Common use of Reports and Data Clause in Contracts

Reports and Data. A. ACCESS TO AND/OR DISCLOSURE OF FINANCIAL RECORDS ---The County and any subcontractors shall make available to the Department, the Department’s authorized agents, and appropriate representatives of the U.S. Department of Health and Human Services any financial records of County or subcontractors that relate to the County’s capacity to bear the risk of potential financial losses, or to the services performed and amounts paid or payable under this Contract. The County shall comply with applicable recordkeeping requirements specified in HFS 105.02(1)-(7) Wisconsin Administrative Code, as amended. B. PERIODIC REPORTS The County agrees to furnish within the Department’s time frame and within the Department’s stated form and format, information and/or data from its records to the Department, and to the Department’s authorized agents, which the Department may require to administer this Contract, including but not limited to the following: 1. Copies of all written complaints by Medicaid/BadgerCare enrollees processed by the County through its grievance procedure, and actions taken to resolve such complaints. 2. Summaries of amounts recovered through the Coordination of Benefits for services rendered to enrollees under this Contract. 3. Enrollee utilization and outcome data in the format described in Addendum II and Addendum IX. 4. Oral complaint logs must be available on request. C. ACCESS TO AND AUDIT OF CONTRACT RECORDS Throughout the duration of the Contract, and for a period of five years after termination of the Contract, the County shall provide duly authorized representatives of the state or federal government access to all records and material relating to the Contractor’s provision of and reimbursement for activities contemplated under the Contract. Such access shall include the right to inspect, audit and reproduce all such records and material and to verify reports furnished in compliance with the provisions of the Contract. All information so obtained will be accorded confidential treatment as provided under applicable laws, rules, or regulations. D. RECORDS RETENTION The County shall retain, preserve and make available, upon request, all records relating to the performance of its obligations under the Contract, including claim forms, for a period of not less than five years from the date of termination of the Contract. Records involving matters, that are the subject of litigation, shall be retained for a period of not less than five years following the termination of litigation. Microfilm copies of the documents contemplated herein may be substituted for the originals with the prior written consent of the Department, provided that the microfilming procedures are approved by the Department as reliable and are supported by an effective retrieval system. Upon expiration of the five (5) year retention period, the subject records shall, upon request, be transferred to the Department’s possession. No records shall be destroyed or otherwise disposed of without the prior written consent of the Department. E. INSURANCE INFORMATION DISCLOSURE The following requirements shall apply if the contractor (or the contractor’s parent firm and/or any subdivision or subsidiary of either the contractor’s parent firm or of the Contractor) is a health care insurer (including but not limited to a group health insurer and/or health maintenance organization) licensed by the Wisconsin Office of the Insurance Commissioner and/or a third party administrator for a group or individual health insurer(s), health maintenance organization(s), and/or employer self-insurer health plan(s): 1. Throughout the Contract term, these insurers and third party administrators shall comply in full with the provisions of s. 49.

Reports and Data. A. ACCESS TO AND/OR DISCLOSURE OF FINANCIAL RECORDS ---The The County and any subcontractors shall make available to the Department, the Department’s authorized agents, and appropriate representatives of the U.S. Department of Health and Human Services any financial records of the County or subcontractors that relate to the County’s capacity to bear the risk of potential financial losses, or to the services performed and amounts paid or payable under this Contract. The County shall comply with applicable recordkeeping requirements specified in HFS 105.02(1)-(7) Wisconsin Administrative Code, as amended. B. PERIODIC REPORTS The County agrees to furnish within the Department’s time frame and within the Department’s stated form and format, information and/or data from its records to the Department, and to the Department’s authorized agents, which the Department may require to administer this Contract, including but not limited to the following: 1. Copies of all written complaints by Medicaid/BadgerCare enrollees processed by the County through its grievance procedure, and actions taken to resolve such complaints. 2. Summaries of amounts recovered through the Coordination of Benefits for services rendered to enrollees under this ContractContract in the format specified. 3. Enrollee utilization and outcome data in the format formats described in Addendum II and Addendum IXXI. 4. Oral complaint logs must be available on request. C. ACCESS TO AND AUDIT OF CONTRACT RECORDS Throughout the duration of the Contract, and for a period of five years after termination of the Contract, the County shall provide duly authorized representatives of the state or federal government access to all records and material relating to the Contractor’s provision of and reimbursement for activities contemplated under the Contract. Such access shall include the right to inspect, audit and reproduce all such records and material and to verify reports furnished in compliance with the provisions of the Contract. All information so obtained will be accorded confidential treatment as provided under applicable laws, rules, or regulations. D. RECORDS RETENTION The County shall retain, preserve and make available, available upon request, request all records relating to the performance of its obligations under the Contract, including claim forms, for a period of not less than five years from the date of termination of the Contract. Records involving matters, matters that are the subject of litigation, litigation shall be retained for a period of not less than five years following the termination of litigation. Microfilm copies of the documents contemplated herein may be substituted for the originals with the prior written consent of the Department, provided that the microfilming procedures are approved by the Department as reliable and are supported by an effective retrieval system. Upon expiration of the five (5) year retention period, the subject records shall, upon request, be transferred to the Department’s possession. No records shall be destroyed or otherwise disposed of without the prior written consent of the Department. E. INSURANCE INFORMATION DISCLOSURE The following requirements shall apply if the contractor Contractor (or the contractor’s parent firm and/or any subdivision sub- division or subsidiary of either the contractor’s parent firm or of the Contractorcontractor) is a health care insurer (including but not limited to a group health insurer and/or health maintenance organization) licensed by the Wisconsin Office of the Insurance Commissioner and/or a third party administrator for a group or individual health insurer(s), health maintenance organization(s), and/or employer self-insurer health plan(s): 1. Throughout the Contract term, these insurers and third party administrators shall comply in full with the provisions of s. 49.