IRIS Provider Agreement - Wisconsin Department of Health Services and <<NAME OF ICA OR FEA>> - Issued January 1, 2021

Sep 22, 2026

IRIS Provider Agreement sets out the contractual framework between the Wisconsin Department of Health Services, Division of Medicaid Services, and a specified ICA or FEA entity. It defines roles, duties, reporting timelines, monitoring rights, technical assistance, and conflict-of-interest expectations. The agreement details the contractual relationship, certification requirements, corrective actions, sanctions, termination terms, indemnification, and legal provisions such as governing law and severability, and it covers contractor administration expectations and compliance responsibilities across required sections.

LanguageEnglish

CategoryLetters

FormatPDF

Pages158

Reading Time55 min

AccessFree to download

Definitions

Functions and Duties of the Department

Department of Health Services

Notification of Changes in Functional Eligibility Criteria

Reports from the Contractors

Right to Monitor

Technical Assistance

Conflict of Interest

Contractual Relationship

Contract

Precedence When Conflict Occurs

Cooperation of Parties and Dispute Resolution

IRIS Contractor Certification

Reporting Deadlines

Modification of the Contract

Corrective Action for Non-Compliance and Non-Performance

Sanctions for Violation, Breach, or Non-Performance

Termination of the Contract

Indemnification

Independent Capacity of the Contractor

Omissions

Choice of Law

Waiver

Severability

Force Majeure

Headings

Assignability

Right to Publish

Survival

Contractor Administration

General Administration Expectations

FEA-Specific Administration Expectations

Liability Insurance

Wisconsin Department of Financial Institutions Status

Duplication of Services

Separation in Lines of Business

Conflict of Interest

Fraud

Expansion and Geographic Service Regions

Physical and Localized Presence

Company Structure and Leadership

Administrative Services Agreements (ASA)

Business Associate Agreement

Business Continuity

Commercial Leases

IRIS PROVIDER AGREEMENT between WISCONSIN DEPARTMENT OF HEALTH SERVICES DIVISION OF MEDICAID SERVICES and <> Issued January 1, 2021 Effective 1/1/2021 – 12/31/2022 Table of Contents I. Definitions ............................................................................................................................. 10 II. Functions and Duties of the Department ........................................................................... 24 Department of Health Services ...................................................................................... 24 Notification of Changes in Functional Eligibility Criteria............................................. 24 Reports from the Contractors ......................................................................................... 24 Right to Monitor ............................................................................................................. 24 Technical Assistance.......................................................................................................... 24 Conflict of Interest ............................................................................................................. 24 III. Contractual Relationship.................................................................................................... 25 Contract .......................................................................................................................... 25 Precedence When Conflict Occurs ................................................................................. 25 Cooperation of Parties and Dispute Resolution ............................................................. 25 IRIS Contractor Certification ......................................................................................... 26 Reporting Deadlines........................................................................................................... 26 Modification of the Contract.............................................................................................. 26 Corrective Action for Non-Compliance and Non-Performance .................................... 27 Sanctions for Violation, Breach, or Non-Performance .................................................. 28 Termination of the Contract ............................................................................................... 31 Indemnification .................................................................................................................. 35 Independent Capacity of the Contractor......................................................................... 36 Omissions........................................................................................................................... 36 Choice of Law ................................................................................................................ 36 Waiver ............................................................................................................................ 36 Severability..................................................................................................................... 37 Force Majeure .................................................................................................................... 37 Headings ......................................................................................................................... 37 Assignability................................................................................................................... 37 Right to Publish.................................................................................................................. 37 Survival .............................................................................................................................. 37 IV. Contractor Administration

FAQs

Who are the parties to the IRIS Provider Agreement?

The agreement is between the Wisconsin Department of Health Services, Division of Medicaid Services, and the identified ICA or FEA entity (shown as <>).

What is the effective period of the agreement?

The agreement is effective from 1/1/2021 through 12/31/2022, and it is issued January 1, 2021.

What actions apply if the contractor is non-compliant or non-performs?

The agreement provides for corrective action for non-compliance and non-performance, along with sanctions for violations, breaches, or non-performance.

Sep 22, 2026

Upload by Sophia Brooks