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Home My WebLink AboutCSA - Compliance Services Association 2015-16GUARANTEED SCH00L‐BASED COMPLIANCE MEDICAID ADⅣⅡNISTRATION AGMEMENT This Agreementis made by and bettveen Compiiance Services Association,lnc, an idaho Gene「al NON―Pront cOrporation,located at 6003 VV Overland RdI Suite 201, Boise,lD 83709,hereinafter referred to as CSA,and Bonnevi∥e School Distnct#93, idaho Fa∥s:D hereinafterreferred to as the SCH00L D:STRICT WHEREAS,CSA is anidaho NON‐Proit corporation o「ganized to provide COMPLIANT MED!CAID administration to ldaho schools,and has developed a complete COMPLIANT MEDiCAID administration program which provides ldaho schooI districts with training,administrative,consultative,statistical,audit services,and a guarantee of comp∥ance; llVHEREAS,the SCH00L DISTRICT wishes to obtain,and CSA wishesto furnish these COMPL!ANT MEDiCA:D administra∥on services; NOW THEREFORE,in cons deration ofthe premises and the mutual promises and undertakings ofthe parties hereinafter set forth,the parties hereby agree as fo∥ows: GUARANTEED SCH00L―BASED COPIPLIANCE ⅣIEDICAID ADMINISTRATION AGREEPIENT a) The administrative fee is payable upon receipt of each invoice which will accompany the fully reconciled remittance report. b) The guarantee is reflected in a service level agreement and will include (Attachment A - Attachment B); . ldaho DHW School-Based Services Medicaid Program compliance. . IEP monitoring for guaranteed NO Audit fees or penalties paid from School District funds for SBS Medicaid billing audits. No guarantee for IDEA compliance. . iTracklEP software and iTrackLOGS. ,VO OyERBTLLIIVG (Must "Opt lN") . Physician refenal. (Must "Opt lN") GUAMNTEE WILL NOT INCLUDE: . Monitoring of IDEA qualifying documentation, services provided, or documentation of services provided in schools. . Monitoring of"no school" days or student absent days- . Monitoring of hiring and/or qualifications of providers of services in schools. Added Value (No Charqe) Services orovided in this aqreement: (Check one box, each line) "Opt lN" "Opt OUT" Assisting with obtaining Signed Physician referrals Use ofiTracklEP(Attachment D)―iTraCkLOGS ンロロ c) The Administrative Fee Table is as follows: - See Attachment E 9: GUA.RANTEED SCHOOL-BASED COMPLIANCE MEDICAID ADMINISTRATION AGREEMENT any such information to CSA at the termination of ihis agreement. SCHOOL DISTRICT agrees that in the case of any attempt to terminate this agreement before the end of lhe term, or any submission of any Medicaid billing(s) performed by SCHOOL DISTRICT or any other person or enlity on its behalF, SCHOOL DISTRICT shall account for all strch submissions and shall owe CSA the above-staled (Section 4(c)i administmtive fee for all such submissions. SCHOoL DISTRICT also acknowledges and agrees not to disclose specialized information and knowledge learned through CSA, to other school districts ortheir agents, or any other person or enlity, via wriften or verbal communications. Such disolosure is a material breach of this agreement. SCHOOL DISTRICT, by sxecuting this agreement, waranls that the person signing this agreement has the authority to do so, so as to bind SCHOOL DISTRICT to its terms, and that all necessary meetings, approvals, authorizations, votes and other matters necessary to make this a valid and enforceable agreement binding SCHOOL DISTRICT have been completed, finalized and perforrned. This agreement represents the entire agreement of the parlies and can be modfted only by a wriling signed by both parties. No prior verbal ptomlses or agreements not contained heiein are valid. This agreement shall be interpreied and enforced under the laws ofthe State of ldaho. ln the event of litigation arising out of an alleged breach of this agreemenl, the prevailing party shall be entitled to costs and attorney fees incuned. lN WTNESS THEREOF, the parties have signed this Agreement. CSA: Compliance Services Association, lnc. Ch百 stopher Hayes,Director―C∥ent Relalons SCH00L DiSTRICT: Bonnevine SchOOI D stdct#93 By: Print:jit , r+tJ Ez)r-/:t", (Duly Authorized Agent) Pige 4 ofs *p pro,i <ot By: GUARANTEED SCHOOL-BASED COMPLIANCE MEDICAID ADMINISTRATION AGREEMENT Attachment A Summary of Guaranteed school-based compliance Medicaid Administrative Services As the guaranteeing consulting and billing agent CSA agrees to adhere to all rules and regulations that govern the submitting of claims under the Rules and Regulations that govern the school-based Rehabilitative and Health Related Services Program. Below is a list of services and responsibilities that CSA agrees to deliver: . Guaranteed School-based services Medicaid compliance, administrative, consulting, audit services, to the School District. Guarantee based on information documented on the IEP and Physician referral. CSA will pay all fees and fines resulting in SBS Medicaid billing audits. No guarantee for IDEA compliance. . State and federal Medicaid information, liaisons, and updates: Timely and accurate information regarding the rules and regulations associated with