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Asuris Northwest Health Medicare Provider Compliance Addendum This is a Medicare Provider Compliance Addendum (the "Compliance Addendum") to the Participating Agreements and any and all amendments, addenda, attachments or exhibits thereto (collectively, the "Agreements" and each individually, the "Agreement"), between Asuris Northwest Health ("Asuris") and (the "Provider" or "FDR" as those terms are defined below), effective this First day of October, 2016. WHEREAS, Asuris has contracts to administer Medicare Advantage Plans and/or Medicare Part D plans (collectively "Medicare") for the Centers for Medicare & Medicaid Services ("CMS") of the U.S. Department of Health and Human Services ("HHS") to administer Medicare benefits within certain counties; WHEREAS, the first tier, downstream or related entity ("FDR") has entered into an Agreement to provide healthcare and or administrative services related to Asuris's Medicare business; and WHEREAS, CMS requires Asuris to incorporate additional Medicare Compliance contract language into its agreements with first tier, downstream, and related entities. NOW, THEREFORE, in consideration, and with full understanding that these provisions may be outlined in the main Agreement or addendum, the parties agree and will abide by the Compliance Addendum, as follows: 1. Com liance with Medicare Laws Re ulations and CMS Guidance: FDR agrees to comply with all applicable Medicare laws, regulations, and CMS guidance. 42 C.F.R §§ 422.504(i)(4)(v) and 423.505(i)(4)(iv). 2. Medicare Standards of Conduct and Policies and Procedures: FDR agrees to make available Standards of Conduct and policies and procedures to all of its employees who provide administrative services or health care services for Asuris's Medicare business pursuant to this Agreement at the time of hire and annually thereafter. FDR may either provide (a) Asuris's Standards of Conduct and policies and procedures to FDR's employees, or (b) FDR's own comparable Standards of Conduct and policies and procedures to FDR's employees. Medicare Managed Care Manual ("MMC Manual"), Chapter 21, §§ 50.1.3 and 50.3.1; and Medicare Prescription Drug Benefit Manual ("PDB Manual"), Chapter 9, §§ 50.1.3 and 50.3.1. 3. Conflict of interest: FDR agrees to comply with Asuris's Conflict of Interest Policy or its own Conflict of Interest Policy that complies with CMS requirements. FDR will require its governing body, officers, and senior leadership (as applicable) to sign a conflict of interest at the time of hire and annually thereafter certifying that they are free from any conflict of interest related to Medicare. 42 C.F.R. §§ 422.503(b)(4)(vi)(A) and 423.504(b)(4)(vi)(A). Fraud, Waste, and Abuse ("FWA") and General Compliance Training: FDR agrees that all of its employees who provide administrative services or health care services for Asuris's Medicare business pursuant to the Agreement participate in Medicare Parts C and D FWA training and Medicare Parts C and D General Compliance training within ninety (90) days of hire and annually thereafter. Required FWA and General Compliance training is developed and provided by CMS and is available through the CMS Medicare Learning Network (MLN) at http://www.cros.gov/MLNProducts. FDRs who have met the FWA certification requirements through enrollment into the Medicare program or accreditation as a Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) are deemed to have met the training and educational requirements for fraud, waste, and abuse only. FDR must maintain documentation sufficient to demonstrate to Asuris that FDR fulfilled the FWA and General Compliance training requirement. MMC Manual, Chapter 21, § 50.3.2; PDB Manual, Chapter 9, § 50.3.2; 42 C.F.R. §§ 422.503(b)(4)(vi)(A) & (C) and 422.504(b)(4)(vi)(A) & (F). Reporting Cam liance and FWA Concerns: FDR agrees to report compliance or FWA concerns to CMS or Asuris. Reporting should occur within five (5) days of discovery; if there is an immediate impact to beneficiary access to care and/or a financial strain, please report immediately but at least within twenty-four (24) hours. Asuris has a no -tolerance policy for retaliation or retribution against any employee or FDR for good -faith reporting of FWA. 42 C.F.R. §§ 422.503(b)(4)(vi)(D) and 423.504(b)(4)(vi)(D). Asuris MA Compliance Addendum 10/2016 Al8816854AA Page 1 of 3