Okaloosa County BOCC — 2013 meeting #1139 (date undetermined) — MEDICAID ORIGINAL 2009 — reading text

requirement is not applicable. X. REPORTING REOUIREMENTS A. General Reporting Requirements 1. The STP shall comply with all Reporting Requirements set forth by the Commission in this Contract. a. The STP is responsible for assuring the accuracy, completeness, and timely submission of each report. 2608/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 78 of 117  b. The STP shall certify the reports, attesting, based on his/her best knowledge, information, and belief, that all data submitted in conjunction with the reports or all documents requested by the Commission are accurate, truthful, and complete. c. The Certification shall be submitted at the same time the data reports are submitted. The Certification page shall include a Certification that the data submitted has been validated and the quality verified in accordance with this Contract. (1) Deadlines for report submission referred to in this Contract specify the actual time of receipt at the Commission, not the date the STP postmarks or transmits the file. The Commission shall date stamp a hard copy report or send an email reply to an emailed report. (2) The STP shall use the timeframes set forth in the table below for submitting all reports. d. Before November 1 of each year, the STP shall deliver to the Commission a Certification that the STP has fairly and accurately presented. all Performance Measure data for the previous Agreement Year. e. If a reporting due date falls on a weekend or State Holiday, the Agency must receive the report on the following Business Day. f. The STP shall file all quarterly reports based on a calendar year quarter. Calendar year quarters are defined as the months ending March 31st, June 30th, September 30th, and December 31st. 2. The Commission shall furnish the STP with the appropriate reporting formats, templates, inStructions, submission timetables, and technical assistance, as required. 3. The Commission reserves the right to modify the reporting requirements, with a sixty (60) Calendar Day notice to allow the STP to complete implementation, unless otherwise required by law. 4. The Commission shall provide the STP with written notification of any modifications to the reporting requirements. 5. Unless otherwise specified, the STP shall record and submit all filings electronically or mail a hard copy to the following address: The Commission for the Transportation Disadvantaged 605 Suwannee Street, MS-49 Tallahassee, Florida 32399 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 79 of 117  6. Unless otherwise set forth below, or in a request for an ad hoc report, the STP shall limit the scope of all reports to operations affecting Medicaid Beneficiaries and shall not include in any report any outside, non-Medicaid or non-Medicaid Beneficiary related information. The STP shall limit all reports and Performance Measures to Transportation Services provided under this Agreement to Medicaid Beneficiaries and shall not include other, non-Medicaid, services or operations that the STP provides. 7. The STP shall grant the Commission, or its representatives, full access to all financial and statistical reports, supporting documents, and any other documents pertinent to this Contract and the Transportation Provider Agreement. The STP and all Transportation Providers shall provide the documentation requested by the Commission, or its representatives, 'in a manner that the Commission will provide when notifying the STP of the on-site surveys and desk reviews B. The STP shall notify the Commission's Project Manager within twenty-four (24) hours of discovering a Violation of the protections provided by HIPAA. , , ,, Required ReportS , , Report # Description Format Frequency , Grievance 4 Covers all Complaints, Hardcopy or electronic Quarterly - Due 30 Caleooar System Summary Report - Grievances, Appeals related to and format. provided Template by the Cays after the end of the reporting quarter. Contains Medicaid's NET Commission. data f" entire reporting Services. quarter. Audited N/A Audited Financial Hardcopy and Annuallv • within 180 Calendar financial Statement. electronic format. .. . . Days after. end of the _Fiscal - Statement Year. Reporting is for each calendar year. Trip Travel 5 Trip Travel Expenses Hardcopy or electronic Monthly • Due 15 Calendar Expense Report by Trip. format. Template Days after the month In which provided by the the SfP provided the Trip. Commission. Safety N/A Copy of the Self- Hardcopy or electronic Annually - Due January 15 of Compliance Self- Certification Report format. each year. Reporting is for Certification (Vehicle Inspections, each calendar year. Report Driver Safety, Drug and Alcohol and Quality monitoring) Systems Outage 6 Notification of a Phone Email and/or Phone Immediatelv upon Notification or System outage affecting NET Services. call, followed by summary • occurrence. report. Template provided by the Commission. Suspected Fraud N/A Suspected Fraud Hard copy, electronic Immediately upon Reporting Report. format, or telephone occurrence. 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 80 of 117  call. Critical Incidents 7 Critical Incident Report. Hardcopy or electronic Upon Occurrence - Initial Report format. Template report due one (1) Business provided by the Day after learning of the Commission. DCF incident. A written final report template available from shall be submitted to the DCF. Commission within 15 business days after the incident. DetaUed report to include measures to prevent similar occurrences In the futUre. Performance N/A Performance Measure Hardcopy or electronic Monthlv - Due 10 Calendar Measures Information - Performance Measure See format. Days after the end of the reporting month. Section for details. B. Reporting Requirement Documents 1. Grievance System a. The Grievance System report shall, include information based on the STP's helpline and contain information about the number of Complaints, Grievances, and Appeals received by the STP, its Subcontractors, and its