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

Recipient shall ensure that the audit complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as defined by Section 215.97(2), Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. 3. If the Recipient expends less than $500,000 in state financial assistance in its fiscal year, an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is not required. However, if the recipient elects to have an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, the cost of the audit must be paid from the nonstate entity's resources (i.e., the cost of such an audit must be paid from the recipient's resources obtained from other than State 4. State awards are to be identified using the Catalog of State Financial Assistance (C5FA) title and number, award number and year, and name of the state agency awarding it. For information regarding the Florida Catalog of State Financial Assistance (CSFA), a Recipient should access the Florida Single Audit Act website located at https:lfapos.fldfs.comifsaaf. 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 93 of 117  PART III: OTHER AUDIT REQUIREMENTS The recipient shall follow up and take corrective action on audit findings. Preparation of a summary schedule of prior year audit findings, including corrective action and current status of the audit findings is required. Current year audit findings require corrective action and status of findings. Records related to unresolved audit findings, appeals, or litigation shall be retained until the action is completed or the dispute is resolved. Access to project records and audit work papers shall be given to the Commission, the Department of Financial Services, and the Auditor General. This section does not Umit the authority of the Commission to conduct or arrange for the conduct of additional audits or evaluations of state financial assistance or limit the authority of any other state official. (NOTE: This part would be used to specify any additional audit requirements imposed by the State awarding entity that are solely a matter of that State awarding entity's policy (i.e., the audit is not required by Federal or State laws and is not in conflict with other Federal or State audit requirements). Pursuant to Section 215.97(8), Florida Statutes, State agencies may conduct or arrange for audits of state financial assistance that are in addition to audits conducted in accordance with Section 215.97, Florida Statutes. In such an event, the State awarding agency must arrange for funding the full cost of such additional audits.) PART IV: REPORT SUBMISSION 1. Copies of reporting packages for audits conducted in accordance with OMB Circular A- 133, as reVised, and required by PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Orcular A-133, as reVised, by or on behalf of the recipient directly to each of the following: A. The Department at the following address: Executive Director Commission for the Transportation Disadvantaged 605 Suwannee Street, MS-49 Tallahassee, Florida 32399-0450 B The Federal Audit Clearinghouse deSignated in OMB Circular A-133, as revised (the number of copies required by Sections .320 (d)(l) and (2), OMB Circular A- 133, as reVised, should be submitted to the Federal Audit Clearinghouse), ilt the following address: Federal Audit Clearinghouse Bureau of the Census 1201 East 10th Street Jeffersonville, IN 47132 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 94 of 117  C. Other Federal agencies and pass-through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as revised. 2. In the event that a copy of the reporting package for an audit required by PART I of this agreement and conducted in accordance with OMB Circular A-133, as revised, is not required to be submitted to the Commission for the reasons pursuant to Section .320 (e)(2), OMB Circular A-133, as revised, the recipient shall submit the required written notification pursuant to Section .320 (e)(2) and a copy of the recipient's audited schedule of expenditures of Federal awards directly to each of the following Executive Director Commission for the Transportation Disadvantaged 605 Suwannee Street, MS-49 Tallahassee, Florida 32399-0450 In addition, pursuant to Section .320 (f), OMS Circular A-133, as revised, the recipient shall submit a copy of the reporting package described in Section .320 (c), OMS Circular A-133, as revised, and any management letters issued by the auditor, to the Commission at each of the following addresses: Executive Director Commission for the Transportation Disadvantaged 605 Suwannee Street, MS-49 Tallahassee, Florida 32399-0450 3. Copies of financial reporting packages required by PART II of this agreement shall be submitted by or on behalf of the recipient directly to each of the following: A. The Commission at the following address: Executive Director Commission for the Transportation Disadvantaged 605 Suwannee Street, MS-49 Tallahassee, Florida 32399-0450 B. The Auditor General's Office at the following address: Auditor General's Office Room 401, Pepper Building 111 West Madison Street Tallahassee, Florida 32399-1450 4. Copies of reports or the management letter required by PART III of this agreement shall be submitted by or on behalf of the recipient directly to: A. The Commission at the following address: Executive Director 2008/2009 Medicaid Non·Emergency Transportation Subcontracted Transportation Provider Contract Page 95 of 117  Commission for the Transportation Disadvantaged 605 Suwannee Street, MS-49 Tallahassee, Florida 32399-0450 5 Any reports, management letter, or other information required to be submitted to the Department pursuant to this Agreement shall be submitted timely in accordance with OMB Circular A-133, Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable. . 6. Recipients, when submitting financial reporting packages to the Commission for audits done in accordance with OMB Circular A-133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, should indicate the date that the reporting package was delivered to the Recipient in correspondence accompanying the reporting package. PART V: RECORD RETENTION The Recipient shall retain sufficient records demonstrating its compliance with the terms of this Agreement for a period of five (5) years from the date the audit report is issued, and shall allow the Commission, or its designee, CFO, or Auditor General access to such records upon request. The Recipient shall ensure that audit working papers are made available to the Commission, or its designee, CFO, or Auditor General upon request for a period of three (3) years from the date the audit report is issued, unless extended in writing by the Commission. 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 96 of 117  ATTACHMENT 2 EXHIBIT 1 FEDERAL and/or STATE resources awarded to the recipient pursuant to this agreement should be listed below. If the resources awarded to the recipient represent more than one Federal or State program, provide the same information for each program and the total resources awarded. Compliance Requirements applicable to each Federal or State program should also be listed below. If the resources awarded to the recipient represent more than one program, list applicable compliance requirements for each program in the same manner as shown here: • (e.g., What services or purposes the resources must be used for) • (e.g., Eligibility requirements for recipients of the resources) • (Etc ... ) • Federal Funds Awarded to the Recipient Pursuant to this Agreement Consist of the Following: Federal Program Federal Agency CFDA CFDA TItle Funding Number Number Amount Medicaid Title 19 93.778 Medical Assistance Payments $98,628.00 Medicaid Title 21 93.767 Childrens' Health Insurance Proqram Medicaid Title 18 19 CLlA 93.777 Survey and Certification State Funds Awarded to the Recipient Pursuant to this Agreement Consist of the Following Matching Funds for Federal Programs: Federal.Program Federal Agency CFDA CFDA TItle .... Funding· Number Number Amount Medicaid Title 19 93.778 Medical Assistance Payments NLA Medicaid Title 21 93.767 Childrens' Health Insurance Program N/A Medicaid Title 18 19 CLlA 93.777 Survey and Certification N/A N/A State Funds Awarded to the Recipient Pursuant to this Agreement Consist of the Following Funds Subject to Section 215.97, F.S.: Federal Program Federal Agency CFDA. CFDA Title Fu ndin 9 Number Number Amount 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 97 of 117  ATTACHMENT 3 REQUIRED DATA ELEMENTS FOR ENCOUNTER DATA Draft Batch File Layout File name should be CTC_EIN_Batch_Number.txt (if CTC_EIN = 123456789 and the Batch_Number for this file is 000987650 then file name would be 123456789_000987650. txt) Maximum of 5000 claims per file (Record_Type = C) Header Record