Common use of Reports and Reporting Clause in Contracts

Reports and Reporting. (a) CONTRACTING PROVIDER shall issue to Anthem BC&BS, at CONTRACTING PROVIDER's expense, such reports related to CONTRACTING PROVIDER's and Represented Providers' services under this Agreement, as Anthem BC&BS reasonably requests, including those reports set forth on Exhibit C hereto. All reports shall be in a form and of content and frequency as Anthem BC&BS and CONTRACTING PROVIDER shall agree, but at a minimum shall meet any criteria that Anthem BC&BS determines are applicable pursuant to HEDIS or other NCQA criteria or NMIS. (b) CONTRACTING PROVIDER agrees to furnish to Anthem BC&BS upon request either (i) an audited balance sheet and related statements of income, retained earnings and changes in consolidated financial position for CONTRACTING PROVIDER as of the and for each fiscal year end during the term of this Agreement, with an unqualified report thereon by CONTRACTING PROVIDER's independent public accountants; or, if audited sheets are not prepared, (ii) an unaudited balance sheet and related statements of income, retained earnings and changes in financial position for CONTRACTING PROVIDER as of and for the each fiscal year end during the term of this Agreement, certified by the principal financial officer of CONTRACTING PROVIDER. In addition, CONTRACTING PROVIDER shall represent that, except as otherwise disclosed in writing to Anthem BC&BS: (i) since the date of the financial statements (the "Financial Statements"), there has been no material adverse change in the financial condition, business, operations or properties of CONTRACTING PROVIDER; (ii) all such Financial Statements have been prepared in accordance with generally accepted accounting principles consistently applied; (iii) the Financial Statements fairly present the financial position of CONTRACTING PROVIDER as of the dates thereof and the results of its operations and cash flows for the period ended on the dates thereof; (iv) the Financial Statements reflect reserves appropriate and adequate for all known material liabilities and reasonably anticipated losses, as required by generally accepted accounting principles; (v) since the date of the Financial Statement, there has been no change in the assets, liabilities or financial condition of CONTRACTING PROVIDER from that reflected therein except for changes in the ordinary course of business consistent with past practice and which have not been materially adverse; and (vi) none of the business, prospects, financial condition, operations, property or affairs of CONTRACTING PROVIDER has been materially adversely affected by any occurrence or development, individually or in the aggregate, whether or not insured against.

Reports and Reporting. (a) CONTRACTING PROVIDER shall issue to Anthem BC&BS, at CONTRACTING PROVIDER's expense, such reports related to CONTRACTING PROVIDER's and Represented Providers' services under this Agreement, as Anthem BC&BS reasonably requests, including those reports set forth on Exhibit C hereto. All reports shall be in a form and of content and frequency as Anthem BC&BS and CONTRACTING PROVIDER shall agree, but at a minimum shall meet any criteria that Anthem BC&BS determines are applicable pursuant to HEDIS the Act, the Medicare Contract, HCFA requirements or other requirements that are generally accepted in the managed care industry as applicable to reports and reporting (including, without limitation, HEDIS, NCQA criteria or and NMIS). (b) CONTRACTING PROVIDER agrees to furnish to Anthem BC&BS upon request either (i) an audited balance sheet sheet, including the management letter, and related statements of income, retained earnings and changes in consolidated financial position for CONTRACTING PROVIDER as of the and for each fiscal year end during the term of this Agreement, with an unqualified report thereon by CONTRACTING PROVIDER's independent public accountants; or, if audited sheets are not prepared, (ii) an unaudited balance sheet and related statements of income, retained earnings and changes in financial position for CONTRACTING PROVIDER as of and for the each fiscal year end during the term of this Agreement, certified by the principal financial officer of CONTRACTING PROVIDER. In addition, CONTRACTING PROVIDER shall represent that, except as otherwise disclosed in writing to Anthem BC&BS: (i) since the date of the financial statements (the "Financial Statements"), there has been no material adverse change in the financial condition, business, operations or properties of CONTRACTING PROVIDER; (ii) all such Financial Statements have been prepared in accordance with generally accepted accounting principles consistently applied; (iii) the Financial Statements fairly present the financial position of CONTRACTING PROVIDER as of the dates thereof and the results of its operations and cash flows for the period ended on the dates thereof; (iv) the Financial Statements reflect reserves appropriate and adequate for all known material liabilities and reasonably anticipated losses, as required by generally accepted accounting principles; (v) since the date of the Financial Statement, there has been no change in the assets, liabilities or financial condition of CONTRACTING PROVIDER from that reflected therein except for changes in the ordinary course of business consistent with past practice and which have not been materially adverse; and (vi) none of the business, prospects, financial condition, operations, property or affairs of CONTRACTING PROVIDER has been materially adversely affected by any occurrence or development, individually or in the aggregate, whether or not insured against. Section 6.2 COMPLIANCE WITH REFERRAL SYSTEM is hereby superseded and replaced as follows: