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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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confidentiality and disclosure of medical records, including disclosures pursuant to court orders and <br />subpoenas; and (b) timely access by enrollees to their records and information. 42 C.F.R. §§ 422.118 <br />and 422.504(a)(13). <br />16. Dual-eli ig bles: If FDR is a health care provider, FDR agrees that all enrollees eligible for both <br />Medicare and Medicaid will not be held liable for Medicare Part A and B cost sharing when the State <br />is responsible for paying such amounts. As a provider, FDR will be informed of Medicare and <br />Medicaid benefits and rules for enrollees eligible for Medicare and Medicaid, and may not impose <br />cost-sharing that exceeds the amount that would be permitted for an individual under Medicaid if the <br />individual were not enrolled in such a plan. Provider will (a) accept Asuris's payment as payment in <br />full, or (b) bill the appropriate State source. 42 C.F.R. §§ 422.504(g)(1)(iii) and 422.504(i)(3)(i). <br />17. ASLIFIS'S contractual obligations: FDR's services and activities pursuant to the Agreement are <br />consistent and comply with Asuris's contractual obligations. 42 C.F.R. § 422.504(i)(3)(iii). <br />18. Prompt -payment: If FDR is a health care provider, Asuris's contract or written agreement with FDR <br />will include a prompt payment provision. 42 C.F.R. §§ 422.504(c), 422.520, 422.520(b), <br />423.505(i)(3)(v), and 423.520. <br />19, Delegatmn: If Asuris delegates to another organization the selection of providers, contractors, or <br />subcontractors, Asuris retains the right to approve, suspend, or terminate any such arrangement. 42 <br />C.F.R. § 422.504(i)(5). <br />20. Amendments required by law: If Medicare laws, regulations, or CMS guidance require a change to <br />any provision of this Compliance Addendum, this Compliance Addendum will be deemed amended to <br />conform with the law, regulation, or guidance on the date said requirements become effective. Asuris <br />will make reasonable business efforts to notify FDR of those changes, but in no event does any lack <br />of notice change the applicability of federal law. <br />21. Location of Services: FDR agrees that it shall not perform functions offshore, or delegate functions to <br />offshore entities or persons, without obtaining advanced approval in writing from Asuris and <br />demonstrating compliance with CMS guidelines and Asuris policies, terms, and conditions. <br />22. Ikon -Discrimination: FDR agrees to provide covered services to members without regard to race, <br />ethnicity, national origin, religion, gender, age, mental or physical disability, sexual orientation, <br />genetic information or source of payments. MMC Manual, Chapter 4, § 10.5. <br />Any term not defined herein shall have the meaning set forth in the Agreement. The terms of this Compliance <br />Addendum shall become a part of, and shall be specifically incorporated into, the terms of the Agreement. In <br />the event of any conflict or inconsistency between the terms of the Compliance Addendum and the terms of <br />the Agreement or any Medicare Advantage Addendum(s), the terms of the most current Compliance <br />Addendum shall apply. <br />IN WITNESS WHEREOF, the parties hereto enter into this Compliance Addendum effective on the Effective <br />Date set forth above. <br />Asuris Northwest Health <br />Sincerely, <br />John Partin <br />VP, Network Management <br />Asuris MA Compliance Addendum 1012016 A18816854AA Page 3 of 3 <br />
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