SHJ25-011 UNITED HEALTHCARE & KCJ Carceral 2025 Medicaid Contract - PARTIALLY EXECUTED

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Washington Regulatory Requirements Appendix In addition to our understandings in the agreement between you and us, there are certain additional items which Washington laws and regulations require us to include in our contract. This Washington Regulatory Requirements Appendix (the "Appendix") sets forth those items and is made part of the agreement between you and us. These requirements apply to products or services sponsored by participating entities or issued or administered by, or accessed through us to the extent they are regulated under Washington laws and for which Washington laws control. The requirements in this Appendix, however, do not apply to the extent they are preempted by the Medicare Modernization Act or other applicable law. We each agree to be bound by the terms and conditions contained in this appendix. In the event of a conflict or inconsistency between this appendix and any term or condition contained in the agreement between you and us, this appendix shall control except with regard to benefit contracts outside the scope of this appendix. For the purpose of this appendix, "enrollee," "enrolled participant," or "member" shall mean customers who are enrolled in products or services insured or administered by us or any participating entity. This appendix will be deemed to be updated to incorporate any changes to the laws and regulations referenced herein, including any changes to definitions referenced herein, effective as of the date of such changes. 1. The following provision is added as bullet -point number 7 and does not replace section "Guiding Principles" of the agreement: Communication. We each agree that nothing in this agreement in any way precludes or discourages you from informing patients of the care they require, including various treatment options, and whether in their view such care is consistent with medical necessity, medical appropriateness, or otherwise covered by the patient's benefit contract with us. We shall not prohibit, discourage, or penalize you otherwise practicing in compliance with the law from advocating on behalf of a member. We do not preclude or discourage patients or those paying for their coverage from discussing the comparative merits of different health carriers with their providers, including you. This prohibition specifically includes prohibiting providers participating in those discussions even if critical of a carrier, including us. 2. The following provisions are added to the end of the section and do not replace section "What you will do" of the agreement: A. Enrolled Participant Protection Provision. You hereby agree that in no event, including, but not limited to nonpayment by us or a participating entity, or our insolvency or breach of this agreement, shall you bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against an enrolled participant or person acting on their behalf, other than us, for services provided pursuant to this agreement. This provision does not prohibit collection of copayments, coinsurance, deductibles and/or payment for non -covered services, which have not otherwise been paid by a primary or secondary carrier in accordance with regulatory standards for coordination of benefits, from enrolled participants in accordance with the terms of the enrolled participant's benefit contract. You agree, in the event of our or a participating entity's insolvency, to continue to provide the services promised in this agreement to enrolled participants for the duration of the period for which premiums on behalf of the enrolled participant were paid or until the enrolled participant's discharge from inpatient facilities, whichever time is greater. Notwithstanding any other provision of this agreement, nothing UHC/SMGA.RFGAPX09.24.WA -19-