Contract monitoring is a continual process that ensures compliance with the terms and conditions of a contract arrangement. It typically consists of administrative, fiscal, and program components. Effective contract monitoring is important for ensuring proper expenditure of funds and accountability. It requires establishing standards for reviewing subcontractors, conducting regular scheduled and unscheduled reviews, and integrating internal and external review processes.
Mitigating Risks Through Contracts - Poorvi ChothaniGetEvangelized
The document discusses legal risks associated with contracts and their mitigation. It defines what a contract is and highlights risks like ambiguity, lack of clarity around obligations, and inadequately defined terms. It then outlines strategies to manage these risks such as having lawyers draft contracts, defining scope of work and deliverables clearly, including liability limitations, dispute resolution clauses, and indemnification clauses. The document emphasizes the importance of reviewing contracts systematically to identify risks and ensure compliance.
10 things lawyers need to know about contract managementBerkman Solutions
Discover 10 techniques to enhance the value of legal services after the contract is signed. Build deeper, sustainable relationships for every outside legal counsel.
As a lawyer, you invest time to understand your client’s objectives, risks, and opportunities. What happens to your carefully drafted contract?
Your contract is filed and forgotten. Your client needs the benefit of your drafting during the entire contract term. Your client’s need is your opportunity.
There are, of course, organizations with mature contract management functions, but for every other client here are…
10 Things Every Business Lawyer Should Know about Contract Management
Immigration Consequences of Mergers & AcquisitionsAngelo Paparelli
What happens to immigration benefits and status when an employer is involved in a merger, acquisition or other form of corporate restructuring? See this presentation
Beth Lansing has over 20 years of experience in the mortgage industry, holding various compliance, auditing, and quality control roles. Most recently, she worked as a Staff Compliance Auditor for BOK Financial Corporation, where she performed audits of various bank departments to ensure regulatory compliance. Prior to that, she spent over 7 years as a Compliance Specialist for BOK Financial, performing quality control reviews of mortgage loans to ensure adherence to policies, regulations, and investor guidelines. She has extensive experience in mortgage loan processing, underwriting, funding, and collateral review.
Briefing contracts enhances cash flow by avoiding rejected billings for noncompliance. Contract briefs summarize all pertinent provisions, including reviewing clauses to determine allowable, allocable, and reasonable costs to bill the government. Briefing contracts provides useful information to contractors such as billing instructions and terms agreed upon by the parties.
Florida Real Estate Litigation Issues By Lloyd SchwedLloyd Schwed
Lloyd Schwed offers legal services related to real estate litigation in Florida. Common issues involve builders failing to complete construction on time or buyers seeking refunds of deposits on preconstruction homes that were not completed. Through thorough review of contracts and documents, many buyers have successfully recovered deposits despite conflicts between contract language and statutes. For any major real estate transaction, the author recommends undertaking a comprehensive document review with an experienced law firm to protect rights from the start.
Mitigating Risks Through Contracts - Poorvi ChothaniGetEvangelized
The document discusses legal risks associated with contracts and their mitigation. It defines what a contract is and highlights risks like ambiguity, lack of clarity around obligations, and inadequately defined terms. It then outlines strategies to manage these risks such as having lawyers draft contracts, defining scope of work and deliverables clearly, including liability limitations, dispute resolution clauses, and indemnification clauses. The document emphasizes the importance of reviewing contracts systematically to identify risks and ensure compliance.
10 things lawyers need to know about contract managementBerkman Solutions
Discover 10 techniques to enhance the value of legal services after the contract is signed. Build deeper, sustainable relationships for every outside legal counsel.
As a lawyer, you invest time to understand your client’s objectives, risks, and opportunities. What happens to your carefully drafted contract?
Your contract is filed and forgotten. Your client needs the benefit of your drafting during the entire contract term. Your client’s need is your opportunity.
There are, of course, organizations with mature contract management functions, but for every other client here are…
10 Things Every Business Lawyer Should Know about Contract Management
Immigration Consequences of Mergers & AcquisitionsAngelo Paparelli
What happens to immigration benefits and status when an employer is involved in a merger, acquisition or other form of corporate restructuring? See this presentation
Beth Lansing has over 20 years of experience in the mortgage industry, holding various compliance, auditing, and quality control roles. Most recently, she worked as a Staff Compliance Auditor for BOK Financial Corporation, where she performed audits of various bank departments to ensure regulatory compliance. Prior to that, she spent over 7 years as a Compliance Specialist for BOK Financial, performing quality control reviews of mortgage loans to ensure adherence to policies, regulations, and investor guidelines. She has extensive experience in mortgage loan processing, underwriting, funding, and collateral review.
Briefing contracts enhances cash flow by avoiding rejected billings for noncompliance. Contract briefs summarize all pertinent provisions, including reviewing clauses to determine allowable, allocable, and reasonable costs to bill the government. Briefing contracts provides useful information to contractors such as billing instructions and terms agreed upon by the parties.
