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Asuris Agreement
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2018-06-05 10:00 AM - Commissioners' Agenda
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Asuris Agreement
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Last modified
1/18/2019 2:03:50 PM
Creation date
1/18/2019 2:03:02 PM
Metadata
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Template:
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
Fully Executed Version
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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ASURIS NORTHWEST HEALTH <br />2013 MEDICARE ADVANTAGE AMENDMENT <br />EFFECTIVE DATE: December 31, 9999 <br />This 2013 Medicare Advantage Amendment (IM "Amendment') amends the following agreements <br />(collee!lvely, the "Agreements· and each in dividuylfy, the *Agreement'") and any and all amendments, <br />addenda, attachments or exhibits to those Agreements, between Asurls 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 Faclllty Agreement <br />4 . Participating Hospital Agreement <br />5 . Participating Organizational Provider (Home Medical Equipment) Agreement <br />6 . Participating Organizallonal 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 Oi) other Mure 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 />'Advanc e ·Monlhly CMS Payments' means the advance monthly payments that are made by <br />CMS to Company, in Company 's capac ity as a Medicare Advanlage organlzaUor,, in ratu m for <br />providing Covered Services to MA Members during those months. <br />Advance Psyinent Adjustment· means the amount or 11ny reduct ion In the Aovance Mont.lily <br />CMS Payme·nts that are made by CMS lo Com pany , ex:pressed as a percentyge reduction from <br />the afTlo unt of the Advance Monthly OMS Payments that Company would ha ve other.vise <br />received lh tne absence. or th e reducllon , .ind 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 1hat was not contemplated by both Company and <br />Provide r, when Company Bnd Provider agree d upon the Medicare Advantage Compensation that <br />s otherwise applicable or payable to Provider un.der the Agreement . Unplanned, unforeseen, or <br />unusual events Include without llmltat on any state or federal budgetary sequestrations , any <br />changes In state or federal law or policy , any mid-year budget adJus1me111s , or any unaolfclpated <br />taxes or hies that cause a reduction in the Advance Monthly CMS Payments otherwise due to, or <br />expected to be received by, Company. <br />Aaurla Medlc9I Standard 2013 Medicare Advantao• Sequestration Amendment A1881S854AA Page1
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