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Docusign Envelope lD: 7 4E827C5-FAB8-8084-827C-41 4AD59920A0 2.1 x. Member(s) means a person(s) eruolled in one of Health Plan's benefit Products or a Health Plan affiliaie's benefit Product and who is eligible to reoeive Covered Servioes, y. Mollna Fee Schedule mearls the Health Plan's fee schedule, inclusiye of all reimbursement rates Health Plan is required to reimburse Provider withitt this Agreement. The Molina Fee Schedule is available upon request. z. Molina Marhetplace means the health benefit program offered and sold by Health Plan to individuals or employers who obtain health coverage through the Washington Health Benefit Exchange, aa. Participating Provider means a healthcare facility or practitioner contracted with and, as applicable, oredentialed by Health PIan or Health Planos designee. bb. Product means the various health insurance progr?ms offered by Health Plan to Members in which Provider agrees to be a Participating Provider, identifled in the compensation exhibit(s), and which will include any successors to such Produots, c0. Prior Authorization means the requirement that a provider must reque st, on behalf of a Member and when required by rule or state and govemment billing instructions, the state or governments designee's approval to provide a health oare service before the Member receives the health care service, prescribed drug, device, or drug-related suppty. dd. Provider means the entity identified on the Signature Page of this Agreement and includes any person or entity performing Covered Services on behalf of Provider and for which: (i) an entity of the Provider bills under an owned tax identification number; and (ii), when applicable, such person or entity has been approved by Health Plan as a Participating Provider. Where Provider is a Group/IPA or Hospital, Provider means and includes all constituent physicians, allied liealth professionals and staff persons who provide health care seruices to Members by arrdior through the GrouplIPA or Hospital. All of said persons are bound by the terms of this Agreement. ee, Provider Manual means the compilation of Health PIan policies, procedures, standards and specimen documents, as may be unilaterally amended or modified fiom time to time by Health Plan, that have been compiled by Health Plan for the use and instruction of Provider, and to which Provider must adhere. ff. Quality Improvement Program means the policies, procedures and systems developed by Health Plan for monitoring, assessing and improving the accessibility, quality and continuity of care provicled to Members. gg. Subcontract means any separate agreement or contract between Health PIan and an individrral or entity ("Subconlractor") to perform all or a portion ofthe duties and obligations that the Health Plan is obligated to perform pursua[t to Flealth Plan's contract with the State or CMS. hh. Subcontractor means an individual or organlzalion, including Downstream Entity, with which Provider coltracts for the provision of Covered Services or adminlstrative functions related to the performance of this Agreement, including delegation activities. For the avoidance of donbt, a Subcontractor does not include individual providers, ii. Utilizatlon Review and Management Program means the policies, plocedures and systems developed by Health Plan for monitoring the utilization of Covered Services by Members, including but not limited to under-utilization and over-utilization. ARTICLE TWO . PROVIDER OBLIGATIONS Serving as a Panel Provider. Provider shall serve on I-Iealth Plan's panel of providers for the Products specified in Exhibit I and its applicable sub-exhibits, Provider agrees that its practice information may be used in Health Plan's provider directories, promotional materials, advertising, and other informational material made available to the public and Members. Practice information includes, but is not limited to, name, address, telephone nnmber, hours of operation, type of practice, and ability to accept new patients. Provider shall promptly notify Health Plan of any changes in this practice information. MHWPROV22.3 MHWPSA-/Revised Jan 2024 Page 4 of25