Common use of Implementation Report Clause in Contracts

Implementation Report. Within 90 days after the Effective Date, Ocean Dental shall submit a written report to OIG summarizing the status of its implementation of the requirements of this CIA (Implementation Report). The Implementation Report shall, at a minimum, include: 1. the name, address, phone number, and position description of the Compliance Officer required by Section III.A, and a summary of other noncompliance job responsibilities the Compliance Officer may have; 2. a copy of the policies and procedures required by Section III.B.; 3. a copy of the notice Ocean Dental posted in its office as required by Section III.C, a description of where the notice is posted, and the date the notice was posted; 4. the following information regarding the training required by Section III.D: a copy of the training certifications for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request. 5. the following information regarding the IRO: (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this CIA; (d) a summary and description of any and all current and prior engagements and agreements between Ocean Dental and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Ocean Dental; 6. a copy of the documentation demonstrating that Ocean Dental has screened all Covered Persons against the Exclusion Lists, as required by Section III.F within 30 days of the Effective Date; 7. a copy of any certifications from Ocean Dental and the third party billing company required by Section III.J (if applicable); 8. a list of all of Ocean Dental’s locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which Ocean Dental currently submits claims; and

Implementation Report. Within 90 120 days after the Effective Date, Ocean Dental First Call shall submit a written report to OIG summarizing the status of its implementation of the requirements of this CIA (Implementation Report). The Implementation Report shall, at a minimum, include: 1. the name, address, phone number, and position description of the Compliance Officer required by Section III.A, and a summary of other noncompliance job responsibilities the Compliance Officer may have; 2. a copy the names and positions of the policies and procedures members of the Compliance Committee required by Section III.B.III.A; 3. the names of the Board members who are responsible for satisfying the Board of Directors compliance obligations described in Section III.A.3; 4. a copy of the notice Ocean Dental posted in its office as First Call’s Code of Conduct required by Section III.CIII.B.1; 5. the number of individuals required to complete the Code of Conduct certification required by Section III.B.1, a description the percentage of where the notice is postedindividuals who have completed such certification, and an explanation of any exceptions (the date the notice was posteddocumentation supporting this information shall be made available to OIG upon request); 46. a summary of all Policies and Procedures required by Section III.B (copies of the Policies and Procedures shall be made available to OIG upon request); 7. the following information regarding the each type of training required by Section III.D: III.C: a. a copy description of such training, including a summary of the training certifications for each Covered Person who completed the trainingtopics covered, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; sessions, and a schedule of training program brochure or other materials from sessions; and b. the training program or training program sponsor that describe the content number of the training programindividuals required to be trained, percentage of individuals actually trained, and an explanation of any exceptions. A copy of all training materials and the documentation supporting this information shall be made available to OIG upon request. 58. a description of the Disclosure Program required by Section III.E; 9. the following information regarding the IRO: IRO(s): (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this CIA; (d) a summary and description of any and all current and prior engagements and agreements between Ocean Dental First Call and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Ocean DentalFirst Call; 610. a copy description of the documentation demonstrating that Ocean Dental has screened all Covered Persons against process by which First Call fulfills the Exclusion Lists, as required by requirements of Section III.F within 30 days of the Effective Dateregarding Ineligible Persons; 7. a copy of any certifications from Ocean Dental and the third party billing company required by Section III.J (if applicable); 811. a list of all of Ocean DentalFirst Call’s locations (including locations and mailing addresses), ; the corresponding name under which each location is doing business, ; the corresponding phone numbers and fax numbers, ; each location’s Medicare and state Medicaid program provider identification number(s), ) and/or supplier number(s), ; and the name and address of each Medicare and state Medicaid program contractor to which Ocean Dental First Call currently submits claims; and; 12. a description of First Call’s corporate structure, including identification of any parent and sister companies, subsidiaries, and their respective lines of business and any individual owners;

