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SHJ25-014 MOLINA HEALTHCARE RENEWAL - PARTIALLY EXECUTED
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2026-05-19 10:00 AM - Commissioners' Agenda
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SHJ25-014 MOLINA HEALTHCARE RENEWAL - PARTIALLY EXECUTED
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Last modified
5/14/2026 12:06:00 PM
Creation date
5/14/2026 12:03:27 PM
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Meeting
Date
5/19/2026
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Item
Request to Approve an Agreement with between Kittitas County and Molina Healthcare of Washington, Inc.
Order
8
Placement
Consent Agenda
Row ID
144485
Type
Contract
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ATTACHMENT <br />REQUIRED PROVISIONS <br />(HEALTH CARE SERVICE PLANS) <br />This attachment sets forth applicable State Laws or other provisions necessary to reflect compliance with State <br />Laws. This attachment will be automatically modified to conform to subsequent changes to Law. All provisions <br />of the Agreement not specifically modified by this attachment remain unchanged and will control. In the event of <br />a conflict between this attachment and any other provision in the Agreement, the provisions in this attachment <br />will control. Capitalized terms used in this attachment will have the same meaning ascribed to them in the <br />Agreement unless otherwise set forth in this attachment. Any purported modification or any provision in this <br />attachment that is inconsistent with Law will not be effective and will be interpreted in a manner that is consistent <br />with the applicable Law. For the avoidance of doubt, this attachment does not apply to the Medicare Product or <br />the Medicare -Medicaid Product to the extent such Products are preempted by Federal Law. <br />1. Provider hereby agrees that in no event, including, but not limited to nonpayment by Health Plan, Health <br />Plan's insolvency, or breach of this Agreement shall Provider bill, charge, collect a deposit from, seek <br />compensation, remuneration, or reimbursement from, or have any recourse against a Member or person <br />acting on their behalf, other than Health Plan, for services provided pursuant to this Agreement. This <br />provision shall not prohibit collection of deductibles, co -payments, coinsurance, and/or noncovered <br />services, which have not otherwise been paid by a primary or secondary carrier in accordance with <br />regulatory standards for coordination of benefits, from Members in accordance with the terms of the <br />Member's health program. <br />2. Provider agrees, in the event of Health Plan's insolvency, to continue to provide the services promised in <br />this Agreement to Members of Health Plan for the duration of the period for which premiums on behalf of <br />the Member were paid to Health Plan or until the Members discharge from inpatient facilities, whichever <br />time is greater. <br />3. Notwithstanding any other provision of this Agreement, nothing in this Agreement shall be construed to <br />modify the rights and benefits contained in the Members health program. <br />4. Provider may not bill the Member for Covered Services (except for deductibles, co -payments, or <br />coinsurance) where Health Plan denies payments because Provider has failed to comply with the terms or <br />conditions of this Agreement. <br />5. Provider further agrees (i) that the provisions of (1), (2), (3), and (4) of this Attachment shall survive <br />termination of this Agreement regardless of the cause giving rise to termination and shall be construed to <br />be for the benefit of Members, and (ii) that this provision supersedes any oral or written contrary <br />agreement now existing or hereafter entered into between Provider and Members or persons acting on <br />their behalf. <br />6. If Provider contracts with other providers or facilities who agree to provide Covered Services to Members <br />of Health Plan with the expectation of receiving payment directly or indirectly from Health Plan, such <br />providers or facilities must agree to abide by the provisions of (1), (2), (3), (4), (5), (7), (11) and (12) of <br />this Attachment. <br />7. Willfully collecting or attempting to collect an amount from a Member knowing that collection to be in <br />violation of this Agreement constitutes a class C felony under RCW 48.80.030 (5) & (6). <br />8. Health Plan will provide Provider not less than sixty (60) days' notice of changes that affect Provider's <br />compensation and that affect health care service delivery unless changes to federal or state law or <br />regulations make such advance notice impossible, in which case notice shall be provided as soon as <br />possible. Subject to any termination and continuity of care provisions of the contract, Provider may <br />terminate the contract without penalty if the Provider does not agree with the changes. No change to this <br />Agreement may be made retroactive without the express consent of Provider. <br />9. Health Plan does not preclude or discourage Provider from informing Members of the care they require, <br />including various treatment options, and whether in their view such care is consistent with medical <br />MHWPROV22.3 MHWPSA/Revised Jan 2024 Page 18 of25 <br />
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