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Docusign Envelope lD: CEBC6B3C-DFA1-4BOC-AFE8-6A4A63440080 <br />2.6.1.I Facility shall cooperate in CHPW's collection, production and distribution of <br />comparative data for quality assurance and utilization review. CHPW may use such data <br />regarding Facility and its Facility-Based Providers' performance in activities such as <br />quality improvement, public reporting to consumers, preferred status designations and <br />other activities that promote transparency to consumers and Members. <br />2.6.I.2 Facility shall cooperate and communicate freely with CHPW regarding quality <br />issues and notify CHPW of any Member's medical situation thatmay benefit from case <br />management using the process set forth inthe Provider Manual. <br />2.6.2Facility shall endorse and adopt procedures for veriffing the correct patient, the <br />correct procedure and the correct surgical site. Such procedures shall meet or exceed <br />those set forth in the Universal Protocol developed by the Joint Commission. <br />2.7 Member Complaint Procedures. Facility shall comply with CHPW's Member complaint <br />and appeals procedures that are set forth inthe Provider Manual, for resolution of a Member's <br />complaints or appeals that may arise from Facility's provision of services or CHPW's denial of <br />coverage. Facility shall notifu CHPW of Member complaints and appeals that it receives. <br />Facility shall cooperate with CHPW in the investigation and resolution of Member complaints <br />and appeals regarding Facility's provision of services. <br />2.8 Record Keeping and Access. Facility shall prepare, maintain, and retain accurate Member <br />health records including appropriate medical, administrative and financial records related to this <br />Agreement and to Covered Services provided hereunder in accordance with the Provider <br />Manual, industry standards, applicable state and federal sponsored health programs, and <br />applicable federal and state statutes and regulations. Such records shall be maintained for the <br />maximum period required by federal or state law as set forth in Section 5.5, below. CHPW shall <br />have continued access to Facility's records necessary for CHPW to perform its obligations <br />hereunder, to administer its Benefit Plans, and to comply with federal or state law or regulations <br />and applicable accreditation requirements. CHPW prefers electronic copies of such information, <br />data and records, but Facility may provide hard copies at its own expense. <br />2.9 Member Copayments, Coinsurance and Deductibles. <br />2.9.1Facility shall collect and may retain Member Cost Sharing amounts authorized under <br />the applicable CHPW Benefit Plan for Covered Services. <br />2.9.2Members enrolled in a CHPW Medicare Advantage Special Needs Plan and for whom <br />a state provides coverage ("Dual Eligible Enrollees") will not be required to pay any Cost <br />Sharing amounts for Covered Services covered by Medicare Parts A and B when the state <br />Medicaid program is required to pay. <br />2.9.2.1In lieu of collecting such Cost Sharing under the Medicare Advantage Benefit <br />Plan, Facility should either (i) bill such Cost Sharing amounts to the appropriate state <br />Medicaid source or (ii) forego collecting cost sharing amounts and accept the Medicare <br />Advantage Benefit Plan reimbursement as payment in full. <br />2020 Facility Agmt - Template Page 8 of51 Contract #5908-662684