Quality Management Program. The Contractor shall ensure its Quality Management (QM) program addresses GFS requirements. The HCA, Office of the State Auditor, or any of their duly-authorized representatives, may conduct announced and unannounced: Surveys, audits and reviews of compliance with licensing and certification requirements and the terms of this Contract; Audits regarding the quality, appropriateness, and timeliness of Behavioral Health services provided under this Contract; and Audits and inspections of financial records, related to GFS services. The Contractor shall participate with HCA in review activities. Participation will include at a minimum: The submission of requested materials necessary for an HCA initiated review within thirty (30) days of the request. The completion of site visit protocols provided by HCA. Assistance in scheduling interviews and agency visits required for the completion of the review. The Contractor shall notify HCA when an entity other than the State Auditor performs any audit described above related to any activity contained in this Contract. HCA defined reporting and data submission methods for Performance Measurement and Reporting: The Contractor shall comply with the reporting and data submissions requirements as directed by HCA and shall make reports available to HCA at least annually through the HCA monitoring process or more frequently, as requested by HCA. Should HCA adopt a subsequent set of requirements during the term of this Contract, HCA shall update the performance requirements as necessary. All performance measures are subject to an audit.
Appears in 2 contracts
Sources: Managed Care Wraparound Contract, Washington Behavioral Health Services Integrated Managed Care Wraparound Contract