Florida Real Estate Litigation Issues By Lloyd SchwedLloyd Schwed
Lloyd Schwed offers legal services related to real estate litigation in Florida. Common issues involve builders failing to complete construction on time or buyers seeking refunds of deposits on preconstruction homes that were not completed. Through thorough review of contracts and documents, many buyers have successfully recovered deposits despite conflicts between contract language and statutes. For any major real estate transaction, the author recommends undertaking a comprehensive document review with an experienced law firm to protect rights from the start.
Managing Breach of Contracts with Obligation ManagementAavenir
Not all breach of contract is a result of non-compliance, but all non-compliance can be considered as a breach of contract.
Breach of contract cannot be eliminated but non-compliance can surely be managed. How? Keep reading the remedies of breach of contract and how obligation management can help.
This document summarizes key contract clauses for outsourcing agreements. It discusses important items to address such as the base services description, service levels and credits, fees, benchmarking, third party consents, regulatory compliance, disaster recovery, termination rights, and intellectual property ownership. It also notes trends toward smaller deals, more multi-sourced environments, and customers being more sophisticated in their outsourcing needs and agreements.
The document discusses contract finance facilities, which provide credit to contractors to execute awarded contracts. Key points include:
- Contract finance facilities are secured by an underlying contract between a contractor and contractee. The facility amount is based on the contract value and bill of quantities, and is intended to be self-liquidating from contract proceeds.
- The contractor must provide 30% equity contribution. Repayment comes from domiciling contract proceeds to the bank.
- Risks include the contractee not paying, the contractor not performing, and funds being diverted. Risks are mitigated by assessing the contractee and contractor's creditworthiness and payment history, contract collateral, and ensuring disbursements are
This document summarizes common mistakes made with contracts and provides tips to avoid them. It discusses the importance of putting agreements in writing, negotiating all terms, and addressing critical elements like price, time, goods/services, and dispute resolution. Failure to have a written contract, missing key terms, or not negotiating can lead to misunderstandings and legal issues down the road. Getting advice from a lawyer can help ensure all parties fully understand obligations and resolve any issues that may arise.
The document provides a summary of qualifications for Shiiril J. Jordan as a Director of Contracts and Senior Contract Manager. Jordan has over 20 years of experience managing multimillion dollar contracts for government agencies and commercial clients. She is proficient in contract law and various contract types. Her experience includes positions as Director of Contracts for Saab Sensis Corporation and Endicott Interconnect Technologies, and Director of Legal Affairs for Tetra Tech. She holds a secret security clearance and coursework in journalism and political science.
This document outlines the roles and responsibilities of various members of the Contracts & Commercial Department. It lists the project steering committee members and project director. It then provides descriptions of the roles of the project controls manager, contracts manager, senior subcontract administrator, and other positions related to cost change management, quantity surveying, subcontract administration, commercial management, and mechanical, electrical and plumbing quantity surveying. Responsibilities include legal review, payment applications, cost evaluations, negotiations, and more.
Under Title V of the Gramm-Leach-Bliley Act, investment advisers must safeguard the privacy of client information. When entering an advisory agreement, the adviser must provide their privacy policy annually to clients. The policy must disclose what non-public personal information is collected and shared, with whom it is shared, and how confidentiality and security are protected. Clients must also be allowed to opt out of sharing. Since privacy policies require specific information, advisers can use an SEC model form to ensure compliance.
Delores Crumlin has over 20 years of experience in contract administration and closeout for government and commercial clients. She has a background in negotiating contracts, ensuring regulatory compliance, managing relationships, and overseeing finances. Crumlin currently works as a Contract Representative for Leidos, where her responsibilities include supporting all elements of contract administration, identifying risks, and facilitating training. She has previously held roles as a Contract Closeout Specialist and Project Financial Administrator.
This talk describes the representations and warranties clauses in a typical business purchase contract, the clauses limiting time in which such clauses may be enforceable, the dollar limits on same, and other non-contract ways to enforce your deals, such as reps and warranties insurance, fraudulent transfer litigation, arbitration, and suits against negligent deal intermediaries
7.30.20 How to Do a Venture Capital Financingideatoipo
This document provides an overview and summary of a presentation on how to do a venture capital financing. The presentation covers what venture capitalists look for in investments and good investors, pre-round considerations, negotiating term sheets, deal documentation, the diligence process, closing and post-closing issues, and common pitfalls. The presentation is given by a venture capital and emerging growth company attorney and provides high-level information on each stage of securing a venture capital financing.
A demand guarantee is usually a concise and simple instrument issued by a bank, or another financial institution, under which the obligation to pay a Beneficiary a fixed or maximum sum of money arises merely upon the making of a demand for payment in the prescribed form and sometimes also the presentation of documents as stipulated in the guarantee within its period of validity. Many demand guarantees are payable on first demand without any additional documents, which reflects their origin in replacing cash deposits, although increasingly guarantees require at least a person planning to enter into a contract for the purchase of goods or the construction of works by the intended counterparty to the contract may wish to have security for the counterparty’s performance of his obligations, especially when no previous dealings have taken place between them. A question that troubles bankers and lawyers is how strictly the documents must conform to the terms of the demand guarantee and LoC. Is the standard a “strict one”, so that even the minor deviations entitle the bank to refuse payment and, indeed, oblige it to do so unless otherwise authorised by the Applicant or Principal of the credit or guarantee? Or is it a standard of “substantial compliance” in terms of which deviations that the bank has no reason to believe are of commercial significance are ignored? Or does the law adopt another standard, i.e. strict compliance in suits by the Beneficiary against the issuing bank or Guarantor, but only substantial compliance in suits by the Applicant or Principal against the Guarantor, in terms of which the bank is free to invoke a strict standard of commonly known as standby LoC.