Implementation Report. Within 90 120 days after the Effective Date, Ocean Dental Trans- Star shall submit a written report to OIG summarizing the status of its implementation of the requirements of this CIA (Implementation Report). The Implementation Report shall, at a minimum, include: 1. the name, address, phone number, and position description of the Compliance Officer required by Section III.A, and a summary of other noncompliance job responsibilities the Compliance Officer may have; 2. a copy of the policies and procedures required by Section III.B.; 3. a copy of the notice Ocean Dental Trans-Star posted in its office as required by Section III.C, a description of where the notice is posted, and the date the notice was posted; 4. the following information regarding the training required by Section III.D: a copy of the training certifications for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request. 5. the following information regarding the IRO: (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this CIA; (d) a summary and description of any and all current and prior engagements and agreements between Ocean Dental Trans-Star and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Ocean DentalTrans-Star; 6. a copy of the documentation demonstrating that Ocean Dental Trans-Star has screened all Covered Persons against the Exclusion Lists, as required by Section III.F within 30 days of the Effective Date; 7. a copy of Trans-Star’s policies and procedures regarding the identification, quantification and repayment of Overpayments required by Section III.H; 8. a copy of any certifications from Ocean Dental Trans-Star and the third party billing company required by Section III.J (if applicable); 89. a list of all of Ocean DentalTrans-Star’s locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which Ocean Dental Trans-Star currently submits claims; and

Implementation Report. Within 90 days after the Effective Date, Ocean Dental Choudhary-Rolla Neurology shall submit a written report to OIG summarizing the status of its implementation of the requirements of this CIA IA (Implementation Report). The Implementation Report shall, at a minimum, include: 1. the name, address, phone number, and position description of the Compliance Officer required by Section III.A, and a summary of other noncompliance job responsibilities the Compliance Officer may have; 2. a copy of the policies and procedures required by Section III.B.; 3. a copy of the notice Ocean Dental Choudhary-Rolla Neurology posted in its office Choudhary-Rolla Neurology’s offices as required by Section III.CIII.A, a description of where the notice is posted, and the date the notice was posted; 42. the following information regarding the one hour of training required by Section III.DIII.B to be completed within 60 days of the Effective Date: a copy of the training certifications program registration for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request. 53. the following information regarding the IRO: (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this CIAIA; (d) a summary and description of any and all current and prior engagements and agreements between Ocean Dental Choudhary-Rolla Neurology and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Ocean Dental; 6Choudhary-Rolla Neurology; 4. a copy of the documentation demonstrating that Ocean Dental Choudhary-Rolla Neurology has screened all Covered Persons against the Exclusion Lists, as required by Section III.F section III.D, within 30 days of the Effective Date; 7; 5. a copy of any certifications from Ocean Dental ▇▇▇▇▇▇▇▇▇-Rolla Neurology and the third party billing company required by Section III.J III.H (if applicable); 86. a list of all of Ocean DentalChoudhary-Rolla Neurology’s locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which Ocean Dental Choudhary-Rolla Neurology currently submits claims; and

Implementation Report. Within 90 days after the Effective Date, Ocean Dental the Providers shall submit a written report to OIG summarizing the status of its their implementation of the requirements of this CIA (Implementation Report). The Implementation Report shall, at a minimum, include: 1. the name, address, phone number, and position description of the Compliance Officer required by Section III.A, and a summary of other noncompliance job responsibilities the Compliance Officer may have; 2. a copy of the policies and procedures required by Section III.B.; 3. a copy of the notice Ocean Dental the Providers posted in its office their office(s) as required by Section III.C, a description of where the notice is posted, and the date the notice was posted; 4. the following information regarding the training required by Section III.D: a copy of the training certifications for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request. 5. the following information regarding the IRO: (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this CIA; (d) a summary and description of any and all current and prior engagements and agreements between Ocean Dental the Providers and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Ocean Dentalthe Providers; 6. a copy of the documentation demonstrating that Ocean Dental has the Providers have screened all Covered Persons against the Exclusion Lists, as required by Section III.F within 30 days of the Effective Date; 7. a copy of any certifications from Ocean Dental the Providers’ policies and procedures regarding the third party billing company identification, quantification and repayment of Overpayments required by Section III.J (if applicable)III.H; 8. a list of all of Ocean Dental’s locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which Ocean Dental currently submits claims; and

