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o <br />Kittitas County Public Health <br />Contract/Agreement Review Form <br />Kittiiae Ccurrty <br />Public Health <br />D?partmaFi <br />Fund/Department <br />Today's Date <br />116- Pubic Heatlh Agenda Date <br />11t2512025 Legal Request #:12072 <br />Contract/Agreeme nt lnformation <br />Bu lnformation <br />Pass Thro <br />tl <br />TotalS Amount: No max amount <br />Begin Date: 0110112026 <br />Contract/Agreement #: K8630 <br />End Date: 1213112029 <br />Contract/Agreem e nt Title : I nteragency Ag reement for Medicaid Administrative Claiming <br />Agenry: Washington State Health Care AuthorityContract/Agreement <br />The purpose of this Contract is to support Medicaid related outreach and linkage activities <br />. <br />performed by Local Health Jurisdictions (LHJ)to Washington State residents who live within its <br />jurisdiction. inese activities assist residents who have no or inadequate medical coverage, and <br />includes explaining the benefits of the Medicaid program, assisting them in the Medicaid <br />application and renewal processes, and linking them to Medicaid covered services. This <br />Agreement provides a piocess for partially reimbursing the Contractor for allowable and <br />relsonable expenses associated with the-time its staff spend performing Medicaid Administrative <br />Claiming (MAC) activities. <br />Contract/Agreement Summa ry <br />of Auditor's <br />reofP R.HCE!VEN <br />s <br />/)-r's i-Date <br />Date <br />Kittitas County Prosecutor and Auditor Review and Comment: <br />Expense Code(s): <br />Revenue Code(s): <br />Agenry is not suspended/disbarred Not Checked (reason) <br />116 - 612.95.51001 <br />1 1 6 - 612.95.333.93.778 <br />Amount to Pass Through <br />Agency to Pass Through <br />Expense Code: <br />Su b-Contract Approved Date: <br />ADMIN Version: O Supersedes:0 Date Adopted : 12 / oU2O24 Katle Odiaga By: