Laserfiche WebLink
ASURIS NORTHWEST HEALTH <br />2013 MEDICARE ADVANTAGE AMENDMENT <br />EFFECTIVE DATE: December 31, 9999 <br />This 2013 Medicare Advantage Amendment (the "Amendment") amends the following agreements <br />(collectively, the "Agreements" and each individually, the "Agreement") and any and all amendments, <br />addenda, attachments or exhibits to those Agreements, between Asuris Northwest Health ("Company") <br />and Provider, as that term is defined below: <br />1. Participating Provider Agreement <br />2. Participating Provider Medical Group Agreement <br />3. Participating Facility Agreement <br />4. Participating Hospital Agreement <br />5. Participating Organizational Provider (Home Medical Equipment) Agreement <br />6. Participating Organizational Provider (Laboratory) Agreement <br />RECITALS <br />A. The Provider and Company are parties to one or more of the Agreements. <br />B. The Company desires to amend the Agreements to address changes in Provider compensation <br />payable under the Medicare Advantage program to account for (i) the federal sequestration <br />announced for 2013, and (ii) other future unplanned, unforeseen, or unusual events. <br />C. Therefore, in consideration of those premises and other good and valuable consideration, the <br />receipt and sufficiency of which are hereby acknowledged, the parties agree to the terms and <br />conditions set forth in this Amendment. <br />AGREEMENT <br />1. Definitions. For purposes of this Amendment, the following terms will have the following stated <br />meanings. Any term not defined in this Amendment will have the meaning given to the term in <br />the Agreement. <br />"Advance Monthly CMS Payments" means the advance monthly payments that are made by <br />CMS to Company, in Company's capacity as a Medicare Advantage organization, in return for <br />providing Covered Services to MA Members during those months. <br />"Advance Payment Adjustment" means the amount of any reduction in the Advance Monthly <br />CMS Payments that are made by CMS to Company, expressed as a percentage reduction from <br />the amount of the Advance Monthly CMS Payments that Company would have otherwise <br />received in the absence of the reduction, and that is caused by or that results from any <br />unplanned, unforeseen, or unusual budgetary event that was not contemplated by Company, or <br />that was not contemplated by Provider, or that was not contemplated by both Company and <br />Provider, when Company and Provider agreed upon the Medicare Advantage Compensation that <br />is otherwise applicable or payable to Provider under the Agreement. Unplanned, unforeseen, or <br />unusual events include without limitation any state or federal budgetary sequestrations, any <br />changes in state or federal law or policy, any mid -year budget adjustments, or any unanticipated <br />taxes or fees that cause a reduction in the Advance Monthly CMS Payments otherwise due to, or <br />expected to be received by, Company. <br />Asuris Medical Standard 2013 Medicare Advantage Sequestration Amendment A18816854AA Pagel <br />