Implementation Report. Within 90 120 days after the Effective Date, Ocean Dental HOTC shall submit a written report to OIG summarizing the status of its implementation of the requirements of this CIA (Implementation Report). The Implementation Report shall, at a minimum, include: 1. the name, address, phone number, and position description of the Compliance Officer required by Section III.A, and a summary of other noncompliance noncompliance- related job responsibilities the Compliance Officer may have; 2. a copy the names and positions of the policies and procedures members of the Compliance Committee required by Section III.B.III.A; 3. the names of the Board members who are responsible for satisfying the Board of Directors compliance obligations described in Section III.A.3; 4. a copy of the notice Ocean Dental posted in its office as HOTC’s Code of Conduct required by Section III.CIII.B.1; 5. the number of individuals required to complete the Code of Conduct certification required by Section III.B.1, a description the percentage of where the notice is postedindividuals who have completed such certification, and an explanation of any exceptions (the date the notice was posteddocumentation supporting this information shall be available to OIG upon request); 46. a summary of all Policies and Procedures required by Section III.B (copies of the Policies and Procedures shall be made available to OIG upon request); 7. the following information regarding the each type of training required by Section III.D: III.C: a. a copy description of such training, including a summary of the training certifications for each Covered Person who completed the trainingtopics covered, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; sessions, and a schedule of training program brochure or other materials from sessions; and b. the training program or training program sponsor that describe the content number of the training programindividuals required to be trained, percentage of individuals actually trained, and an explanation of any exceptions. A copy of all training materials and the documentation supporting this information shall be made available to OIG upon request. 58. a description of the Disclosure Program required by Section III.E; 9. the following information regarding the IRO: IRO(s): (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this CIA; (d) a summary and description of any and all current and prior engagements and agreements between Ocean Dental HOTC and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Ocean DentalHOTC; 10. a description of the process by which HOTC fulfills the requirements of Section III.F regarding Ineligible Persons; 6. a copy of the documentation demonstrating that Ocean Dental has screened all Covered Persons against the Exclusion Lists, as required by Section III.F within 30 days of the Effective Date; 7. a copy of any certifications from Ocean Dental and the third party billing company required by Section III.J (if applicable); 811. a list of all of Ocean DentalHOTC’s locations (including locations and mailing addresses), ; the corresponding name under which each location is doing business, ; the corresponding phone numbers and fax numbers, ; each location’s Medicare and state Medicaid program provider identification number(s), number and/or supplier number(s), ; and the name and address of each Medicare and state Medicaid program contractor to which Ocean Dental HOTC currently submits claims; 12. a description of HOTC’s corporate structure, including identification of any HOTC and sister companies, subsidiaries, and their respective lines of business; and

Implementation Report. Within 90 days after the Effective Date, Ocean Dental Family Dermatology shall submit a written report to OIG summarizing the status of its implementation of the requirements of this CIA (Implementation Report). The Implementation Report shall, at a minimum, include: 1. the name, address, phone number, and position description of the Compliance Officer required by Section III.A, and a summary of other noncompliance job responsibilities the Compliance Officer may have; 2. a copy of the policies and procedures required by Section III.B.; 3. a copy of the notice Ocean Dental Family Dermatology posted in its office as required by Section III.C, a description of where the notice is posted, and the date the notice was posted; 4. the following information regarding the training required by Section III.D: a copy of the training certifications for each Covered Person who completed the training, the name of the training course, the name of the entity that provided the training, the location, date and length of the training; and a training program brochure or other materials from the training program or training program sponsor that describe the content of the training program. A copy of all training materials shall be made available to OIG upon request. 5. the following information regarding the IRO: (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this CIA; (d) a summary and description of any and all current and prior engagements and agreements between Ocean Dental Family Dermatology and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Ocean DentalFamily Dermatology; 6. a copy of the documentation demonstrating that Ocean Dental Family Dermatology has screened all Covered Persons against the Exclusion Lists, as required by Section III.F III.G within 30 days of the Effective Date; 7. a copy of any certifications from Ocean Dental Family Dermatology’s policies and procedures regarding the third party billing company identification, quantification and repayment of Overpayments required by Section III.J (if applicable)III.I; 8. a list of all of Ocean DentalFamily Dermatology’s locations (including locations and mailing addresses), the corresponding name under which each location is doing business, the corresponding phone numbers and fax numbers, each location’s Medicare and state Medicaid program provider identification number(s), and/or supplier number(s), and the name and address of each Medicare and state Medicaid program contractor to which Ocean Dental Family Dermatology currently submits claims; and