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

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3.41 Overpayment. Provider shall report to Carrier when it has received an overpayment and will return the overpayment to the Carrier within 60 calendar days after the date on which the overpayment was identified. Provider will notify Carrier in writing of the reason for the overpayment. 3.42 Electronic Visit Verification (EVV). Provider shall cooperate with State requirements for electronic visit verification for personal care services and home health services, as applicable. 3.43 Bi-Directional Behavioral and Physical Health Integration. Outpatient behavioral health and primary care practices shall use reasonable efforts to complete the Washington Integrated Care Assessment (WA-ICA) as defined by the Clinical Integration Assessment Workgroup. Outpatient behavioral health and primary care practices shall use reasonable efforts to complete the WA- ICA in July of each year, consistent with the implementation schedule defined by the Clinical Integration Assessment Workgroup. SECTION 4 ADDITIONAL REQUIREMENTS FOR DELEGATED ADMINISTRATIVE FUNCTIONS 4.1 This Section applies to those Providers to whom Carrier has delegated an Administrative Function. Provider shall perform those delegated Administrative Functions set forth in the Agreement through an exhibit or otherwise. Any changes or modifications to the Administrative Functions shall be agreed to in writing by the parties. 4.2 Prior to delegation, Carrier shall perform an evaluation of Provider's ability to successfully perform and meet the requirements of the State Contract for any delegated Administrative Function. 4.3 Provider agrees to cooperate with Carrier's requirements for delegation of Administrative Functions, including but not limited to ongoing monitoring and an annual evaluation for the purpose of determining Provider's compliance with requirements related to the delegated Administrative Functions. As a result of such monitoring activities, Carrier shall identify to Provider any deficiencies or areas for improvement mandated under the applicable State Contract and Provider shall take appropriate corrective action. 4.4 If Provider is at financial risk, Provider shall comply with, and maintain throughout the term of the Agreement, the solvency requirements established by Carrier from time to time. Carrier shall monitor Provider's compliance with such solvency requirements. 4.5 Provider shall maintain records necessary to adequately document the performance of delegated Administrative Functions and shall release to Carrier any data or information necessary for Carrier to perform its reporting obligations under the State Contract. 4.6 In addition to its termination rights under the Agreement, Carrier shall have the right to revoke any delegated Administrative Functions Carrier delegates to Provider under the Agreement or impose other sanctions consistent with the applicable State Contract if in Carrier's reasonable judgment Provider's performance of a delegated Administrative Function is inadequate. SECTION 5 CARRIER RE' QUIREMENTS 5.1 Prompt Payment. Carrier shall pay Provider pursuant to the State Contract, applicable State law and regulations, including the timeliness of payment standards specified in applicable state law, noted in the Agreement and the timeliness of payment standards specified for Medicaid fee -for - service in Section 1902(a)(37)(A) of the Social Security Act and 42 CFR 447.46, 42 CFR WIC/STATE PROGRAMS REGAPX WA.02.25 40