Patricia Diane Marshall has over 15 years of experience in contracts management and paralegal work. She has worked as a Senior Contracts Manager for Alliant Techsystems and Bell Helicopter, managing contracts for aerospace and defense programs. Her responsibilities included contract negotiations, reviewing terms and conditions, and ensuring compliance. She also has experience in paralegal roles focused on areas such as employment law, intellectual property, and immigration. Marshall has an MBA and degrees in Business Management and Business Administration, along with paralegal and government contracting certifications.
How to Obtain a Standby Letter of Credit?hansongroupus
An SBLC standby letter of credit is a guarantee issued by a bank to a third party beneficiary promising to pay a specific sum if the terms and conditions are met. It can help establish trust in business partnerships and is used for import/export transactions. The letter of credit ensures contractual obligations will be fulfilled, with the bank paying the third party if the client defaults. To obtain one, a business provides proof of creditworthiness to the bank, with a quicker approval process than a loan but an upfront fee of 1-10% of the amount charged annually.
The document discusses project delay damages and related topics. It addresses what constitutes delay damages, the role of damages experts, difficult items in delay claims, sources of information useful for claims, types of recoverable costs including unabsorbed overhead and profit. It also discusses who delay damages can be claimed against and the economic loss rule. The document aims to provide construction claim professionals with guidance on assessing and pursuing delay damage claims.
The document discusses compliance and accounts receivable risk areas for skilled nursing facilities. It identifies five main risk areas for bad debt and lost revenue: bad debt, compliance issues, inefficiencies and waste, cash flow problems, and theft. It also provides tips for minimizing these risks through best practices in admissions, compliance processes, personnel management, billing and collection standards, and oversight and monitoring.
Here are the key points I would reflect on from this case:
- Maintaining integrity and independence is important as an auditor, even when under budget pressure. Falsifying time spent on audit procedures violates accounting standards and ethics.
- Learning to manage expectations and communicate issues with the engagement team is an important skill. Being transparent about delays outside of my control allows for informed decision making.
- Understanding motivations and pressures at different levels (e.g. manager's promotion review) provides context, but cannot justify compromising audit quality or standards.
- Gaining experience and trusting my own judgment, while also seeking advice from more experienced team members. Knowing when "stuff happens all the time" is acceptable versus a red
1. The Assessing Materiality and Risk simulation identifies important components of the auditing process such as assessing risks, sampling accounts, and considering interrelated risks.
2. There are three interrelated risks in an audit: inherent risk, control risk, and detection risk. A high inherent risk can lead to higher control and detection risks.
3. Auditors use sampling because reviewing all items is not always possible or economically justified. Sampling allows auditors to review a portion of items and make conclusions about the overall population.
"In the times where acquisitions and buyouts are trending, the field of due diligence emerges as one of the most relevant fields. Prima facie, without delving in"
TaxGuru is a platform that provides Updates On Amendments in Income Tax, Wealth Tax, Company Law, Service Tax, RBI, Custom Duty, Corporate Law , Goods and Service Tax etc.
To know more visit https://taxguru.in/corporate-law/process-due-diligence.html
"In the times where acquisitions and buyouts are trending, the field of due diligence emerges as one of the most relevant fields. Prima facie, without delving in"
TaxGuru is a platform that provides Updates On Amendments in Income Tax, Wealth Tax, Company Law, Service Tax, RBI, Custom Duty, Corporate Law , Goods and Service Tax etc.
To know more visit https://taxguru.in/corporate-law/process-due-diligence.html
Managing Breach of Contracts with Obligation ManagementAavenir
Not all breach of contract is a result of non-compliance, but all non-compliance can be considered as a breach of contract.
Breach of contract cannot be eliminated but non-compliance can surely be managed. How? Keep reading the remedies of breach of contract and how obligation management can help.
This document summarizes key contract clauses for outsourcing agreements. It discusses important items to address such as the base services description, service levels and credits, fees, benchmarking, third party consents, regulatory compliance, disaster recovery, termination rights, and intellectual property ownership. It also notes trends toward smaller deals, more multi-sourced environments, and customers being more sophisticated in their outsourcing needs and agreements.
The document discusses contract finance facilities, which provide credit to contractors to execute awarded contracts. Key points include:
- Contract finance facilities are secured by an underlying contract between a contractor and contractee. The facility amount is based on the contract value and bill of quantities, and is intended to be self-liquidating from contract proceeds.
- The contractor must provide 30% equity contribution. Repayment comes from domiciling contract proceeds to the bank.
