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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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2.9.2.2 Facility may determine that a Member is a Dual Eligible Enrollee by reviewing <br />plan information on the Member's ID card, through the CHPW internet provider portals, <br />or as otherwise set forth in the Provider Manual. <br />2.10 Non -Covered Services. Facility and professional providers rendering services within the <br />Facility shall notify Members of their personal financial obligations for non -Covered Services <br />before rendering such services. Facility and Facility -Based Providers shall not bill a Member for <br />non -Covered Services unless the Member has, prior to the provision of non -Covered Services, <br />signed a written acknowledgement and acceptance of financial responsibility after full written <br />disclosure of (i) Facility's intent to bill Member for non -Covered Services, and (ii) the non - <br />liability of CHPW for such non -Covered Services. <br />2.11 Hold Harmless and Insolvency. <br />2.11.1 In no event, including, but not limited to non-payment by CHPW, CHPW insolvency, <br />or breach of this Agreement, shall Facility bill, charge, collect a deposit from, seek <br />compensation, remuneration or reimbursement from, or have any recourse against HCA, a <br />Member, or person acting on a Member's behalf other than CHPW for Covered Services <br />provided pursuant to this Agreement. This provision shall not prohibit Facility's collection of <br />Copayments, Coinsurance and Deductibles and/or fees for non -Covered Services from <br />Member in accordance with the terms of this Agreement and Member's Benefit Plan that <br />have not otherwise been paid by a primary or secondary carrier in accordance with regulatory <br />requirements for coordination of benefits. <br />2.11.2 In the event of CHPW's insolvency, Facility shall continue to provide the Covered <br />Services promised in this Agreement to Members for the duration of the period for which <br />premiums on behalf of Members were paid to CHPW or until Member is discharged from <br />inpatient facilities, whichever time is greater. <br />2.11.3 Notwithstanding any other provision herein, nothing in this Agreement shall be <br />construed to modify the rights and benefits contained in a Member's Benefit Plan. <br />2.11.4 Facility may not bill Members for Covered Services (except for Copayments, <br />Coinsurance and Deductibles) when CHPW denies payment because Facility failed to <br />comply with the terms of this Agreement. <br />2.11.5 If Facility contracts with other providers or facilities to provide Covered Services to <br />Members with the expectation of receiving payment directly or indirectly from CHPW, such <br />providers or facilities must agree to abide by the requirements of this Section 2.11. <br />2.11.6 This Section 2.11 shall survive termination of this Agreement regardless of the cause <br />giving rise to such termination and shall be construed to be for the benefit of Members, and <br />this provision supersedes any oral or written contrary agreement now existing or hereafter <br />entered into between Facility and Members or persons acting on their behalf. <br />2020 Facility Agmt — Template Page 9 of 51 Contract #{Contract #1-fPRC Agreement ID) <br />
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