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Docusign Envelope lD: CEBC6B3C-DFA1-4BGC-AFE8-6A4A63440086 <br />ExmnrrB-2-B <br />Mnprcmr Aov.qNTA,cn <br />Rneurnnp PnovrsroNs <br />The Centers for Medicare and Medicaid Services ("CMS") requires that specific terms and <br />conditions be incorporated into agreements between a Medicare Advantage Organization and a First <br />Tier Entity and between a First Tier Entity and Downstream Entity to comply with the Medicare <br />laws, regulations, and CMS instructions, including, but not limited to, the Medicare Prescription <br />Drug, Improvement and ModernizationAct of 2003, Pub. L. No. 108-173,117 Stat.2066 <br />('MMA");and <br />Except as provided herein, all other provisions of the Agreement or other agreements between <br />Community Health Plan of Washington ("CI{PW''or "MA Organization") and Facility not <br />inconsistent with this Exhibit B-2-B shall remain in full force and effect. This Exhibit B-2-B shall <br />supersede and replace any inconsistent provisions to such agreements with regard to services <br />provided to Members of a Medicare Advantage Benefit Plan. To ensure compliance with required <br />CMS provisions, this Exhibit B-2-B shall continue concurrently with the term of such agreements. <br />Definitions. The following definitions apply to this Exhibit B-2-B: <br />Centers for Medicare and Medicaid Services ('CMS"): the agency within the Department of Health <br />and Human Services that administers the Medicare progtam. <br />Completion of Audit: completion of audit by the Department of Health and Human Services, the <br />Govemment Accountability Office, or their designees of a Medicare Advantage Organization, <br />Medicare Advantage Organization contractor or related entity. <br />Downstream Entity: any party that enters into a written arrangement, acceptable to CMS, with <br />persons or entities involved with the MA benefit, below the level of the arrangement between an <br />MA organization and a First Tier Entity. These written arrangements continue down to the level <br />of the ultimate provider of both health and administrative services. <br />Final Conhact Period: the final term of the contract between CMS and the Medicare Advantage <br />Organization. <br />First Tier Entrty: any party that enters into a written arrangement, acceptable to CMS, with an <br />MA organization or applicant to provide administrative services or health care services for a <br />Medicare eligible individual under the MA program. Facility is a First Tier Entity for purposes <br />of this Agreement. <br />Medicare Advantage ("MA"): an altemative to the traditional Medicare program in which private <br />plans run by health insurance companies provide health care benefits that eligible beneficiaries <br />would otherwise receive directly from the Medicare program. <br />2020 Facility Exh B2B - MAProv Page 43 of5L Contract #5908 -662684