- Risks include the contractee not paying, the contractor not performing, and funds being diverted. Risks are mitigated by assessing the contractee and contractor's creditworthiness and payment history, contract collateral, and ensuring disbursements are
This document summarizes common mistakes made with contracts and provides tips to avoid them. It discusses the importance of putting agreements in writing, negotiating all terms, and addressing critical elements like price, time, goods/services, and dispute resolution. Failure to have a written contract, missing key terms, or not negotiating can lead to misunderstandings and legal issues down the road. Getting advice from a lawyer can help ensure all parties fully understand obligations and resolve any issues that may arise.
The document provides a summary of qualifications for Shiiril J. Jordan as a Director of Contracts and Senior Contract Manager. Jordan has over 20 years of experience managing multimillion dollar contracts for government agencies and commercial clients. She is proficient in contract law and various contract types. Her experience includes positions as Director of Contracts for Saab Sensis Corporation and Endicott Interconnect Technologies, and Director of Legal Affairs for Tetra Tech. She holds a secret security clearance and coursework in journalism and political science.
This document outlines the roles and responsibilities of various members of the Contracts & Commercial Department. It lists the project steering committee members and project director. It then provides descriptions of the roles of the project controls manager, contracts manager, senior subcontract administrator, and other positions related to cost change management, quantity surveying, subcontract administration, commercial management, and mechanical, electrical and plumbing quantity surveying. Responsibilities include legal review, payment applications, cost evaluations, negotiations, and more.
Under Title V of the Gramm-Leach-Bliley Act, investment advisers must safeguard the privacy of client information. When entering an advisory agreement, the adviser must provide their privacy policy annually to clients. The policy must disclose what non-public personal information is collected and shared, with whom it is shared, and how confidentiality and security are protected. Clients must also be allowed to opt out of sharing. Since privacy policies require specific information, advisers can use an SEC model form to ensure compliance.
Delores Crumlin has over 20 years of experience in contract administration and closeout for government and commercial clients. She has a background in negotiating contracts, ensuring regulatory compliance, managing relationships, and overseeing finances. Crumlin currently works as a Contract Representative for Leidos, where her responsibilities include supporting all elements of contract administration, identifying risks, and facilitating training. She has previously held roles as a Contract Closeout Specialist and Project Financial Administrator.
This talk describes the representations and warranties clauses in a typical business purchase contract, the clauses limiting time in which such clauses may be enforceable, the dollar limits on same, and other non-contract ways to enforce your deals, such as reps and warranties insurance, fraudulent transfer litigation, arbitration, and suits against negligent deal intermediaries
7.30.20 How to Do a Venture Capital Financingideatoipo
This document provides an overview and summary of a presentation on how to do a venture capital financing. The presentation covers what venture capitalists look for in investments and good investors, pre-round considerations, negotiating term sheets, deal documentation, the diligence process, closing and post-closing issues, and common pitfalls. The presentation is given by a venture capital and emerging growth company attorney and provides high-level information on each stage of securing a venture capital financing.
A demand guarantee is usually a concise and simple instrument issued by a bank, or another financial institution, under which the obligation to pay a Beneficiary a fixed or maximum sum of money arises merely upon the making of a demand for payment in the prescribed form and sometimes also the presentation of documents as stipulated in the guarantee within its period of validity. Many demand guarantees are payable on first demand without any additional documents, which reflects their origin in replacing cash deposits, although increasingly guarantees require at least a person planning to enter into a contract for the purchase of goods or the construction of works by the intended counterparty to the contract may wish to have security for the counterparty’s performance of his obligations, especially when no previous dealings have taken place between them. A question that troubles bankers and lawyers is how strictly the documents must conform to the terms of the demand guarantee and LoC. Is the standard a “strict one”, so that even the minor deviations entitle the bank to refuse payment and, indeed, oblige it to do so unless otherwise authorised by the Applicant or Principal of the credit or guarantee? Or is it a standard of “substantial compliance” in terms of which deviations that the bank has no reason to believe are of commercial significance are ignored? Or does the law adopt another standard, i.e. strict compliance in suits by the Beneficiary against the issuing bank or Guarantor, but only substantial compliance in suits by the Applicant or Principal against the Guarantor, in terms of which the bank is free to invoke a strict standard of commonly known as standby LoC.
Patricia Diane Marshall has over 15 years of experience in contracts management and paralegal work. She has worked as a Senior Contracts Manager for Alliant Techsystems and Bell Helicopter, managing contracts for aerospace and defense programs. Her responsibilities included contract negotiations, reviewing terms and conditions, and ensuring compliance. She also has experience in paralegal roles focused on areas such as employment law, intellectual property, and immigration. Marshall has an MBA and degrees in Business Management and Business Administration, along with paralegal and government contracting certifications.
How to Obtain a Standby Letter of Credit?hansongroupus
An SBLC standby letter of credit is a guarantee issued by a bank to a third party beneficiary promising to pay a specific sum if the terms and conditions are met. It can help establish trust in business partnerships and is used for import/export transactions. The letter of credit ensures contractual obligations will be fulfilled, with the bank paying the third party if the client defaults. To obtain one, a business provides proof of creditworthiness to the bank, with a quicker approval process than a loan but an upfront fee of 1-10% of the amount charged annually.
