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conllde nffalily and disclosure of medical records, including disclosures pursuant to court orders and
<br />subpoenas ; and (bl timely access by enrollee,s to the ir records arid information , 42 C.F.R, §§ 422 .1 18
<br />and 422 ,604(a)(13).
<br />18, D~I~~; It FDR Isa health care provider, FDR agrees lhat all emrolleei. eligible forbolli
<br />Medicare and Medicaid will not be held Hable for Medicare Part A and B cost sharing ,When the State
<br />I responsib le lor payln,g !iU¢h amount$. As a provider , FOR wlll ba Informed of Medicare and
<br />Medicaid benefits and rules for enrollees elig ib le for Medlcare and Med icaid. ahd may not. impose
<br />cos-t-sharlng that exceeds the amount lhat would be permitted for an ,-idl11ldual 1,1nder Medicaid If the
<br />Ind ividual were not enrolled In such a plan. Provider will (a) accept Asur l s's payment as payment n
<br />ru11, or {b) bill Che 11ppropriate Stale source . 42 C,F,R . §§ 422 .504(9)(1 )(111) and 422 ,604(1)(3)(1).
<br />17 , A sy ris's can rao ~JJml!aolio,m;; FDR's -services and aclMlles pursuant to fhe Agreement are
<br />cons istent and comply with Asuris's COi'ltrac:tval obl igations. 42 C.F ,R. § 422.504Q)(3)(Tii),
<br />18 . Prompt wmeJ!t II FDR Is a health care provider , Asuris's contract or written agreement with FDR
<br />will Include a.prompt payment prov l&i!ln , 42 C,F .R. §§ 422,504(c), 422.520, 422,S20(b),
<br />423.506(i)(3)(1,), and 423 .520 . ·
<br />19. !1ti1~g~tlrui: If Asuris delegates to anothe, organization the selecl!on of providers, con tractors . cir
<br />subcontractors , Asu ris retains the ri ght to approve , suspend , or terminate any such arrangement 42
<br />C.F .R. § 422.504(1)(5,).
<br />20 , fillJ§MIJ) nts re_cu !J,w.d ~ If Medicare laws, regulat lon:t, or CN'(S au ldJ1nce requ re ._a change to
<br />any prov ision of this Complla11ce Addendum, th is Compllan.ce Addendum wlll be deemed amended to
<br />conform with the law, r~ulaUon, or gu idance on the date !la id re q1,uramenls become effective . Asur ls
<br />,viii make reasonable bus iness efforts lo notlry FDR ol thos.e changes, tlul tn no event does any lack
<br />of notice cl'lange the eppliC11b Illy of rederal law, ·
<br />21 ~f Se ce : FDR agrees that It shall not perform runctrons offshore. o delegate functions to
<br />offshore entities O!' pe sons , ,wlthoul obtaining advanced appf()ll!ll ln vnilfng from Asu rfs and
<br />demonstrating compliance '#Ith CMS guldeHnes and Asuris policies, terms -, and conditions ,
<br />22 . Nru:!:Qi.§crimination : FDR agrees 1.0 PfOV de cove l ~d services to mem~rs without regard lo race,
<br />ethnicity . nat ional orig in, religion , gender, age, mental or ptJys fcal disability , sexual orientation,
<br />.,genetic inforrnallon or source of payments . M¥C Manual , Chapter 4, § 10.5.
<br />Any term not defined herein shall have ·the mean ing aetforth in the Agreemenl The terms of this Compllance
<br />Ac(dendum shall become a part of. and shall be spec iflcafly ncorporated ltito. lhe terms oflhe Agreement. In
<br />the event of any conflict or fnconsi&t~ncy betwee r, the terms of tM Compliance Addendum end the term&-of
<br />the '°!greemeht or any Medicare Adva,-itage Addendum(s), the terms of the most current Compliance
<br />Addendum shall apply .
<br />IN WITNESS WHEREOF, the parties hereto enler into this Compliance Addendum effecUve on the Effective
<br />Dale set forth above,
<br />Asurla Northwest Health
<br />Sincerely,
<br />John Partin
<br />VP, Network Management
<br />Aaurls MA CompHmnce Addendum 1012018 A18818854AA Pa~e 3 of3
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