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2.10 2.11 2.12 2.13 2.14 2.15 2.16 FCHN-PRO-0420 I 6 programs , pharmacy and specialty pharmacy programs, pharmacy benefit substitution process, referral management, quality assurance and improvement programs and Medical Necessity oversight. Provider further agrees to share Participant information as specifically related to the Medical Management Program and utilization management functions described above. Provider is required to allow access to Participant records , provide for copying and release of records, and to speak to the FCHN or Payor Medical Director or designee upon request, as allowed by applicable law and regulation, in a timely manner to facilitate the Medical Management Program and utilization review . Non-compliance with the Medical Management Program may result in non-payment of Provider by Payor. Subcontracts If Provider subcontracts with any other provider to provide Covered Services to Participants hereunder, Provider understands and agrees that the subcontract and the subcontracting provider must comply with all terms of this Agreement and applicable state law and regulation . Non-Covered Services/Exclusions Provider shall provide notice to Participant of Participant's personal financial obligations for non-covered services, which includes services that are not Medically Necessary. Provider may bill a Participant for non-covered services only if Provider has , prior to the provision of non-covered services, obtained a written acknowledgment and acceptance of financial responsibility for such services from the Participant after full disclosure to Participant of (i) Provider's intent to bill Participant for non-covered services, and (ii) the non-liability of FCHN or Payors for such non-covered services. FCHN Provider Policies and Procedures Providers shall comply with all Provider Policies and Procedures which are electronically accessible to Provider, as updated with sixty (60) days advance notice to Provider, or if applicable, the notice described in Section 3.2 below, including, but not limited to, billing and claims payment, provider credentialing, Participant grievances, appeal and adverse benefit determination procedures, Utilization Review, quality management, data reporting requirements, pharmacy benefit substitution processes , confidentiality requirements and any applicable federal or state requirements. Subject to any continuation of care provisions of this Agreement, Provider may terminate this Agreement in accordance with Section 8.2.1 if Provider does not agree with such updates. In the event that any provision in the Provider Policies and Procedures or any amendment thereto is inconsistent with the terms of this Agreement, the terms of this Agreement shall control. Claims Payment Provider shall look only to Payors for payment of claims. FCHN is not a guarantor of, or in any way responsible to Provider for, any claim payments. Acceptance of Payment Provider shall seek and accept payment from Payors for Covered Services as outlined in Schedule B to this Agreement in accordance with the FCHN Provider Policies and Procedures and the applicable Benefit Plan. Provider shall have the right to bill, charge , or collect a deposit directly from the Participant for any applicable Deductible, Co-payment, or Coinsurance, or , consistent with Section 2.11, for any service that is not a Covered Service. In no event may Provider bill or collect from Participants any difference between Provider's charges and the amount of the FCHN fee schedule for Covered Services set forth in Schedule B. Compliance Provider agrees to comply with all of the terms of this Agreement, all applicable federal and state laws and regulations, all applicable rules and standards of accrediting agencies having jurisdiction over and designated by FCHN, and as applicable, the ethical standards of the American Medical Association, all of the above as they may be adopted, amended, revised, or renumbered. Provider Group Where Provider is a Provider Group, Provider agrees to ensure that the licensed physicians and other healthcare providers comprising the Provider Group are informed of, and agree to comply with and be bound by, the terms of this Agreement. 5