The document discusses project delay damages and related topics. It addresses what constitutes delay damages, the role of damages experts, difficult items in delay claims, sources of information useful for claims, types of recoverable costs including unabsorbed overhead and profit. It also discusses who delay damages can be claimed against and the economic loss rule. The document aims to provide construction claim professionals with guidance on assessing and pursuing delay damage claims.
The document discusses compliance and accounts receivable risk areas for skilled nursing facilities. It identifies five main risk areas for bad debt and lost revenue: bad debt, compliance issues, inefficiencies and waste, cash flow problems, and theft. It also provides tips for minimizing these risks through best practices in admissions, compliance processes, personnel management, billing and collection standards, and oversight and monitoring.
Here are the key points I would reflect on from this case:
- Maintaining integrity and independence is important as an auditor, even when under budget pressure. Falsifying time spent on audit procedures violates accounting standards and ethics.
- Learning to manage expectations and communicate issues with the engagement team is an important skill. Being transparent about delays outside of my control allows for informed decision making.
- Understanding motivations and pressures at different levels (e.g. manager's promotion review) provides context, but cannot justify compromising audit quality or standards.
- Gaining experience and trusting my own judgment, while also seeking advice from more experienced team members. Knowing when "stuff happens all the time" is acceptable versus a red
1. The Assessing Materiality and Risk simulation identifies important components of the auditing process such as assessing risks, sampling accounts, and considering interrelated risks.
2. There are three interrelated risks in an audit: inherent risk, control risk, and detection risk. A high inherent risk can lead to higher control and detection risks.
3. Auditors use sampling because reviewing all items is not always possible or economically justified. Sampling allows auditors to review a portion of items and make conclusions about the overall population.
"In the times where acquisitions and buyouts are trending, the field of due diligence emerges as one of the most relevant fields. Prima facie, without delving in"
TaxGuru is a platform that provides Updates On Amendments in Income Tax, Wealth Tax, Company Law, Service Tax, RBI, Custom Duty, Corporate Law , Goods and Service Tax etc.
To know more visit https://taxguru.in/corporate-law/process-due-diligence.html
"In the times where acquisitions and buyouts are trending, the field of due diligence emerges as one of the most relevant fields. Prima facie, without delving in"
TaxGuru is a platform that provides Updates On Amendments in Income Tax, Wealth Tax, Company Law, Service Tax, RBI, Custom Duty, Corporate Law , Goods and Service Tax etc.
To know more visit https://taxguru.in/corporate-law/process-due-diligence.html
This document provides standards and guidelines for customer service units within Pre-paid Inpatient Health Plans (PIHPs) in Michigan. It outlines 14 standards for customer service operations, including requirements to have dedicated staff, publish contact information, maintain provider directories, and assist with grievance processes. The document also provides background on the federal regulations requiring these protections and Michigan's process for developing the standards.
The stages of auditing are as follows: determine audit approach, understand the entity, assess risk of material misstatement, select audit procedures, prepare report, and report to management. Auditors determine risks, formulate responses like additional procedures, and test controls and substantive procedures. Audit risk is the risk of giving an inappropriate opinion and comes from inherent, control, and detection risk. Business risk impacts the organization directly from operations.
Leveraging Corporate Integrity Agreements for Healthcare CompliancePolsinelli PC
An effective compliance program is essential for healthcare providers and companies. These programs should be reviewed and updated according to the latest guidance. OIG's Corporate Integrity Agreements shed light on where the enforcement "hot spots" are, as well as identify potential areas of risk that your compliance program should address. Monitoring CIA trends provides much needed guidance to help shape an effective compliance program.
Additional topics of discussion:
Recent trends and developments in CIAs and what they mean for compliance programs
Best practices to prevent a CIA
Best practices for leveraging CIA lessons in your compliance program
Presenters:
Brian D. Bewley, Shareholder, Polsinelli
Jennifer L. Evans, Shareholder, Polsinelli
Auditing A Practical Approach Canadian 2nd Edition Moroney Solutions ManualGalvinee
Full download : https://alibabadownload.com/product/auditing-a-practical-approach-canadian-2nd-edition-moroney-solutions-manual/ Auditing A Practical Approach Canadian 2nd Edition Moroney Solutions Manual
This document discusses SSAE16 audits and why companies undergo this process. It provides the following key points:
1) Regulators and lenders have shifted their focus from traditional financial metrics to assessing the integrity of a company's information systems and data security in light of recent high-profile data breaches.
2) In response, the American Land Title Association created a set of security standards known as ALTA Best Practices, focusing on information security controls.
3) Most companies in the title and escrow industries undergo SSAE16 audits to demonstrate compliance with ALTA Best Practices and assure lenders that appropriate controls are in place, as these audits are now effectively required to satisfy
The auditor conducted 29 audits in 2014, examining firms for compliance with standards. Their top priorities were risk analysis, communicating standards to clients, and monitoring policies. They created an audit schedule, implemented new procedures, and updated insurance requirements. Milestones included completing recalls and discussions with MCM. Goals for the upcoming year are to help implement the transition to an integrated MCM/ACF audit program. The auditor believes additional training could improve their skills and duties may change once the transition is complete.
Federal Benefits Developments - Audits Abound: Are You Ready?CBIZ, Inc.
