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Asuris and KCPHD Agreement
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2018-06-05 10:00 AM - Commissioners' Agenda
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Asuris and KCPHD Agreement
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Last modified
5/31/2018 1:16:16 PM
Creation date
5/31/2018 1:14:19 PM
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Meeting
Date
6/5/2018
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Alpha Order
k
Item
Request to Approve an Agreement between Asuris Northwest Health and the Kittitas County Public Health Department
Order
11
Placement
Consent Agenda
Row ID
45299
Type
Agreement
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motions. The arbitrator shall be bound by applicable federal and state <br />law and shall render a written decision within thirty (30) days of the <br />hearing. The arbitrator shall award the prevailing party any applicable <br />filing fees and arbitrator's fees paid by the prevailing party. The <br />arbitrator also may award the prevailing party attorneys' fees and costs <br />associated with the arbitration proceeding. Judgment upon an award <br />rendered by the arbitrator may be entered in any court having jurisdiction <br />thereof. <br />The parties agree that the joinder or consolidation of an arbitration <br />proceeding under the Agreement with an arbitration of disputes or claims <br />of any non-party to the Agreement is prohibited, regardless of the nature <br />of the issues or disputes involved. <br />9.4 FAILURE TO TIMELY APPEAL — If the disputing party (the party that demands or <br />initiates the internal provider appeal, external review, mediation, arbitration, or judicial <br />remedy) fails to demand or initiate an internal provider appeal, external review, <br />mediation, arbitration or judicial remedy as required by this Agreement and within the <br />time frames prescribed in Exhibit D and this Agreement, the Company's last <br />determination on the disputed issue(s) shall be deemed final and binding. In addition, the <br />disputed issue(s) shall be conclusively deemed to have been waived by the disputing <br />party and shall not be the subject of any further internal, external, judicial, or other <br />dispute resolution process. Once the decision is deemed final, nothing in this Agreement <br />shall prevent the prevailing party from pursuing remedies available to it, including without <br />limitation a judicial remedy, to collect any amounts owed to it by the other party. Also, <br />nothing in this Agreement shall prevent a party from asserting defenses, claims, causes <br />of action or demands in response to an internal appeal, mediation, arbitration or judicial <br />remedy initiated by the disputing party. This provision shall survive termination of this <br />Agreement. <br />9.5 PRECEDENTIAL EFFECT OF DECISIONS — The parties agree that any disputes that <br />arise under this Agreement shall be considered independently and on their own merits <br />without regard for any other determination made by a third -party through one of the post - <br />appeal processes or by Company through the internal provider appeal process or <br />otherwise. The parties agree that none of the determinations made under this <br />Agreement through one of the dispute resolution processes described above shall be <br />used as precedent for other disputes that may arise between Company and Medical <br />Group or between Company and any third -party. This provision shall survive termination <br />of this Agreement. <br />9.6 OTHER APPEALS — In the event a dispute arises that does not meet the requirements to <br />be reviewed through one of the other dispute resolution processes set forth herein, <br />Medical Group may contact Medical Group's provider consultant to attempt to resolve the <br />dispute informally or Medical Group may send a written request as outlined further in the <br />Company's Administrative Manual. The Administrative Manual provides detailed contact <br />information. If the dispute cannot be resolved, Medical Group may make a formal <br />request for a meeting on the disputed issue(s) no later than ninety (90) days from the <br />date Medical Group first raised the dispute with the Company. The request must be made <br />in writing and provide details on the disputed issue(s) and the relief requested. The <br />meeting may be by phone or in person and should be held within forty-five (45) days of <br />the Company's receipt of the meeting request. <br />The Company will provide Medical Group with a written determination of its position on <br />the disputed issue(s) no later than thirty (30) days after the meeting. <br />X. GENERAL PROVISIONS <br />10.1 SEVERADI.LITY — If any provision of this Agreement is rendered invalid or unenforceable <br />by any state or federal statute or regulations or declared null and void by any court of <br />Asuris MGA Agreement (Rev. 05/2017) A18816854AA Page 17 of 20 <br />
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