SHJ25-014 MOLINA HEALTHCARE INTERIM AGREEMENT- PARTIALLY EXECUTED

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1.4 Claims for Covered Reentry Initiative Services will be subject to a review for correct coding. This review includes coding rules outlined in the appropriate Molina Healthcare provider manual ("Provider Manual"), HCA and Centers for Medicare and Medicaid Services ("CMS") guidelines including but not limited to the National Correct Coding Initiative. Claims are also subject to post -claim coding review and audits by Health Plan for coding, fraud, waste and abuse other payment integrity concerns. Provider agrees to provide information and otherwise cooperate in reviews and/or audits by Health Plan, the Health Care Authority, or any other government agency. 1.5 Services must be listed as covered with the specific code listed in the Reentry Initiative Covered Procedure Code List posted on HCA's Provider Billing Guide and Fee Schedule page. Providers must obtain prior authorization for all Covered Reentry Initiative services that are listed in Molina Healthcare's Provider Manual as requiring Prior Authorization. 1.6 Provider agrees to abide by the terms of Attachment A. Molina Healthcare is not permitted to cover the services if Provider does not agree to this term. 1.7 Provider agrees to cooperate with Molina Healthcare's medical director and utilization review staff by providing information when requested for prior, concurrent and/or retrospective review of patient care, discharge planning, and coordination of needed services. 1.8 If a Member's coverage with Molina Healthcare ends, the specific terms in this Agreement will terminate for that Member on that day as well. 1.9 Claims shall be submitted to Molina Healthcare as directed by HCA: i. At the following address: Molina Healthcare of Washington, Inc., PO Box 22612 Long Beach, CA 90801; or ii. EDI Submission Number: 38336 1.10 Claims will be subject to terms in Attachment A. 2. Other Terms and Conditions: 2.1 Standards for Provision of Care. a. Provision of Covered Reentry Initiative Services. Provider shall provide Covered Reentry Initiative Services to Members, within the scope of Provider's business and practice, in accordance with this Agreement, Health Plan's policies and procedures, the terms and conditions of the IIealth Plan Product which covers the Member, and the requirements of any applicable government sponsored program. b. Standard of Care. Provider shall provide Covered Reentry Initiative Services to Members at a level of care and competence that equals or exceeds the generally accepted and professionally recognized standard of practice at the time of treatment, all applicable rules and/or standards of professional conduct, and any controlling governmental licensing requirements. c. Facilities, Equipment, and Personnel. Provider's facilities, equipment, personnel and administrative services shall be at a level and quality as necessary to perform Provider's duties and responsibilities under this Agreement and to meet all applicable legal requirements, including the accessibility requirements of the Americans with Disabilities Act. d. Member Eligibility Verification. Provider shall verify eligibility of Members for coverage by Health Plan under the Apple Health Medicaid program prior to rendering services. 2.2 Compliance with Applicable Law. Provider shall comply with all applicable state and federal laws ("Laws") governing the delivery of Covered Reentry Initiative Services to Members or other aspects of its operations including, but not limited to ACA Section 1557m Title VI of the Civil Rights Act of 1964; the Age Discrimination Act of 1975; the Section 504 of the Rehabilitation Act of 1973; the Balanced Budget Act of 1997; the Americans with Disabilities Act, and Federal Drug and Alcohol Confidentiality Laws in M11WCm1SSCA.082025 Revised Aug 2025 (MHW) Page 2 of 12