From Benefits Law Journal, Summer 2014 Issue. This article covers:
- What Triggers a Plan Audit?
- DOL Audits of Health and Pension Plans
- IRS Audits of Pension and Retirement Plans
- HIPAA Privacy and Security Audits
- How Can a Plan Sponsor Best Be Fortified
to Withstand an Audit?
- What Should a Plan Sponsor Do?
Dependent Verification: What You Don't Know Can Hurt YouHodges-Mace
Regardless of whether an employee’s intent is to defraud their employer, or whether the employee simply does not understand the plan rules, the time to correct an eligibility error is before a major health issue arises.
The audit committee plays an important role in overseeing the financial reporting process and audit of a company's financial statements. The key responsibilities of an audit committee include:
1. Overseeing and monitoring the financial reporting process to ensure accuracy and compliance.
2. Appointing, compensating, and overseeing the independent auditor.
3. Reviewing and discussing the audit plan, audit results, and auditor's report with the independent auditor.
4. Reviewing the adequacy of the company's internal controls and risk management procedures.
The audit committee helps provide oversight of management, the internal auditors, and the independent auditor to strengthen the integrity of financial reporting and maintain public trust in the
Audit is the process and Assurance is the product. Auditors go through the process of testing client’s financial reports (audit) in order to give the client the confidence that their report is what it seems to be (assurance).
The above is based on a business concept often referred to as “agency theory”.
The secondary agent (auditor) delivers assurance to the principal (shareholder) that the report (financial statements) provided by the primary agent (director) is what it appears to be (shows a true and fair view).
External audit is the name given to the formal audit process of auditing financial statements prepared by directors in order to give an opinion on the truth and fairness of those financial statements to shareholders. External audit is by far the most common form of audit but its objective is the same as the objective of any other audit service. The objective of external audit is assurance. The purpose of external audit is the delivery of confidence in financial statements to the shareholders.
Auditors in Dubai play a constructive role in society by delivering added value to clients and critical insights to enhance the performance of the company.
The document is a knowledge level exam paper from the Institute of Chartered Accountants of Bangladesh. It contains questions on assurance, internal control, internal and external audit. The paper covers key concepts in these areas like the two types of assurance engagements, objectives of internal control, components of internal control like control environment and risk assessment process, roles of internal and external audit functions and key differences between them. It provides suggested answers to questions testing understanding of these fundamental assurance, internal control and audit concepts.
The New Paradigm In Vendor Management Under CFPB - Law360John Barnes
The document discusses the Consumer Financial Protection Bureau's (CFPB) oversight of third-party vendors that provide services to financial institutions. It outlines that the CFPB holds financial institutions responsible for the conduct of their third-party service providers. The CFPB has taken enforcement actions against banks for issues caused by vendors' noncompliance. The document also notes uncertainty around which types of entities would be considered "service providers" by the CFPB, leaving financial institutions to assume broad oversight of companies involved in lending.
The document is a report from the Insurance Regulatory and Development Authority's Committee to Evaluate the Performance of Third Party Administrators (Health Services) from April 2009.
The report provides recommendations on the scope of activities TPAs can engage in, best practices for customer service, and infrastructure and financial requirements for TPAs. It recommends standardizing processes, documents, timelines and establishing a common industry body. It also suggests increasing capital requirements for TPAs based on revenue amounts to ensure adequate infrastructure and financial security. The creation of an industry association for TPAs is endorsed to help standardize the sector and address issues collectively.
2. Contract Monitoring DefinedContract Monitoring Defined
ContinualContinual processprocess ensuringensuring
compliance with the terms andcompliance with the terms and
conditions of the contact -conditions of the contact -
arrangement; typically consisting ofarrangement; typically consisting of
three components;three components;
AdministrativeAdministrative
Terms/conditions of contract (insurance,Terms/conditions of contract (insurance,
internal processes, HR)internal processes, HR)
FiscalFiscal
Invoices; billed amount within contract,Invoices; billed amount within contract,
ProgramProgram
Client eligibility, medical necessity,Client eligibility, medical necessity,
outcomesoutcomes
3. What’s new, we already do this…What’s new, we already do this…
[I think] most experience is in[I think] most experience is in
managing contracts for discreet fee-managing contracts for discreet fee-
for-service arrangements; psychiatricfor-service arrangements; psychiatric
services and one payer…State/GR.services and one payer…State/GR.
Sub-Contracting federallySub-Contracting federally
reimbursed services [with statereimbursed services [with state
match] adds a whole new dimensionmatch] adds a whole new dimension
to contract management.to contract management.
4. Give me one good reason forGive me one good reason for
Monitoring & Managing Contracts!Monitoring & Managing Contracts!
6. Case & PointCase & Point
Krizek, MD (psychiatrist) (1997):Krizek, MD (psychiatrist) (1997):
1986 to 1992 submitted 8,002 false1986 to 1992 submitted 8,002 false
claims resulting in $245,392claims resulting in $245,392
overpayment. Wife was billing.overpayment. Wife was billing.
False claims: two issues; medicallyFalse claims: two issues; medically
unnecessary and up-coded.unnecessary and up-coded.
