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which includes, but is not limited to, posting on Health Plan's interactive web -portal, with a physical
<br />copy available upon request. Supplemental Materials become binding upon Provider as of the
<br />Effective Date indicated on the Supplemental Materials or, if applicable, the Effective Date will be
<br />determined in accordance with this Agreement.
<br />2.5 Licensure and Standing.
<br />a. Licensure. Provider warrants and represents that it is appropriately licensed to render health care
<br />services within the scope of Provider's practice, including having and maintaining a current narcotics
<br />number, where appropriate, issued by all proper authorities. Provider shall provide evidence of
<br />licensure to Health Plan upon request. Provider shall maintain its licensure in good standing, free of
<br />disciplinary action, and in unrestricted status throughout the term of this Agreement. Provider shall
<br />immediately notify Health Plan of any change in Provider's licensure status, including any
<br />disciplinary action taken or proposed by any licensing agency responsible for oversight of Provider.
<br />b. Unrestricted Status. Provider represents to its best knowledge, information, and belief, neither it, nor
<br />any of its owners, employees, temporary employees, volunteers, consultants, members of its board of
<br />directors, officers, or contractors (collectively, "Personnel") have been excluded from participation in
<br />the Medicare Program, any state, commonwealth or the District of Columbia's Medicaid Program, or
<br />any other federal health care program (collectively "Federal Health Care Program"). Provider agrees
<br />that it must check the Department of Health and Human Services Office of Inspector General List of
<br />Excluded Individuals and Entities, the System for Award Management, any other list maintained by a
<br />state, commonwealth, or federal government and every state, commonwealth, and the District of
<br />Columbia's Medicaid exclusion lists to determine whether Provider or any of its Personnel have been
<br />excluded from participation in any Federal Health Care Program. These databases must be checked
<br />for any new Personnel and thereafter not less than monthly. Provider will notify Health Plan
<br />immediately in writing if Provider determines that Provider or any of its Personnel are suspended or
<br />excluded, or could be suspended or excluded, from any Federal Health Care Program. Provider agrees
<br />that it is subject to 2 CFR Part 376 and will require its Personnel to agree that they are subject to 2
<br />CFR Part 376. If a governmental agency imposes a penalty, sanction, or other monetary adjustment or
<br />withhold due to Provider's non-compliance with this provision or any payments were made to
<br />Provider while under non-compliance with this provision, Health Plan may collect the amount by: (i)
<br />offsetting from amounts due to Provider, or (ii) issuing a recoupment letter to Provider. If required,
<br />such offset or recoupment will be done in a manner that is compliant with Laws and Government
<br />Program Requirements. This section will survive any termination.
<br />c. Malpractice and Other Actions. Provider shall give immediate notice to Health Plan of: (a) any
<br />malpractice claim asserted against it by a Member, any payment made by or on behalf of Provider in
<br />settlement or compromise of such a claim, or any payment made by or on behalf of Provider pursuant
<br />to a judgment rendered upon such a claim; (b) any criminal investigations or proceedings against
<br />Provider; (c) any convictions of Provider for crimes involving moral turpitude or felonies; and (d) any
<br />civil claim asserted against Provider that may jeopardize Provider's financial soundness.
<br />2.6 Member Hold Harmless. Provider hereby agrees that in no event, including, but not limited to
<br />nonpayment by Health Plan, Health Plan's insolvency, or breach of this contract will Provider bill,
<br />charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any
<br />recourse against a Member or person acting on their behalf, other than Health Plan, for services provided
<br />pursuant to this Agreement. This provision does not prohibit collection of deductibles, copayments,
<br />coinsurance, and/or payment for Covered Reentry Initiative Services, which have not otherwise been paid
<br />by a primary or secondary issuer in accordance with regulatory standards for coordination of benefits,
<br />from Members in accordance with the terms of the Member's health plan.
<br />2.7 Offset. In the event that Health Plan determines that a Claim has been overpaid or paid in duplicate, or
<br />that funds were paid which were not provided for under this Agreement, Health Plan may make a written
<br />request for repayment: (1) within twenty-four (24) months after the date that the payment was made; (2)
<br />within thirty (30) months after the date that the payment was made if the request is related to coordination
<br />MHWCBHSSCA.082025 Revised Aug 2025 (MH W) Page 4 of 12
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