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

information, data, and procedures to determine the extent to which they are accurate, reliable, free from bias, and in accord with standards for data collection and analysis. 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 115 of 117  Violation - A determination by the Agency, in its sole discretion, that the Recipient, or one of the Recipient's Subcontractors or Transportation Providers, failed to act as specified in this Agreement or applicable statutes, rules, or regulations governing Medicaid Vendors. The Agency shall consider each day that an ongoing Violation continues, for the purposes of this Agreement, to be a separate Violation. In addition, the Agency shall consider each instance of failing to furnish necessary and/or required Transportation Services to Medicaid Beneficiaries, for purposes of this Agreement, to be a separate Violation. As well, the Agency shall consider each day that the Recipient, or one of the Recipient's Subcontractors or Transportation Providers, fails to furnish necessary and/or required Transportation Services to Medicaid BenefiCiaries, for purposes of this Agreement, to be a separate Violation. Will Call - A scheduled Trip that could not be fulfilled within the timeframes of this Agreement leading to the Transportation Provider making an unscheduled Medicaid compensable Trip. Example - a Medicaid Beneficiary notifies the Transportation Provider that a doctor is running later than originally scheduled and asks to reschedule his or her Trip to his or her destination. When the Medicaid BenefiCiary notifies the Transportation Provider that he or she is ready for pick up, the Transportation Provider puts in a Will Call pick up order to its driver to pick up the Medicaid Beneficiary and take him or her to his or her destination. B. Acronyms AHCA -Agency for Health Care Administration ALF - Assisted Living Facility ALS - Advanced Life Support BLS - Basic Life Support CAP - Corrective Action Plan CFR - Code of Federal Regulations CTAA - Community Transportation Association of America DCF - Department of Children & Families DHHS - United States Department of Health & Human Services DJJ - Department of Juvenile Justice EDI - Electronic Data Interchange EQR - External Quality Review EQRO - External Quality Review Organization FAC - Florida Administrative Code FTE - Full Time Equivalent Position HCBS - Home and Community Based Services Waiver HIPAA - Health Insurance Portability & Accountability Act LCB - Local Coordinating Board LEIE - List of Excluded Individuals & Entities MCO - Managed Care Organization MFCU - Medicaid Fraud Control Unit of the Florida Attorney General's Office MPI- Bureau of Medicaid Program Integrity, a part of the Agency NET - Non-Emergency Transportation services OOBC - Open Database Connectivity 2008/2009 Medicaid Non-Emergency Transportation Subcontracted Transportation PrOVider Contract Page 116 of 117  PM - Performance Measure PRTS - Purchased Residential Treatment Services QI - Quality Improvement QIP - Quality Improvement Program RHC - Rural Health Clinic SAMH - Substance Abuse & Mental Health District SFTP - Secure File Transfer Protocol SOBRA - Sixth Omnibus Budget Reconciliation Act SQL - Structured Query Language SSI - Supplemental Security Income UM - Utilization Management 2008(2009 Medicaid Non-Emergency Transportation Subcontracted Transportation Provider Contract Page 117 of 117