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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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Template:
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-DFA1-4BOC-AFE8-6A4A63440080 <br />Z.2.2Faciliry shall cooperate in and comply with CHPW credentialing criteria and <br />verifi cation procedures for facilities. <br />2.2.3 Facility must inform CHPW in writing within three (3) business days of any adverse <br />action taken against it in regard to its licensure accreditation. <br />2.2.4Facility represents that it is not and at no time has been excluded from participation in <br />any state or federally funded health care program including Medicare and Medicaid. Facility <br />shall promptly notify CIIPW of any threatened, proposed or actual exclusion of Facility, a <br />Facility employee or a Facility-Based Provider from any state or federal health care program. <br />2.2.5 Facility's loss or suspension of licensure or accreditation, or its exclusion from any <br />federally funded health care program, including Medicare and Medicaid, shall constitute <br />cause for immediate termination pursuant to Section 6.2 of this Agreement. <br />2.2.6Facilify shall participate in and cooperate with CFIPW's education and training <br />programs for Participating Providers and for Members. <br />2.3 Services. <br />2.3.1Facility provides Covered Services at the locations listed in Exhibit A, attached hereto <br />and incorporated herein. Facility shall promptly notifu CHPW in writing of changes to the <br />information in Exhibit A. <br />2.3.2Facility shall deliver or arrange for the efficient and effective provision of Covered <br />Services to Members of those Benefit Plans listed on Exhibit B and indicated as being <br />included in this Agreement. Covered Services shall be Medically Necessary and appropriate <br />to Members' clinical condition in accordance with the terms hereof, the Provider Manual, <br />industry standards, accreditation requirements, and applicable state and federal laws and <br />regulations. <br />2-3.3 Facility shall not delegate the provision of Covered Services without CIIPW's prior <br />written approval. <br />2.3.4Facility shall provide all services hereunder to Members in the same manner and <br />timeliness as such services are made available to non-Members, without regard to an <br />individual's participation in private health care coverage or in one of the state and federal <br />sponsored health programs, in accordance with this Agreement and industry standards. <br />2.3.5 Services shall include provision of clean facilities and equipment; maintenance of <br />sufficient numbers of courteous, consumer-oriented, properly trained and credentialed staff; <br />and maintenance of orderly and efficient systems for providing health services. Facility shall <br />not require duplicate tests or procedures except as Medically Necessary. <br />2.3.6 Member Access to Services <br />2020 Facility Agmt- Template Page 4 of51 Contract #5908-662684
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