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State Contrast. 3.11, Qare Coordination. Provider shall comply wiih Health Plan's policies and support Ilealth Plan's efforts regarcling care coordinatior\ transfers between levels of care and medication management. If applioable, Provider shall ensure that discharge plans and facilitation to post-discharge services are documented in a Covered Person's electronic health record. If Provider is an inpatient substance use disorder (SIID) heatment provider, then Provider shall have policies in place for prompt exchange of Covered Person information between behavioral health treatment agencies to facilitate continuity of care, consistent with the State Contract. 3.L2, Sulcontractine. Provider may not subcontract any services under the Apple Health Program without the prior written consent of I{ealth Plan. Any subcontract entered into by Provider must be in writing consistent with 42 C.F.R. $ 434.6, and a1l Provider requirements contained in this Attachment must be propagated downward into any other iower tiered subcontracts. 3.13, Reasonable-Accommodations for Disabilities. Provicler shall cooperate with Health Plan to make reasonable accommodation for Covered Persons with disabilities, in accordance withthe Americans with Disabilities Act, fur all Covered Services and shall assure physical and communication barriers shall not inhibit Covered Persons with disabilities from obtaining Covered Services. 3.14. Surgical lleallh and Safety. If Provider is a hospital, ambulatory cars surgery center, or office-based surgery site, Provider shall endorse and adopt procedures for verifying the corect patienl, the correct procedure and the correct surgical site that rneet or exoeed those set forth in the Universal ProtocolrM development by the Joint Commission or other similar standards. 3.15, Practice Guidelines. Provider shall comply with applicable physical and behavioral health practice guidelines adopted by Health Plan. 3.16. Timely Acqpss to Care. Provicler shall offer access comparable to that offered to commercial enrollees or if Provider serves only Medicaid enrollees, then comparable to Medicaid fee-for-service. 3 .17 . Hours of Operation. Provider's hours of operation for Covered Persons shall be no less than the hours of operation offered to any other of Provicler's patients. 3.18. Adrninishative SimpliJioation. Unless oiherwise directed by Health Plan, Provider shall use and follow the most recent updated versions of: Current Procedural Terminology f 'CPT"); International Classification of Diseases ("ICD'); Healthcare Common koceclure Coding System ("HCPCS"); CMS Relative Value Units f'RVUs'); CMS biiling instructions and rules; The Diagnostic and Statistical Manual of Mental Disorders; NCPDP Telecommunication Standard D.O.; and Medi-Span@ Master Drug Dirta or any other nationally recognized drug database with approval by HCA. 3.79. Claims Payment Standatals. Except as otherwise allowed under Applicable Law, orunless otherwise agreed by the Parlies in writing on a claim-by-c1aim basis, Health Plan shall meet the following minimxn sllandards for timeliness of payment: 95% of Clean Claims shal1 be paid within 30 calendar days of receipt of the paper or electronic claim i 95o/o of all claims shall be paid or denied within 60 calendar days of receipt of the paper or electronio clarm; and99% of Clean Claims shall be paid or denied within 90 calendar days of receipt. 3,20, App_-ointment Wait Time Standards. As applicable, Provider shall meet the following appointment wait time standards with respect to Covered Persons: (a) Transitional healthcare services by a PCP shall be available for clinical assessment and care planrring within swen calendar days of discharge from inpatient or institutional care for physical or behavioral health disorders or discharge from a SUD treatment progftur. PPA WA - Kittitas County Public Hsalth - 05.A1.2025 - ICMProviderAgreernenl36(D68 Page4 of 12