Matrix 1

PROVIDER PARTICIPATION CONTRACTS AND/OR AGREEMENTS

COUNTY:_______________________

IPA/Group/Provider Name First Tier & Downstream Contracts and/or Agreements
CMSREGULATIONS – 42 CFR 422	Section/Page	Section/Page	Section/Page	Section/Page	Section/Page
All Provider Contracts
Gives HHS, GAO and designees right to audit etc. for 6 years or periods exceeding 6 years or completion of an audit, whichever is later 422.504(e)(2); 422.504(e)(3); 422.504(i)(2)(ii); 422.504(e)(4)
Comply with all confidentiality and enrollee record accuracy requirements 422.504(a)(3)(iii); 422.188
Hold harmless provisions 422.504(g)(1)(I)
Specify delegation requirements in manner consistent with reg 422.504(i)(3)(iii); 422.504(i)(4)
Prompt payment 422.520(b)
Comply with reporting requirements in 422.516 and 422.257 422.504(a)(8)
Accountability provisions 422.504(i)(3)(ii)(A)
Comply with applicable Medicare laws and Regulations 422.504(i)(4)(v)
Benefit continuation 422.504(g)(2)(i); 422.504(g)(2)(ii); 422.504(g)(3)
Dated and Signed 422.505
Term 422.505

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