of this Contract by the deadlines specified by EOHHS, including but not limited to, for most requests such as those described in this Section, providing a sufficient response within one week of receiving the request. Such requests may include but are not limited to requests for: 1) Records or data to assist the Contractor and EOHHS in identifying and resolving issues and inconsistencies in the Contractor’s data submissions to EOHHS; 2) Analysis of utilization, patterns of care, cost, and other characteristics to identify opportunities to improve the Contractor’s performance on any cost or quality measures related to this ContractContract or the Contractor’s Approved ACO Agreements; 3) Documentation and information related to the Contractor’s care delivery, Care Management, or Community Partners responsibilities, to assist EOHHS with understanding the Contractor’s activities pursuant to these requirements; 4) Information about the Contractor’s member protections Member Protections activities, including Grievances; and 5) Cooperation and coordination with EOHHS, the Massachusetts Office of the Attorney General, and the Massachusetts Office of the State Auditor in any Fraud detection and control activities, or other activities as requested by EOHHS; and. b. If the Contractor fails to satisfactorily respond within the time requested by EOHHS without prior approval from EOHHS for a late response, EOHHS may invoke the remedies for poor performance as described in Section 6.225.22.