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benefits on the date(s) that such services are rendered 3.11 GOVERNMENT PROGRAMS — Medical Group agrees to accept the Medicaid reimbursement made by the Company, or the Company's reimbursement, as payment in full for Covered Services rendered to Members enrolled in the State of Washington, Department of Social and Health Services Medical Assistance Programs (Medicaid). This provision is intended to cover those Medicaid Members who receive care outside of their assigned Provider Network. In no event shall the Medical Group seek additional reimbursement for Covered Services rendered to such Members. All claims for Medicaid Members must be submitted within three hundred sixty five (365) days from the date of service. The Medical Group is not obligated to accept all or any Medicaid Members referred to it, nor is the Medical Group automatically a Participating Provider in the Company's Medicaid programs by accepting the Medicaid reimbursement. Medical Group agrees to report to Company any occurrence in which a Medicaid member is billed for a Covered Service or Non -Covered Service, regardless of Member consent to assume financial liability. IV. COMPLIANCE WITH COMPANY'S POLICIES AND PROGRAMS 4.1 PROFESSIONAL REQUIREMENTS — Medical Group and Medical Group Providers will remain in full compliance with all applicable laws and regulations governing the practice of medicine and will be duly licensed, in good standing, to practice medicine in Medical Group's respective jurisdiction (s), including such jurisdictions as may be required by virtue of Medical Group's participation in a Provider Network. Evidence of such licensure and of Medical Group's DEA certification will be made available to Company upon request. The Medical Group agrees that it and its subcontractors and employees shall comply with all applicable statutes, laws and regulations, including those set forth in WAC 284-43 and those that govern health care service delivery to Members. Medical Group agrees to notify Company, in writing, within five (5) working days of any material change in the status of Medical Group which is likely to impair or interfere with Medical Group's performance under this Agreement including, but not limited to: (i) loss or suspension of licensure or certification; (ii) placement on probation by professional licensing or certification agency; (iii) loss or restriction of full active admitting privileges at any hospital; (iv) the issuance of any formal charges against Medical Group by any governmental agencies, or any other licensing or accreditation organization which would, if sustained, materially impair Medical Group's ability to comply with Medical Group's duties and obligations under this Agreement; and (v) suspension or expulsion from the Medicare or Medicaid programs. 4.2 ADMINISTRATIVE MANUAL — The Company shall make available to the Medical Group copies of the Company's Administrative Manual, electronically, which outlines billing requirements, general benefits information, Medical Management requirements and other updated information. The Medical Group agrees to comply with the policies and procedures set forth in the Administrative Manual and that compliance is necessary to meet the obligations under this Agreement. The Company may revise and update the Administrative Manual from time to time with ninety (90) days' notice to the Medical Group. The Medical Group agrees that such revisions become a part of the Administrative Manual and the Medical Group agrees to comply with any such revisions. The Medical Group agrees to abide by Company directives, whether communicated by the Company through its Administrative Manual or other communications and publications. Notwithstanding the foregoing, the parties understand that if there are any conflicts with the Administrative Manual and the Agreement, this Agreement shall prevail. 4.3 UTILIZATION MANAGEMENT AND QUALITY IMPROVEMENT — To the extent that Medical Group participates in Provider Networks for Health Plans which have implemented utilization management and/or quality improvement policies and programs, Medical Group will fully comply with such policies and programs, the details of which are Asuris MGA Agreement (Rev. 05/2017) A18816854AA Page 9 of 20