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SHJ25-009 KCJ AND CHPW - PARTIALLY EXECUTED
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2025-06-17 10:00 AM - Commissioners' Agenda
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SHJ25-009 KCJ AND CHPW - PARTIALLY EXECUTED
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Last modified
6/12/2025 12:54:55 PM
Creation date
6/12/2025 12:49:59 PM
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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 SHJ25-009 Community Health Plan of Washington - 1115 Medicaid Re-Entry Initiative
Order
16
Placement
Consent Agenda
Row ID
132242
Type
Contract
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refund sooner that six (6) months after receipt of the request. This section is not applicable to <br />subrogation claims. <br />4.5.4 Except in the case of fraud, Facility may not request payment from CHPW to satisfy a <br />claim unless it does so in writing within twenty-four (24) months after the date the claim was <br />denied or payment intended to satisfy the claim was made. In the case of coordination of <br />benefits, Facility must request any additional balances owed from CHPW within thirty (30) <br />months after original payment was made. Additional payment cannot be requested any <br />sooner than six (6) months after request is made. This section is not applicable to <br />subrogation claims. <br />V. MUTUAL OBLIGATIONS <br />5.1 Independent Contractors. CHPW and Facility are independent entities. No provision herein <br />is intended to create, nor shall be construed to create, any relationship other than that of <br />independent entities contracting with each other solely for the purpose of effecting this <br />Agreement. Neither party nor any of its respective employees and subcontractors shall be <br />construed to be the principal, agent, employee, or representative of the other. <br />5.2 Representatives. Each party shall designate a representative who is responsible for <br />coordination and communication between Facility and CHPW in performance of this Agreement <br />including review of the Provider Manual and subsequent updates. Each party's representative <br />and their respective contact information are set forth on Exhibit E, attached hereto and <br />incorporated herein. Each party shall promptly notify the other in writing pursuant to Section 7.( <br />of any changes to the representative's designation or contact information. <br />5.3 Compliance. <br />5.3.1 Each party shall comply in all material respects with requirements of applicable <br />federal and state laws and regulations, the terms of this Agreement and applicable terms and <br />conditions set forth in the CHPW's contracts with state and federal agencies obligating it to <br />administer all or some of the Benefit Plans referred to herein, including: <br />5.3.1.1 Applicable Medicare laws, regulations, and CMS Instructions; <br />5.3.1.2 Title VI of the Civil rights Act of 1964 implemented by regulations at 45 CPR 84; <br />5.3.1.3 The Age Discrimination Act of 1975, implemented by regulations at 45 CFR 91; <br />5.3.1.4 The Rehabilitation Act of 1973; <br />5.3.1.5 The Americans with Disabilities Act; <br />5.3.1.6 The False Claims Act (32 U.S.C. §3729 et seq.); <br />5.3.1.7 The Anti -kickback Statute (Section 112813(b) of the Social Security Act); <br />5.3.1.8 Other laws applicable to recipients of federal funds; <br />5.3.1.9 Applicable federal and state laws that pertain to enrollee rights; and <br />5.3.1.10 As applicable, additional provisions included in a Benefit Plan Exhibit in Exhibit B, <br />including but not limited to Medicaid Additional Provisions set forth in Exhibit 13-1-13, <br />attached hereto and incorporated herein, and Medicare Advantage Additional Provisions <br />set forth in Exhibit 13-2-13, attached hereto and incorporated herein. <br />2020 Facility Agmt— Template Page 15 of 51 Contract It {Contract #1-(PRC Agreement ID) <br />
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