SHJ25-014 MOLINA HEALTHCARE RENEWAL - PARTIALLY EXECUTED

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10. Provider shall assure that all sterilizations and hysterectomies performed under this Agreement are in compliance with 42 CFR 441 Subpart F, and that the Sterilization Consent Form (DSHS 13-364(x)) or its equivalent is used. 11. Provider shall make reasonable accommodation for enrollees with disabilities, in accord with the Americans with Disabilities Act, for all Covered Services and shall assure physical and communication barriers shall not inhibit enrollees with disabilities from obtaining Covered Services. 12. Provider shall comply with all Program Integrity provisions, including, but not limited to the Washington Medicaid Contract and the following regulations: Sections 1902(a)(68) and 1128J(d) of the Social Security Act, 42 C.F.R. § 438.608 , 42 C.F.R. § 455, 42 C.F.R. § 1000 through 1008, and Chapter 182-502A WAC, and Chapters 74.09 and 74.66 RCW and as documented in Health Plan Provider Manual and as set forth by 42 CFR 438.608 and the Health Plan's contracts with HCA. 13. Provider shall comply with Patient Identifying Information from an alcohol or drug abuse "program", as defined in 42 C.F.R. §2.11, that is federally assisted in the manner described in 42 C.F.R. §2.12(b), then it is fully bound by the federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R. Part 2, with respect to such information and records, including but not limited to the duty to resist injudicial proceedings any efforts to obtain access to such information or records, other than as permitted by law. 14. Provider warrants and represents that it has not been convicted of crimes as specified in Section 1128 of the Social Security Act (42 U.S.C. 1320a-7), excluded from participation in the Medicare or Medicaid program, assessed a civil penalty under the provisions of Section 1128, entered into a contractual relationship with an entity convicted of a crime specified in Section 1128, or taken any other action that would prohibit it from participation in Medicaid and/or state health care programs. 15. Behavioral Health Services. If Provider provides behavioral health services, Provider must: a. Hold all necessary licenses, certifications, and/or permits as required by law for the performance of the activity to be performed under this Agreement. b. Notify the Health Plan in the event of a change in status of any required license or certification. c. Use the Global Appraisal of Individual Needs -Short Screener ("GAIN -SS") and assessment process that includes use of the quadrant placement. i. Failure to implement and maintain the Integrated Co -Occurring Disorder Screening and Assessment process shall result in corrective action. ii. If the results of the GAIN -SS are indicative of the presence of a co-occurring disorder, this information must be considered in the development of the treatment plan including appropriate referrals. 16. As applicable, Provider shall ensure that all written information provided to Members or potential Members is: accurate, not misleading, comprehensible to its intended audience, designed to provide the greatest degree of understanding, written at the sixth (6) grade reading level, provided in a font size no smaller than 12 point, and fulfills other requirements of the Contract as may be applicable to the materials. Molina must have the written approval of HCA prior to use, as required by the Washington Medicaid Contract (42 CFR 438.10(d)(6)). 17. As applicable, for Members who have primary health insurance, benefits available under the Washington Medicaid Contract shall be secondary to any other medical coverage, in accordance with applicable state and federal law. Provider shall not refuse or reduce services provided under the Washington Medicaid Contract solely due to the existence of similar benefits provided under any other health care contracts. Health Plan shall pay preventive pediatric care, and services covered under EPSDT, including Applied Behavior Analysis treatment services and medically intensive children's program services, and then seek reimbursement from third parties (42 CFR 433.139(b)(3), 42 USC 1396(a)(25), RCW 41.05A.005). 18. As applicable, Provider shall not directly or indirectly conduct door-to-door telephonic, or other cold -call marketing of enrollment (42 CFR 438.104(b)(1)(v)). MHWPROV22.3 MHWPSA/Revised Jan 2024 Page 23 of 25