Exhibit_B_BDPP_Rev._10-4-24.pdf

California Department of Corrections and Rehabilitation (CDCR)/ Proposal Number: SD23-00094 California Correctional Health Care Services (CCHCS) Exhibit B Budget Detail and Payment Provisions

Rev. 10/4/2024 Page 1 of 5

ELECTROCARDIOGRAPH (ECG) EQUIPMENT AND CARDIOLOGIST OVER-READ

AND INTERPRETATION SERVICES

ARTICLE I

BUDGET DETAIL AND PAYMENT PROVISIONS

1. Invoices/Claims and Payment

For services satisfactorily rendered, and upon receipt and approval of Contractor’s invoices/claims, California Department of Corrections and Rehabilitation/California Correctional Health Care Services (CDCR/CCHCS) agrees to compensate Contractor for completed services in accordance with the rates specified in Exhibit B-1 Bid Rate Sheet, which is included as part of this Agreement. Except for emergency care, CDCR/CCHCS shall not compensate Contractor for services which did not receive prior authorization in accordance with Exhibit A Scope of Work, and/or Exhibit A-1 Service Specifications, and/or exceed the services as defined in California Code of Regulations (CCR), Title 15, Section 3999.98 and 3999.200.

a. Services shall be completed as set forth in Exhibit A Scope of Work, and/or Exhibit A-1 Service Specifications, and in accordance with prior authorization provisions, and all other terms and conditions of this Agreement.

b. Invoices/claims shall be reimbursed in accordance with Exhibit B-1 Bid Rate Sheet and with the following terms: no CDCR/CCHCS employee may independently negotiate or implement a rate increase on behalf of CDCR/CCHCS. Rate increases must be formalized by Direct Care Contracts Section (DCCS) through a formal amendment. Any invoice/claim that is sent to CDCR/CCHCS with reimbursement rates above the specified rates by CDCR/CCHCS in writing within the contract shall be invalid. Payment of an erroneous invoice/claim does not constitute acceptance of the erroneous pricing and CDCR/CCHCS may seek reimbursement of the overpayment or may withhold such overpayment from future invoices/claims.

c. CDCR/CCHCS will not accept requests for early payment, down payment or partial payment.

2. Budget Contingency Clause

a. It is mutually agreed that if the California State Budget Act for the current fiscal year and/or any subsequent fiscal years covered under this Agreement does not appropriate sufficient funds for the program, this Agreement shall be of no further force and effect. In this event, the state shall have no liability to pay any funds whatsoever to Contractor, or to furnish any other considerations under this Agreement, and Contractor shall not be obligated to perform any provisions of this Agreement.

b. If funding for the purposes of this program is reduced or deleted for any fiscal year by the California State Budget Act, the state shall have the option to either cancel this Agreement with no liability occurring to the state, or offer an Agreement amendment to Contractor to reflect the reduced amount.

3. Prompt Payment Clause

Payment will be made in accordance with, and within the time specified in, California Government Code (GC) Section 927 et seq. Payment to a small business or microbusiness shall be made in accordance with, and within the time specified in, GC Section 927 et seq.

CDCR/CCHCS Proposal Number: SD23-00094 Budget Detail and Payment Provisions Exhibit B

Rev. 10/4/2024

4. Subcontractors

For all Agreements, with the exception of Interagency Agreements and other governmental entities/auxiliaries that are exempt from bidding, nothing contained in this Agreement, or otherwise, shall create any contractual relationship between the state and any subcontractors, and no subcontract shall relieve Contractor of Contractor’s responsibilities and obligations hereunder. Contractor agrees to be as fully responsible to the state for the acts and omissions of its subcontractors and of persons either directly or indirectly employed by any of them, as it is for the acts and omissions of persons directly employed by Contractor. Contractor’s obligation to pay its subcontractors is an independent obligation from the state’s obligation to make payments to Contractor. As a result, the state shall have no obligation to pay or to enforce the payment of any monies to any subcontractor.

ARTICLE II

SPECIAL BUDGET DETAIL AND PAYMENT PROVISIONS

1. Submission of Invoices

a. In order to ensure prompt and accurate payment, all invoices/claims shall be submitted according to the applicable directions listed below. It is the responsibility of Contractor to ensure that invoices are sent to the correct address as set forth below according to service type. Invoices sent to the incorrect address will be deemed not submitted, will not be processed for payment, and will not be subject to late payment penalties per GC Sections 927.2, subdivision (j) and 927.4.

b. All invoices must be completed thoroughly, with all applicable fields completed. Invoices that are submitted to the appropriate location, but have been altered, are inaccurate, or do not provide all necessary information, will not be accepted and will be denied and returned to Contractor for correction.

c. Any changes to this provision relating to the invoice submittal process, including but not limited to an address, form, or process change, shall be an administrative change managed through the appropriate designated CDCR/CCHCS office and shall not require an Agreement amendment.

d. All invoices shall include the Agreement number and shall not be submitted more frequently than monthly in arrears, unless authorized by HIS management.

e. Invoices submitted shall include the information listed in section 3(f) and must be legible in order to be considered complete and acceptable for processing or the invoice will be returned and disputed back to Contractor. Disputed/returned invoices shall not be subject to late payment penalties, as set forth in GC Section 927.4.

