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Docusign Envelope lD: 7 4E827C5-FAB8-8084-827C-41 4AD59920A6
<br />10. Provider shall assure that ali sterilizations and hysterectomies performed under this Agreement are in
<br />compliance with 42 CFR 441 Subpart F, and that the Sterilization Consent Form (D$HS l3-364(x)) or its
<br />equivalent is used.
<br />11. Provider shall make reasonable accommodation for enrollees with disabilities, in accord with the Americans
<br />with Disabilities Act, for all Covered Services and shall assure physical and communication barriers shall
<br />not inhibit eruollees with disabilities from obtaining Covered Services.
<br />12. Provider shall comply with all Program Integrity provisions, including, but not limited to the Washington
<br />Medicaid Contract and the following regulations: Sections 1902(a)(68) and 1128J(d) of the Social Security
<br />Act,42 C.F.R. $ 438.608 , 42 C.F.R. g 455,42 C.F,R. $ 1000 through 1008, and Chapter 182-502A WAC,
<br />and Chapters 74.09 and 74.66 RCW and as documented in Health Plan Provider Manual and as set forth by
<br />42 CFR 438.608 and the Health Plan's contracts with HCA.
<br />13. Provider shall comply with Patient ldentifying Information from an alcohol or drug abuse "program", as
<br />defined in 42 C.F.R. g2.ll, that is federally assisted in the manner desuibed in 42 C.F.R. $2.12(b), then it
<br />is fully bound by the federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient
<br />Records, 42 C.F.R. Part2,with respect to such information and records, including but not limited to the
<br />duty to resist injudicial proceedings any efforts to obtain access to such information or records, other than
<br />as permitted by law
<br />14. Provider warrants and represents that it has not been convictecl of crimes as specified in Section 1128 of the
<br />Social Security Lct(42 U.S.C. 7320a-7), excluded from participation in the Medicare or Medicaid program,
<br />assessed acivil ponalty undor the provisions ofSection I 128, entered into a contractual relationship with an
<br />entity convicted of a crime specified in Section 1128, or taken any other action that would prohibit it from
<br />participation in Medicaid and/or state health care programs.
<br />15. Behavioral Healttr Services. lfProvider provides behavioral health services, Provider must:
<br />a. Hold all necessary licenses, certifications, and/or permits as required by law for the performance of the
<br />activity to be performed under this Agreement,
<br />b. Notify the l{ealth Plan in the event of a change in status of any required license or certification.
<br />c. Use the Global Appraisal of Individual Needs-Short Screener ("GAIN-SS") and assessment process
<br />that includes use of the quadrant placement.
<br />i. Failure to implement and maintain the Integrated Co-Occuming Disorder Screening and Assessment
<br />process shall result in corrective action.
<br />ii. If the results of the GAIN-SS are indicative of the presence of a co-occurring disorder, this
<br />information must be considered in the development of the treatment plan including appropriate
<br />referrals.
<br />16, As applicable, Provider shall ensure that all written information provided to Members or potential Members
<br />is: acourate, not misleading, comprehensible to its intended audiencg designed to provide the greatest
<br />degr.ee of understanding, written at the sixth (6) grade reading level, provided in a font size no smaller than
<br />12 poinl, and futlills other requirements of the Contract as may be applicable to the materials. Molina must
<br />have the written approval of HCA priof to use, as required by the Washington Medicaid Contract (42 CFR
<br />438.10(dX6).
<br />17, As applicable, for Members who have primary health insurance, benefits available under the Washington
<br />Medicaid Contract shall be secondary to any other medical coverage, in accordance with applicable state
<br />and federal law. Provider shall not refuse or reduce services provided under the Washington Medicaid
<br />Contract solety due to the existence of similar benefrts provided under any other health cate contracts.
<br />Health Plan shall pay preventive pediatric care, and serryices covered under BPSDT, including Applied
<br />Behavior Analysis treatment services and medically intensive children's program services, and then seek
<br />reimbursement from third parties (42 CFR 433.139(bX3), 42 USC 1396(a)(25), RCW 41.05A'005).
<br />18. As applicable, Provider shall not directly or indirectly conduct door-to-door telephonic, or other cold-call
<br />marketing of enrollment (42 CFR 43 L i0a(bXl )(v)).
<br />MrrwPRov22.3 MIIWPSA,/Revised Jan 2024 Page 23 of25
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