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SHJ25-008 COORDINATED CARE CONTRACT - PARTIALLY EXECUTED
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2025-06-17 10:00 AM - Commissioners' Agenda
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SHJ25-008 COORDINATED CARE CONTRACT - PARTIALLY EXECUTED
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Last modified
6/12/2025 12:53:41 PM
Creation date
6/12/2025 12:49:58 PM
Metadata
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Template:
Meeting
Date
6/17/2025
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Item
Request to Approve Agreement SHJ25-008 Coordinated Care - 1115 Medicaid Re-Entry Initiative
Order
15
Placement
Consent Agenda
Row ID
132242
Type
Contract
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7.2.2. With Cause. This Agreement, or the participation of any Contracted Provider as a <br />Participating Provider in one or more Products under this Agreement, may be terminated by either Party giving at <br />least 90 days' prior written notice of termination to the other Party if such other Party (or the applicable Contracted <br />Provider) is in breach of any material term or condition of this Agreement and such other Party (or the Contracted <br />Provider) fails to cure the breach within the 60 day period immediately following the giving of written notice of such <br />breach. Any notice given pursuant to this Section 7.2.2 must describe the specific breach. In the case of a termination <br />of a Contracted Provider, Provider shall immediately notify the affected Contracted Provider of such termination. <br />7.2.3. Suspension of Partici ation. Unless expressly prohibited by applicable Regulatory <br />Requirements, Health Plan has the right to immediately suspend or terminate the participation of a Contracted <br />Provider in any or all Products by giving written notice thereof to Provider when Health Plan determines that (i) <br />based upon available information, the continued participation of the Contracted Provider appears to constitute an <br />immediate threat or risk to the health, safety or welfare of Covered Persons, or (ii) the Contracted Provider's fraud, <br />malfeasance or non-compliance with Regulatory Requirements is reasonably suspected. Provider shall immediately <br />notify the affected Contracted Provider of such suspension. During such suspension, the Contracted Provider shall, <br />as directed by Health Plan, discontinue the provision of all or a particular Covered Service to Covered Persons. <br />During the term of any suspension, the Contracted Provider shall notify Covered Persons that his or her status as a <br />Participating Provider has been suspended. Such suspension will continue until the Contracted Provider's <br />participation is reinstated or terminated. <br />7.2.4. Insolvency. This Agreement may be terminated immediately by a Party giving written notice <br />thereof to the other Party if the other Party is insolvent or has bankruptcy proceedings initiated against it. <br />7.2.5. Credentialing. The status of a Contracted Provider as a Participating Provider in one or more <br />Products may be terminated immediately by Health Plan giving written notice thereof to Provider if the Contracted <br />Provider fails to adhere to Health Plan's credentialing criteria, including, but not limited to, if the Contracted Provider <br />(i) loses, relinquishes, or has materially affected its license to provide Covered Services in the State, (ii) fails to <br />comply with the insurance requirements set forth in this Agreement; or (iii) is convicted of a criminal offense related <br />to involvement in any state or federal health care program or has been terminated, suspended, barred, voluntarily <br />withdrawn as part of a settlement agreement, or otherwise excluded from any state or federal health care program. <br />Provider shall immediately notify the affected Contracted Provider of such termination. <br />7.3. Effect of Termination. After the effective date of termination of this Agreement or a Contracted <br />Provider's participation in a Product, this Agreement shall remain in effect for purposes of those obligations and <br />rights arising prior to the effective date of termination. Upon such a termination, each affected Contracted Provider <br />(including Provider, if applicable) shall (i) continue to provide Covered Services to Covered Persons in the applicable <br />Product(s) during the longer of the 90 day period following the date of such termination or such other period as may <br />be required under any Regulatory Requirements, and, if requested by Company, each affected Contracted Provider <br />(including Provider, if applicable) shall continue to provide, as a Participating Provider, Covered Services to Covered <br />Persons until such Covered Persons are assigned or transferred to another Participating Provider in the applicable <br />Product(s), and (ii) continue to comply with and abide by all of the applicable terms and conditions of this Agreement, <br />including, but not limited to, Section 3.5 (Hold Harmless) hereof, in connection with the provision of such Covered <br />Services during such continuation period. During such continuation period, each affected Contracted Provider <br />(including Provider, if applicable) will be compensated in accordance with this Agreement and shall accept such <br />compensation as payment in full. Company shall make a good faith effort to provide written notice of termination <br />within 15 working days of receipt or issuance of a notice of termination to all Covered Persons who are patients seen <br />on a regular basis by each affected Contracted Provider that is terminated, regardless of the cause for termination. <br />The Contracted Provider will inform any Covered Person that seeks the Contracted Provider's services that this <br />Agreement has been terminated. <br />7.4. Survival of Obligations. All provisions hereof that by their nature are to be performed or complied <br />with following the expiration or termination of this Agreement, including without limitation Sections 2.8, 2.11, 3.3, <br />PPA WA - Kittitas County Public Health - 05.07.2025 - iCMProviderAgreement_360268 Page 13 of 24 <br />
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