90844 versus 9084390844 versus 90843
““Seriously deficient” record keepingSeriously deficient” record keeping
Some claims over 21 hours.Some claims over 21 hours.
““Failed utterly” to review bills submittedFailed utterly” to review bills submitted
on his behalf…reckless disregard.on his behalf…reckless disregard.
$5,745,000.$5,745,000.
7. Really…are they serious?Really…are they serious?
TheThe
American Recovery and Reinvestment Act of 2American Recovery and Reinvestment Act of 2
(Recovery Act) provides the Department(Recovery Act) provides the Department
of Health and Human Services (HHS),of Health and Human Services (HHS),
Office of Inspector General (OIG), with $17Office of Inspector General (OIG), with $17
million in funding for oversight and review.million in funding for oversight and review.
The Recovery Act provided an additionalThe Recovery Act provided an additional
$31,250,000 to OIG for the purpose of$31,250,000 to OIG for the purpose of
ensuring the proper expenditure of fundsensuring the proper expenditure of funds
under Medicaid.under Medicaid.
OIG will assess whether HHS is using theOIG will assess whether HHS is using the
$165.4 billion in Recovery Act funds in$165.4 billion in Recovery Act funds in
accordance with legal and administrativeaccordance with legal and administrative
requirements and is meeting therequirements and is meeting the
accountability objectives defined by theaccountability objectives defined by the
Office of Management and Budget.Office of Management and Budget.
8. Back to “what’s new?”Back to “what’s new?”
We have traditionally been inWe have traditionally been in
the role of proving up our goodthe role of proving up our good
work. Our contract monitoringwork. Our contract monitoring
process focused on internalprocess focused on internal
controls; QM, Finance etc.controls; QM, Finance etc.
LPND puts us in the role ofLPND puts us in the role of
proving up ‘their’ work.proving up ‘their’ work.
Again, we take the money.Again, we take the money.
9. Come on…it is just DSHS!Come on…it is just DSHS!
Who paid you toWho paid you to
do what and whatdo what and what
do they expect indo they expect in
return?return?
PrivatePrivate
FoundationsFoundations
StateState
IRSIRS
DOJDOJ
GAOGAO
OIGOIG
CMSCMS
Hi-Tech ActHi-Tech Act
HIPPAHIPPA
FCAFCA
STARKSTARK
10. What needs monitoring?What needs monitoring?
RelationsRelations
Performance to include;Performance to include;
Program/service deliverablesProgram/service deliverables
Fiscal/financialFiscal/financial
Record – keepingRecord – keeping
BillingBilling
SystemsSystems
Quality ManagementQuality Management
Utilization ManagementUtilization Management
Human Resource ManagementHuman Resource Management
Corporate ComplianceCorporate Compliance
11. How are other folks doing?How are other folks doing?
March 2004; OIG assess the RyanMarch 2004; OIG assess the Ryan
White Care Act Title I & Title IIWhite Care Act Title I & Title II
[HRSA] grantees’ monitoring of ‘sub-[HRSA] grantees’ monitoring of ‘sub-
grantees’grantees’
Findings:Findings: monitoring is limitedmonitoring is limited, 15, 15
of 20 granteesof 20 grantees did not havedid not have
comprehensive documentationcomprehensive documentation
demonstrating consistentdemonstrating consistent
monitoring activities.monitoring activities.
12. OIG recommended HRSA…OIG recommended HRSA…
Set standards for monitoring sub-Set standards for monitoring sub-
grantees that, at a minimum requiregrantees that, at a minimum require
a formal agreement, program report,a formal agreement, program report,
fiscal report and schedule of sitefiscal report and schedule of site
visits.visits.
Require grantees to report how theyRequire grantees to report how they
monitor their sub-grantees inmonitor their sub-grantees in
accordance with these standards asaccordance with these standards as
part of every applicationpart of every application
Increase efforts to monitor granteesIncrease efforts to monitor grantees
oversight of sub-grantees…oversight of sub-grantees…
14. Who: What does a contractWho: What does a contract
manager look like?manager look like?
15. Is there a job title?Is there a job title?
Should not beShould not be
one person butone person but
a coordinateda coordinated
effort to include;effort to include;
RelationsRelations
QMQM
FinanceFinance
ComplianceCompliance
It is not a job, itIt is not a job, it
is a processis a process
16. EqualityEquality
All providers within a network are reviewedAll providers within a network are reviewed
and treated the same by the LMHA/QM.and treated the same by the LMHA/QM.
The same measures used for one providerThe same measures used for one provider
is used for the provider of the same serviceis used for the provider of the same service
whether they are external or internal.whether they are external or internal.
If a provider is accredited or licensed byIf a provider is accredited or licensed by
another regulatory authority the scope ofanother regulatory authority the scope of
the authority review may change.the authority review may change.
Can the provider demonstrate goodCan the provider demonstrate good
standing with an accrediting and/orstanding with an accrediting and/or
licensing body? If so, can all or some oflicensing body? If so, can all or some of
the provider services be ‘deemed’?the provider services be ‘deemed’?
17. WhenWhen
Reviews may occur pre andReviews may occur pre and
post contract/opening.post contract/opening.
