Common use of Access to Provider Records Clause in Contracts

Access to Provider Records. (a) Participating Provider agrees to provide at no cost to the following entities or their designees with prompt, reasonable, and adequate access to Carolina Complete or Payor and the Agreement and any records, books, documents, and papers that relate to Carolina Complete or Payor and the Agreement and/or Participating Provider’s performance of its responsibilities under this Agreement for purposes of examination, audit, investigation, contract administration, the making of copies, excerpts or transcripts, or any other purpose NC DHHS deems necessary for contract enforcement or to perform its regulatory functions: (i) the United States Department of Health and Human Services or its designee; (ii) the Comptroller General of the United States or its designee; (iii) NC DHHS, its Medicaid managed care program personnel, or its designee; (iv) the Office of Inspector General; (v) North Carolina Department of Justice Medicaid Investigations Division; (vi) any independent verification and validation contractor, audit firm, or quality assurance contractor acting on behalf of NC DHHS; (vii) the North Carolina Office of State Auditor, or its designee; (viii) a state or federal law enforcement agency; and (ix) any other state or federal entity identified by NC DHHS, or any other entity engaged by NC DHHS. (b) Participating Provider shall cooperate with all announced and unannounced site visits, audits, investigations, post-payment reviews, or other program integrity activities conducted by the NC DHHS. (c) Nothing in this section shall be construed to limit the ability of the federal government, the Centers for Medicare and Medicaid Services, the U.S. Department of Health and Human Services Office of Inspector General, the U.S. Department of Justice, or any of the foregoing entities’ contractors or agents, to enforce federal requirements for the submission of documentation in response to an audit or investigation. (Section VII, G(3)(f)).

Access to Provider Records. (a) Participating The Provider agrees to provide at no cost to the following entities or their designees with prompt, reasonable, and adequate access to Carolina Complete or Payor the PIHP and the Provider Contract/Agreement and any records, books, documents, and papers that relate to Carolina Complete or Payor the PIHP and the Provider Contract/Agreement and/or Participating the Provider’s performance of its responsibilities under this Agreement contract for purposes of examination, audit, investigation, contract administration, the making of copies, excerpts or transcripts, or any other purpose NC DHHS deems necessary for contract enforcement or to perform its regulatory functions: (i) the The United States Department of Health and Human Services or its designee; (ii) the The Comptroller General of the United States or its designee; The North Carolina Department of Health and Human Services (iii) NC DHHS), its Medicaid managed care Managed Care program personnel, or its designee; (iv) the designee The Office of Inspector General; (v) General North Carolina Department of Justice Medicaid Investigations Division; (vi) any Division Any independent verification and validation contractor, audit firm, or quality assurance contractor acting on behalf of NC DHHS; (vii) the The North Carolina Office of State Auditor, or its designee; (viii) a designee A state or federal law enforcement agency; and (ix) . And any other state or federal entity identified by NC DHHS, or any other entity engaged by NC DHHS. (b) Participating . The Provider shall cooperate with all announced and unannounced site visits, audits, investigations, post-payment reviews, or other program integrity Program Integrity activities conducted by the NC DHHS. (c) Department of Health and Human Services. Nothing in this section shall be construed to limit the ability of the federal government, the Centers for Medicare and Medicaid Services, the U.S. Department of Health and Human Services Office of Inspector General, the U.S. Department of Justice, or any of the foregoing entities’ ' contractors or agents, to enforce federal requirements for the submission of documentation in response to an audit or investigation. (Section VII, G(3)(fAttachment ▇.▇.▇▇ p. 323)).

Access to Provider Records. (a) Participating The Provider agrees to provide at no cost to the following entities or their designees with prompt, reasonable, and adequate access to Carolina Complete or Payor and the Agreement Contract and any records, books, documents, papers, and papers video recordings that relate to Carolina Complete or Payor and the Agreement Contract and/or Participating the Provider’s performance of its responsibilities under this Agreement Contract for purposes of examination, audit, investigation, contract administration, the making of copies, excerpts or transcripts, or any other purpose NC DHHS deems necessary for contract enforcement or to perform its regulatory functions: (i) the : i. The United States Department of Health and Human Services or its designee; (; ii) the . The Comptroller General of the United States or its designee; ; iii. The North Carolina Department of Health and Human Services (iii) NC DHHS), its Medicaid managed care Managed Care program personnel, or its designee; (; iv) the . The Office of Inspector General; (v) ; v. North Carolina Department of Justice Medicaid Investigations Division; (; vi) any . Any independent verification and validation contractor, audit firm, or quality assurance contractor acting on behalf of NC DHHS; (; vii) the . The North Carolina Office of State Auditor, or its designee; (viii) a . A state or federal law enforcement agency; and (. ix) . And any other state or federal entity identified by NC DHHS, or any other entity engaged by NC DHHS. (b) Participating . The Provider shall cooperate with all announced and unannounced site visits, audits, investigations, post-post- payment reviews, or other program integrity Program Integrity activities conducted by the NC DHHS. (c) Department of Health and Human Services. Nothing in this section Attachment shall be construed to limit the ability of the federal government, the Centers for Medicare and Medicaid Services, the U.S. Department of Health and Human Services Office of Inspector General, the U.S. Department of Justice, or any of the foregoing entities’ ' contractors or agents, to enforce federal requirements for the submission of documentation in response to an audit or investigation. (Section VII, G(3)(f)).