1993 - 09-20-93 Regular Meeting - Laserfiche WebLink

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~o, i5 oR~_ 3 16. To conduct cost determination activities and to maintain accounting records for Medicaid services provided in accordance with the approved Medicaid State Plan. Cost determination methods utilized must be approved by the Division of Medical Assistance, Assistant Director of Financial Operations. 17. To furnish to the Division of Medical Assistance, HCFA or the Attorney General Fraud Control Unit, any information maintained under fifteen (15) and Sixteen (16). 18. To reimburse DEHNR all monies incorrectly or inappropriately paid by Medicaid. 19. To maintain accounting records in accordance with generally accepted accounting principles which will permit auditing in accordance with the North Carolina reimbursement plan and to maintain such records for a minimum period of five (5) years from date of service. 20. The accounting records will be established and maintained for receipts from recipients of service. These records will reflect which of the reimbursable service programs earned the receipts. 21. That the provider becomes liable for such accounting upon signature of this agreement and will maintain required documentation to establish adequate audit trails. 22. To allow Federal and State officials, and their contractual agents, to make certification and compliance surveys, inspections, medical and professional reviews, and audits of data relating to services to Title XIX patients as may be necessary under Federal and State statutes, rules and regulations. Such visits will be allowed at any time during hours of operation, including unannounced visits. All such surveys, inspections, medical and professional reviews, and audits will be in keeping with both legal and ethical practice governing patient confidentiality. 23. To submit claims for approved services on the mutually agreed upon form/format through DEHNR's fiscal accounting office. 24. To comply with 42 CFR Part 456, utilization control review, by participating in the assessment of Standards for Local Health Departments, funding guidelines and assessment of Standards for Developmental Evaluation Centers and other approved accountability requirements established by DEHNR. 25. To comply with the rules and policies that govern reimbursement for special therapies under Children's Special Health Services Programs as set forth by DEHNR. The Department of Environment. Health, and Natural Resources Agrees: 1. To serve as intermediary between the North Carolina Medical Assistance Program and the Provider including assistance with billing, payment, cost determination, cost settlement, and negotiation of reimbursement rates. 017 2. To receive and hold in escrow payments for service in accordance with applicable laws and DEHNR policy.