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SHJ25-009 fully executed document
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2025-06-17 10:00 AM - Commissioners' Agenda
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SHJ25-009 fully executed document
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Last modified
9/17/2025 3:19:55 PM
Creation date
9/17/2025 3:19:18 PM
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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 SHJ25-009 Community Health Plan of Washington - 1115 Medicaid Re-Entry Initiative
Order
16
Placement
Consent Agenda
Row ID
132242
Type
Contract
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Docusign Envelope lD: CEBC6B3C-DFA1-486C-AFE8-6A4A634400B6 <br />provide the greatest degree of understanding, and written at a sixth (6th) grade reading level, in <br />addition to any other requirements imposed by CHPW based on the nature of the materials. Such <br />materials must generally be approved by CHPW prior to use and must comply with the State <br />Contract. <br />10. Coordination of Benejits. Services and benefits available under the Agreement shall be <br />secondary to any other medical coverage, except in accordance with Chapter 284-51WAC, as <br />applicable. CHPW shall not refuse or reduce services provided under the Agreement solely due <br />to the existence of similar benefits under any other health care contract, except in accord with <br />applicable coordination of benefits rules in WAC 284-5I. CHPW shall provide prenatal care and <br />preventive pediatric care and then seek reimbursement from third parties. <br />11. Subcontracting. Facility may not subcontract any services under the Apple Health <br />Program without the prior written consent of CHPW. Any subcontract entered into by Facility <br />must be in writing consistent with 42 C.F.R. S 434.6, and all Facility requirements contained in <br />this Exhibit must be propagated downward into any other lower tiered subcontracts. <br />12. Reasonable Accommodations for Disabilities. Facility shall cooperate with CHPW to <br />make reasonable accommodation for Members with disabilities, in accordance with the <br />Americans with Disabilities Act, for all Covered Services and shall assure physical and <br />communication barriers shall not inhibit Members with disabilities from obtaining Covered <br />Services. <br />13. Surgical Health and Safety. If Facility is a hospital, ambulatory care surgery center, or <br />office-based surgery site, Facility shall endorse and adopt procedures for verifying the correct <br />patient, the correct procedure and the correct surgical site that meet or exceed those set forth in <br />the Universal ProtocolrM development by the Joint Commission or other similar standards. <br />14. Practice Guidelines. Facility shall comply with applicable physical and behavioral health <br />practice guidelines adopted by CHPW. <br />15. Supervision of Behavioral Health Care Providers. If applicable under the behavioral <br />health practice guidelines, Facility will receive payment for the supervision of behavioral health <br />providers whose license or certification restricts them to working under supervision, effective as <br />of the first day of the term following August 2019. <br />16. Timely Access to Care. Facility shall offer access to care comparable to that offered to <br />commercial enrollees or if Facility serves only Medicaid enrollees, then comparable to Medicaid <br />fee-for-service. <br />17. Hours of Operation. Facility's hours of operation for Members shall be no less than the <br />hours of operation offered to any other of Facility's patients. <br />18. Administrative Simplffication.Unless otherwise directed by CHPW, Facility shall use <br />and follow the most recent updated versions of: Current Procedural Terminology ("CPT"); <br />International Classification of Diseases ("ICD"); Healthcare Common Procedure Coding System <br />("HCPCS"); CMS Relative Value Units ("RVUs"); CMS billing instructions and rules; The <br />Diagnostic and Statistical Manual of Mental Disorders; NCPDP Telecommunication Standard <br />2020 Facility Exh BIB - McaidProv Page 33 of51 Contract #5908-662684
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