the Rehabilitative and Health Related Services Program . Assistance with research and eventual identification of the School District Medicaid eligible population . Reasonable efforts in securing physician's refenals (Attachment C) . Upon request, on-site and web training and instruction for Administrators, health- related professionals, paraprofessionals, and aides . Guaranteed, Accurate, dependable, and confidential Billing Process. Tracking and Reconciliation of all submifted claims . Access to online service delivery software and Administrative reporting tools . Customized reports showing the status of all Medicaid transactions and reimbursements . Data warehousing and digital archival of School District billing information, submitted claims, service records, adjustment details, and audit informalion . Assistance in Audit Readiness preparation and facilitation to ensure proper procedure and compliance; lnterface with the Department of Health and Welfare as appropriate for audit findings Page 5 of 8 GUARANTEED SCH00L―BASED COMPLIANCE PIEDICAID ADⅣllNISTRATION AGREEDIEENT Attchment B School District Responsibilities As the Provider of Record, the SCHOOL DISTRICT agrees to provide information to CSA that adheres to all Rules and Regulations that govern the School-based Rehabilitative and Health Related Seruic* Program. Below is a list of services and responsibilities that the SCHOOL DISTRICT agrees to perform: The SCHOOL DISTRICT is responsible for the following: . Ensure that; One time consents are signed, students qualify for services listed on the lEP, all services listed on the IEP and Physician referrals are performed and documented by qualified personnel, that all services and documentation is in accordance with IDEA, and that the compliant billing documentation is accurate with the documented services listed on the IEP and Physician referrals. . Submit timely and accurate; IEP cover page and service page, amendmenis, service delivery logs (records) that meet Medicaid requirements for documenting service delivery and for which the SCHOOL DISTRICT is seeking reimbursement and to submit such records to CSA via paper claims or web-based software provided by CSA, so that CSA may provide timely and accurate Medicaid claims and reporting for the district. . lnsure that certifications and licensures of all practitioners are accurate and up- to-date. lnsure that all practitioners submitting claims are not disqualified to do so by the Department of Health & Welfare or the Center for Medicare and Medicaid Services (CMS). Maintain necessary paperwork related to certifications, licensures, etc. of all qualified staff including contracted services for whose services the School District is seeking reimbursement . Maintain all lndividual Education Programs (lEPs) according lo Rehabilitative and Health Related Servlces program guidelines for all services for which the SCHOOL DISTRICT is seeking Medicaid reimbursement. Provide CSA with the IEP cover page and service page and amendments. . Maintain on file and provide CSA with copies of all recommendations or referrals from a physician or oiher practitioner of ihe healing arts for services for which the SCHOOL DISTRICT is seeking reimbursement. Page 6 of I GUARANTEED SCHOOL-BASED COMPLIANCE MEDICAID ADMINISTRATION AGREEMENT Attachment c Physicians Referral ln the event that the SCHOOL DISTRICT does "Opt lN" to have CSA provide assistance in obtaining physician referrals as part of the contractual arrangement the following applies: . CSA will monitor physician referrals for all students for which the district is submitting Medicaid claims. No claims will be submitted without insuring that a timely refenal has been obtained by the district for the services identifled in the student's lEP. CSAwill coordinate the referral process with the District and make reasonable efforts to obtain a referral on behalf of the School District. . When CSA has exhausted reasonable means, CSA will notify the District of the names of the students for whom a referral was not obtained along with the reason why. . CSA will maintain and archive referrals from a physician or other practitioner of the healing arts for services for which the School District seeks reimbursement Attachment D iTracklEP Software Solution No cost to Bonneville SD. iTracklEP cost are limited to the state reimbursement amount for IEP software, Free data storage, Free updates, Free training, Free form creation and upgrades. CSA, lnc. utilizes 'proprietary software" and its accompanying database system for processing, storing, and retrieving all Medicaid Billing Records. This system has been optimized for the ldaho Medicaid school-based services program, including data collection and electronic transmission requirements, and provides accurate billing services to participating ldaho School Districts. Page 7 of 8 GUARANTEED SCH00L¨BASED COⅣIPLIANCE MEDICAID ADMINISTRAT10N AGREEP□NT Attachment E Administration Fee Table Combined Percentage(Aggregate)Not Shown ifthe Federa:reirnbursement share is: Tier l Tier 2 Tier 3 Tier 4 Tier 5 Tle「