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5.1 Nationbl Committee for Quality. Assurance (.'T{COA") Acgfeditation of Health Plans Stan&rds. Eaoh facility agrees to: i) cooperate with Qualfu Management and Improvement (*QI') activities; ii) maintain the confidentiality of a Covered Persons information and records pursuant to the Agreement; and iii) allow the Company to use facility's performance data, 6. Long Term Services and Suppgrts ("LTSS'l and Home and Communitv-Based Services ('HCBS".) Providers. If Provider or a ContraotEd Providq is a provider of LTSS, the following provisions apply: 6.1 Definition. LTSS generally includes assistance with daily self-care activities (e.g., walking, toileting, bathing, and dressing) and activities that support an independent lifestyle (e.g., food preparation, transportation, and managing medications). The broad category of LTSS also includEs care and service coordination for people who live in their own home, a residential sotting, a nursing ftcility, or other institutional setiing. Home and community-based servicm are a subset of LTSS that functions outside of institutional care to maximize independence in the community. 6.2 HCBS Waiver Authorization. Provider shall not ptovide HCBS Covered Services to Covered Person without the required HCBS waiver authorization. 6.3 Conditions for Reimbursernent. No payment shall be made to the Provider unless the Provider has skictly conformed to ths policies and procedures of the HCBS Waiver Program, including but not limited to not providing HCBS Covered Ssrvice,s without prior authorization of Health Plan. For the purposes of this schedule, "HCBS Waiver Progranf' shall mean any special Medicaid program operated under a waiver approved by the Centers forMedicare andMedicaid Services whichallows the provision of a specialpackage of approved services to Covered Person 6.4 Acknowledgement. Health Plan acknowledges that Provider is a provider of LTSS antl is not necessarily a provider of medical or health care services. Nothing in this Agreement is intended to require Provider to provide medical or health care sErvises that Provider does not routinely provide, but would not prohibit providers from offering these services, as appropriate, 6.5 Notification Requiremonk. Provider or the applicable Contracted Provider shal1 provide the following notifications to Health P1an, via written notice or via telephone contact at a number to be provided by Health P1an, within the following time frames: 6.5.1 Provider or the applicable Conlracted Provider shall notify EIeaIth Plan of a Covered Person's visit to urgent care or the emergency department of any hospital, or of a Covered Person's hospitalization, within 24 hours of becoming aware of such visit or hospitalization. 6.5.2 Provider or the applicable Contracted Provider shall notifu Health Plan of any ohcrrge to the designated/assigned services being provicled under a Covered Person's plan of care and/or service plan, withtn 24 hours of beooming aware of zuch change. 6.5.3 Provider or the applicable Contracted Provider shall notify I-Iealth Plan if a Covored Person misses an appointment with Provider, within 24 hours of becoming aware of such missed appoinhnent. 6.5.4 Provider or the applicable Contracted Provider shall notifr Health Plan of any change in a Covered Person's medical or behavioral health condition, wifhnn24 hours of becoming aware of such change , (Examples of changes in condition are set forth in the I{ealth Plan Policies and Procedures.) 6.5,5 Provider or the applicable Contracted Provider shall notify Health Plan of any safety issue identified by Provider or Contracted Provider or its agent or subcontractor, within 24 hours of the PPA WA - Ifittitas Counry Public Health - 05.07.2025 - ICMproviderAgreernent_360269 Page2l of24