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2025-06-17 10:00 AM - Commissioners' Agenda
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Fully executed agreement
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Last modified
9/16/2025 9:37:03 AM
Creation date
9/16/2025 9:36:37 AM
Metadata
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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
Fully Executed Version
Supplemental fields
Item
Request to Approve Agreement SHJ25-008 Coordinated Care - 1115 Medicaid Re-Entry Initiative
Order
15
Placement
Consent Agenda
Row ID
132242
Type
Contract
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interpretation of this Agreement, or any other clairn or cause of action hereunder, whether sounding in tort, contract <br />orunder stahrte (a'Dispute') shall first be addressed by exhausting the applicable policies andprocedures pertaining <br />to claims payment, credentialing, utilization management, or other programs. If, at the conclusion of these applicable <br />procedures, the matter is not resolved to the satisfaction of the Provider Party and the Administrator Party, or if there <br />are no such policies, their the Provicler Party and the Administrator Party agree that they will ergage in a period of <br />good faith negotiations between their designated representatives who have authority to settle the Dispute, which <br />negotiations may be initiated by either the Provider Party or the Administrator Parly upon written request to the other, <br />provided such request takes place within one year of the date on which the requesting party first had, or reasonably <br />should have had, knowledge of the event(s) giving rise to the Dispute. Administrator Party must render a decision on <br />a Provider Parby oomplaint within a reasonable time for the type of dispute. In the case of billing disputes, the <br />Administrator Party must render a decision within 30 days of a cornplaint. If a written complaint is submitted by the <br />Provider Pmty and the Administrator Party does not grant or reject such written complaini lrrithin 30 days, then the <br />Provider Party may, but is not required to, choose to proceed as if the complaint is rejected. and submit the complaint <br />to nonbinding mediation. Alternatively, if the matter has not been resolved within 60 days of such request, either the <br />Provider Party or the Adminiskator Party may initiate arbikation purzuani to Section 6,2 below by providing a writteir <br />request to the other party. The other party may, but is not required to, consent to such binding arbitration process. <br />6.2. Artitration. IfmuhmllyagrceduponbytheProviderPartyandtheAdministratorParty,eitherofthe <br />Provider Party and the AdministratorParty wishing to pursue the Dispute as provided in Section 6.1 may submit it to <br />binding arbitration conducted in accordance with the Commercial Arbibation Rules of the American Arbitration <br />Associaxion ("AAA"). In no event may any arbitration be initiated more than I year following, as applicable, the end <br />of the 60 day negotiation pe,riod set forth in Section 6.1 , or the date of notice of temrination. Arbitration proceedings <br />shall be conducted by an arbitrator chosen from the National Healthcare Panel at a mutually agreā¬d upon location <br />within the State. Any arbitration in which the total amount in controversy is less than $100,000 shall be conducted in <br />a single hearing day. The Parfies and the Contracted Providers, on behalf of themselves and those that they may now <br />or hereafter represent, agree to and do hereby waive any right to pursug on a class basis, any Diqpute. Each ofthe <br />Provider Party and the Adminishator Party shall bear its own costs and attorneys' fees related to the arbitration except <br />that the AAA's admiuistralive fees, all arbitrator compensation and travel and other expense$, and al1 costs of any <br />proofproduced at the direct request ofthe arbitrator shall be borne equally by the applicable parties, and the arbitrator <br />shall not have the authority to order otherwise. The existence of a Dispute or arbitration proceeding shall not in and <br />of itself constitute cause for terrrination of this Agreement, Except as hereafter provicled during an arbitration <br />proceeding, each of the Provider Party and the Administrator Party shall continue to perform its obligations under <br />this Agreement pending the decision of the arbitrator, Nothing herein shall bar either the Provider Party or the <br />Administrator Party from seeking emergency injunctive relief to preclude any actual or perceived breach of this <br />Agreement. Nothing contained inthis Article VI shall limit a Party's right to terrninate this Agreemont with orwithout <br />cause in accotdance with Section 7.2. Nothing herein shall be construed to require altematiye dispute reeolution to <br />the exclusion ofjudicial remedies. <br />ARTICLE VII - TERM AND TERMINATION <br />7.1,. Term, This Agreement is effective as of the Effective Date, and will remain in effeet for an initial <br />term ('Tnitial Term') of 1 year, a{ter which it will automatically renew for successive terms of one year each (each a <br />"Rsnewal Term'), unless this Agreement is sooner terminated as provided in this Agreement or either Party gives <br />the other Party written notice of non-renewal of this Agreement not less than i80 days prior to the end of the then- <br />cufrent term. <br />7.2. Termination. This Agreernent, or the participation of Provider or a Contracted Provider as a <br />Participating Provider in onc or more Products, may be tenninated or suspencled as set forth below. <br />7.2.1. U.S.o-n Notice. This Agreement may be tenninated by either Party giving the other Party at <br />least 180 days' prior written notice of zuch termination. <br />PPA WA - I(ttitas CountyPublic I-Iealth - 05.07.2025 - ICMProviderAgreement_360268 Page 12 of24
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