Laserfiche WebLink
provide the greatest degree of understanding, and written at a sixth (6th) grade reading level, in <br />addition to any other requirements imposed by CHPW based on the nature of the materials. Such <br />materials must generally be approved by CHPW prior to use and must comply with the State <br />Contract. <br />10. Coordination of Benefits. Services and benefits available under the Agreement shall be <br />secondary to any other medical coverage, except in accordance with Chapter 284-51 WAC, as <br />applicable. CHPW shall not refuse or reduce services provided under the Agreement solely due <br />to the existence of similar benefits under any other health care contract, except in accord with <br />applicable coordination of benefits rules in WAC 284-51. CHPW shall provide prenatal care and <br />preventive pediatric care and then seek reimbursement from third parties. <br />11. Subcontracting. Facility may not subcontract any services under the Apple Health <br />Program without the prior written consent of CHPW. Any subcontract entered into by Facility <br />must be in writing consistent with 42 C.F.R. § 434.6, and all Facility requirements contained in <br />this Exhibit must be propagated downward into any other lower tiered subcontracts. <br />12. Reasonable Accommodations for Disabilities. Facility shall cooperate with CHPW to <br />make reasonable accommodation for Members with disabilities, in accordance with the <br />Americans with Disabilities Act, for all Covered Services and shall assure physical and <br />communication barriers shall not inhibit Members with disabilities from obtaining Covered <br />Services. <br />13. Surgical Health and Safety. If Facility is a hospital, ambulatory care surgery center, or <br />office -based surgery site, Facility shall endorse and adopt procedures for verifying the correct <br />patient, the correct procedure and the correct surgical site that meet or exceed those set forth in <br />the Universal ProtocolTM development by the Joint Commission or other similar standards. <br />14. Practice Guidelines. Facility shall comply with applicable physical and behavioral health <br />practice guidelines adopted by CHPW. <br />15. Supervision of Behavioral Health Care Providers. If applicable under the behavioral <br />health practice guidelines, Facility will receive payment for the supervision of behavioral health <br />providers whose license or certification restricts them to working under supervision, effective as <br />of the first day of the term following August 2019. <br />16. Timely Access to Care. Facility shall offer access to care comparable to that offered to <br />commercial enrollees or if Facility serves only Medicaid enrollees, then comparable to Medicaid <br />fee -for -service. <br />17. Hours of'Operation. Facility's hours of operation for Members shall be no less than the <br />hours of operation offered to any other of Facility's patients. <br />18. Administrative Simplification. Unless otherwise directed by CHPW, Facility shall use <br />and follow the most recent updated versions of: Current Procedural Terminology ("CPT"); <br />International Classification of Diseases ("ICD"); Healthcare Common Procedure Coding System <br />("HCPCS"); CMS Relative Value Units ("RVUs"); CMS billing instructions and rules; The <br />Diagnostic and Statistical Manual of Mental Disorders; NCPDP Telecommunication Standard <br />2020 Facility Exh BI B - McaidProv Page 33 of 51 Contract #{Contract 0}-(PRC Agreement ID) <br />