Reviews occur postReviews occur post
contract/opening as regularlycontract/opening as regularly
scheduled reviews,scheduled reviews,
unannounced reviews or focusunannounced reviews or focus
reviews.reviews.
18. MonitoringMonitoring
All materials required of the RFP haveAll materials required of the RFP have
been received and reviewed by the centerbeen received and reviewed by the center
contract holder. The proposal is complete.contract holder. The proposal is complete.
Financial stability of the potential providerFinancial stability of the potential provider
has been reviewed and determined to behas been reviewed and determined to be
sound.sound.
The contract holder notifies QM that aThe contract holder notifies QM that a
preliminary review of the provider capacitypreliminary review of the provider capacity
to meet standards and contractto meet standards and contract
requirements may be scheduled.requirements may be scheduled.
QM assigns the contract review andQM assigns the contract review and
schedules with the provider a date andschedules with the provider a date and
time to conduct the review.time to conduct the review.
The purpose of the review is twofold:The purpose of the review is twofold:
Basic structure exists to meet contract?Basic structure exists to meet contract?
Willingness to meet contract?Willingness to meet contract?
19. Post Contract ReviewPost Contract Review
Immediate responsibility for compliance rests withImmediate responsibility for compliance rests with
the provider. All providers are required tothe provider. All providers are required to
demonstrate a process for internal accountability ofdemonstrate a process for internal accountability of
data and fidelity to service provision. This processdata and fidelity to service provision. This process
is shared with the provider’s contract holder,is shared with the provider’s contract holder,
manager and QM.manager and QM.
All provider services should be reviewed on anAll provider services should be reviewed on an
ongoing basis by their manager and contract holder.ongoing basis by their manager and contract holder.
All providers are placed on the QM review scheduleAll providers are placed on the QM review schedule
for external validation of internal methods offor external validation of internal methods of
accountability and service fidelityaccountability and service fidelity
All reviews are conducted with an establishedAll reviews are conducted with an established
protocol developed by QM which may also be usedprotocol developed by QM which may also be used
by the provider, the provider’s manager/contractby the provider, the provider’s manager/contract
holder for internal management purposes.holder for internal management purposes.
On at least an annual basis the provider’sOn at least an annual basis the provider’s
compliance with service standards, recordscompliance with service standards, records
standards, training, health, safety and advocacystandards, training, health, safety and advocacy
standards is verified by QMstandards is verified by QM
20. Post Contract contPost Contract cont
Reviews may be triggered by dataReviews may be triggered by data
reviewed of ongoing service informationreviewed of ongoing service information
received by the manager and QM from thereceived by the manager and QM from the
provider.provider.
High risk or persistent questions of serviceHigh risk or persistent questions of service
compliance may warrant an unannouncedcompliance may warrant an unannounced
or focus review of the provider.or focus review of the provider.
Focus review are normally conducted byFocus review are normally conducted by
QM, however, a focus review may beQM, however, a focus review may be
requested of the provider as formatted byrequested of the provider as formatted by
QM or the manager.QM or the manager.
21. Integrate: Internal & ExternalIntegrate: Internal & External
Ideally, the same process of review occurs forIdeally, the same process of review occurs for
internal and external monitors.internal and external monitors.
The contract holder would monitor the provider’sThe contract holder would monitor the provider’s
adherence to contract requirements as an internaladherence to contract requirements as an internal
manager would monitor the compliance of anmanager would monitor the compliance of an
internal provider’s adherence to performanceinternal provider’s adherence to performance
contract requirements.contract requirements.
Oversight and validation of this process isOversight and validation of this process is
conducted through QM. Risks to performanceconducted through QM. Risks to performance
contract requirements are identified as arecontract requirements are identified as are
corporate program compliance risks associated withcorporate program compliance risks associated with
state and federal healthcare compliancestate and federal healthcare compliance
requirements.requirements.
The summary of data and reviews is collated,The summary of data and reviews is collated,
analyzed and shared with the Executive Director,analyzed and shared with the Executive Director,
Executive Staff and Center Board on a quarterlyExecutive Staff and Center Board on a quarterly
and annual basis.and annual basis.
22. What to monitor.What to monitor.
The review process is formatted and has aThe review process is formatted and has a
protocol.protocol.
The review process includes:The review process includes:
Physical site reviewPhysical site review
Policy and procedures reviewPolicy and procedures review
Record structure reviewRecord structure review
Staff training and credentialing reviewStaff training and credentialing review
Debriefing with potential providerDebriefing with potential provider
Plan of Improvement if neededPlan of Improvement if needed
Scheduling technical assistanceScheduling technical assistance
Formal review report to potential provider andFormal review report to potential provider and
contract holder recommending LMHA action.contract holder recommending LMHA action.
23. Steps to take:Steps to take:
Develop policy – procedureDevelop policy – procedure
Designate coordinator andDesignate coordinator and
appropriate department/staffappropriate department/staff
Designate provider relationsDesignate provider relations
Develop audit instrumentsDevelop audit instruments
Develop monitoring calendarDevelop monitoring calendar
Credentialing process toolCredentialing process tool
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