2011 Fee-For-Service Agreement for DHHS Networks General

2011 Fee-For-Service Agreement for DHHS Networks

General Updates

New Definitions

APPLIES TO WRAPAROUND ONLY

APPLIES TO WIser CHOICE ONLY

PROGRAM SPECIFIC

Civil Rights Compliance (CRC)

CRC (Cont’d)……. .

CRC (Cont’d)……. .

CRC (Cont’d)……. .

Wisconsin Civil Rights Compliance Officer

DHHS Provider Networks/Contract Administration Interface

Insurance & Audit Requirements

Insurance Requirement

Insurance (Professional Liability)

Insurance (Professional Liability)

Insurance (cont’d)

Insurance (cont’d)

Who Must Have An Audit?

Allowable Costs & Allowable Profits or Reserves

Allowable Costs & Allowable Profits or Reserves

Other Allowable Cost Issues

Other Allowable Cost Issues

Maintaining Financial Records

Maintaining Financial Records

Audit Waiver

Audit Waivers

Common Errors or Omissions and Findings

Common Errors or Omissions (cont’d)

Names & Address for Submissions

Submissions (cont’d)

Quality Assurance – Policies and Procedures

Noncompliance with Policies and Procedures

Risk Assessment Criteria

Basic Review Indicators

Basic Review Indicators (cont’d)

Criminal Background Checks

Criminal Background Checks (cont’d)

Reporting of Criminal Background Checks

Basic Audit/Review Indicators (cont’d)

Basic Review Indicators (cont’d)

Basic Review Indicators (cont’d)

Documentation

Documentation (cont’d)

Documentation Reminders

CONTACT INFO

CONTACT INFO (contd. )