07-L(1) Health Contract - Laserfiche WebLink

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Departments shall comply with RECEIVING AGENCY fee collection policies detailed in 25 TAC § 1.91. General Provisions, Program Income Article, is revised to include: All revenues directly generated by a Contract Attachment(s) supported activity or earned only as a result of the Attachment(s) during the term of the Attachment(s) are considered program income. PERFORMING AGENCY shall identify and report all program income monthly. Program Income may be retained by PERFORMING AGENCY so long as it is used to provide services specified in the scope of work detailed in this Attachment. This shall be demonstrated only by submission of acceptable billing vouchers for services provided to Title V eligible clients which exceeds PERFORMING AGENCY'S Attachment amount by the total program income amount. General Provisions, Reports Article, is revised to include: PERFORMING AGENCY shall submit: • Title V MCH Monthly Aggregate Activity Report, in conjunction with each monthly billing request. Each report shall detail the total unduplicated number of clients seen for the first time within a service category type during the contract period by age, and race/ethnicity. Billing requests will not be processed for payment by RECEIVING AGENCY unless accompanied by a complete corresponding aggregate report; • A Request for Advance or Reimbursement Form 270 (TDH form GC-10), no later than ninety (90) days after the end of the attachment term; and, • Other reports as deemed necessary by RECEIVING AGENCY upon reasonable notice to PERFORMING AGENCY. In addition to the site visits authorized by the Inspections Article of the General Provisions, PERFORMING AGENCY shall allow RECEIVING AGENCY to conduct on-site quality assurance reviews as deemed necessary by RECEIVING AGENCY. Unsatisfactory review findings may result in implementation of General Provisions, Sanctions Article. PERFORMING AGENCY certifies that neither the PERFORMING AGENCY nor any individual who has a direct or indirect ownership or controlling interest of 5% or more of the PERFORMING AGENCY nor any PERFORMING AGENCY officer, director, agent or managing employee (e.g. general manager, business manager, administrator, director, or like individual who exercises operational or managerial control over PERFORMING AGENCY or who directly or indirectly conducts the day-to-day business of the PERFORMING AGENCY), is an entity or individual who: • Has been convicted of any offense under 42 U.S.C. § 1320a-7(b)(1)-(3); ATTACHVIENT - Page 4