Exhibit_31_HIPAA,_FWA,_and_Grievance_Reports.xlsx

This document is an Excel-based reporting exhibit (Exhibit 31) for HIPAA, Fraud, Waste, and Abuse (FWA), and Grievance Reports related to the OEIBA Program, with submissions required to the Oklahoma Office of Management and Enterprise Services (OMES). The exhibit details quarterly reporting requirements for four specific report types: HIPAA Incident Report, FWA Prevention Incident Report, Grievance Report, and MAPD Grievance Report, all of which must be submitted electronically via a secure email domain within 60 days following the close of each calendar quarter.

The reporting templates include comprehensive tracking mechanisms for various incident types, with columns capturing details such as incident discovery dates, number of individuals involved, detailed complaint descriptions, resolutions, and closure dates. The grievance reports specifically track open and closed cases across categories including Access, Benefits, Customer Service, Enrollment, Payment Issues, Quality of Care, and Other, providing a structured mechanism for monitoring and addressing member and provider complaints. Each report type follows a standardized format designed to capture essential information about incidents, grievances, and potential systemic issues within the program.