(1) On-Site Cardiology Over-read and Interpretation Services

a. Contractors of on-site cardiology over-read and interpretation services shall submit an invoice for reimbursement.

b. Invoices submitted for payment of cardiology over-read and interpretation services shall include all applicable information listed below:

1. Contractor’s Name

2. Invoice Number

3. Agreement Number

Budget Detail and Payment Provisions Exhibit B

Rev. 10/4/2024

4. Invoice Date

5. Remit Address (Contractor name, mailing address, phone number)

6. Patient’s CDCR number

7. Name of patient

8. Institution and Physical Address

9. Date(s) of service

10. Place of service

11. Type(s) of service (e.g. Routine over-read, STAT over-read, Interpretation Service)

12. Rate per Service

13. Total Invoice Amount

14. Contractor or provider’s National Provider Identifier (NPI) number

15. Contractor Federal Employer Identification Number (FEIN)/Federal Tax ID

16. First and last name of Contractor or provider performing services (In the event that Contractor or provider is a medical group, list the group name. The NPI number should reflect this listing.)

17. Any other medical information or documentation from external sources reasonably required to verify and substantiate the provision of services and the charges for such services.

c. Invoices for on-site cardiology over-read and interpretation services shall be submitted via encrypted email to the CCHCS Healthcare Invoicing Section (HIS) Manual Claims Team at m_HISManualClaims@cdcr.ca.gov. If email submittal is not available, invoices and supporting documentation may be mailed to the following address:

California Correctional Health Care Services Healthcare Invoicing Section Attention: Manual Claims Team PO Box 588500, Building D-2 Elk Grove, CA 95758

2. Reimbursement for Goods/Durable Medical Equipment (DME)

a. Agreements that contain a goods component such as, but not limited to: hearing aids, eye glasses, prosthetics, and/or orthotics, shall submit health care service invoices separately (e.g., Contractor or Provider who conducts a hearing test and supplies hearing aids shall submit one invoice for the hearing test and a separate claim for the hearing aid). Invoices shall also include the Agreement Number and the Purchase Order Number.

b. Damaged Equipment: Contractor may seek reimbursement from CDCR/CCHCS for damaged equipment per Exhibit A Section 1(d). Reimbursement for damaged equipment shall be submitted on an invoice with the incident report and vendor purchase cost invoice or proof of payment attached. If the appropriate documentation is not attached, the invoice shall not be reimbursed and will be returned.

c. Invoices submitted for goods/Durable Medical Equipment (e.g. ECG Machine Rentals, ECG Holter Monitors, and Cardiac Event Monitors) and to seek reimbursement for damaged equipment shall include all applicable information listed below:

(1) Contractor’s Name

Budget Detail and Payment Provisions Exhibit B

Rev. 10/4/2024

(2) Invoice Number

(3) Agreement Number

(4) Invoice Date

(5) Remit Address (Contractor name, mailing address, phone number)

(6) Total Invoice Amount

(7) Type of Goods/DME (e.g. ECG Machine Rentals, ECG Holter Monitors, and Cardiac Event Monitors, Type of Damaged Equipment)

(8) Institution and Physical Address

(9) List patient name and CDCR number

(10) Occurrence Date

(11) Place of service, if different than item 7 above.

(12) Contractor Federal Employer Identification Number (FEIN)/Federal Tax ID, if applicable

(13) Incident report

d. Health care goods and equipment must be reviewed and approved prior to Contractor’s and/or Provider’s submittal of an invoice for payment by the ordering institution. Approved health care goods and equipment invoices shall be mailed to the following address:

Sacramento Regional Accounting Office Attention: Accounts Payable A P.O. Box 187015 Sacramento, CA 95818-7015 Email address: APA.invoices@cdcr.ca.gov

3. Rejection of Contractor’s Invoice

CDCR/CCHCS reserves the right to reject a Contractor’s invoice if Contractor fails to submit the invoice in the appropriate format or within the appropriate time frame specified within this Agreement. Disputed invoices will be returned to Contractor without payment and will include an explanation of the invoice dispute. Contractor will have the right to appeal or otherwise resubmit the invoice with the pertinent documentation to the address below. Disputed/returned invoices shall not be subject to late payment penalties, as set forth in GC Section 927.4.

4. Invoice Billing Appeals

Contractor shall refer to the formal health care invoice appeal process outlined in Exhibit D Special Terms and Conditions & Additional Provisions of this Agreement.

5. Invoice Audits and Refunds

CDCR/CCHCS has the right to review invoices retrospectively to ensure invoices were processed correctly and per the contract terms. Should CDCR/CCHCS determine that invoices resulted in an overpayment;

CDCR/CCHCS shall request a refund in the incorrect dollar amounts. Contractor shall refund any monies found from these retrospective audits. Contractor shall refer to Exhibit D Section 64 for specific information regarding overpayments.

6. Invoice Payment Inquiry

Budget Detail and Payment Provisions Exhibit B

Rev. 10/4/2024

Should Contractor have questions or concerns regarding the processing and/or payment of invoices, the parties shall make a first attempt in good faith to resolve the question or concern through informal discussion(s).

a. Healthcare Services Invoices

Contractor shall contact the HIS Help Desk at (916) 691-0699 or via email at m_HISProgramSupport@cdcr.ca.gov with any questions regarding the health care services invoices.

If resolution to the patient invoice cannot be resolved via the verbal inquiry process, Contractor shall refer to the formal health care claim appeal process outlined in Exhibit D Special Terms and Conditions & Additional Provisions of this Agreement.

b. Healthcare Goods and Equipment Invoices

Contractor shall contact the Sacramento Regional Accounting Office via email at APA.invoices@cdcr.ca.gov with any questions or concerns regarding the healthcare goods and equipment invoice submittal process.