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Docusign Envelope lD: CEBC6B3C-DFA1 -4BOC-AFE8-6A4A63440086 <br />CovruuNITY HBAl.rrr PL,q.N OF WASHINGTON <br />F.tcrr.,rrY AGREEMENT <br />This Agreement ("Agreement") is made by and between Community flealth Plan of Washington <br />("CHPW"), a not for profit Washington Colporation and Kittitas County Sherriff s Office Jail <br />("Facility") and is effective the 7t1t2025 ("Effective Date"). <br />RECITALS <br />A. Community Health Plan of Washington ("CHPW"; is a 501(c)(4)taxexempt corporation, <br />accredited by the National Committee on Quality Assurance ("NCQA") and certified as a health <br />care services contractor, organized and operating under the laws of the State of Washington to <br />provide or affange for provision of covered health care services to individuals enrolled in its <br />Beneht Plans ("Members"); <br />B. CHPW arranges for provision of covered health services to Members pursuant to its contracts <br />with state and federal agencies, including Washington State Health Care Authority ("HCA"), and <br />Centers for Medicare and Medicaid Services ("CMS"), that sponsor various health programs <br />(collectively, "state and federal sponsored health programs"); <br />C. Facility holds all required licenses, registration or certification required by state and federal <br />agencies to provide the health care services specified herein; and <br />D. CHPW desires to contract with Facility to provide Covered Services to Members pursuant to <br />CHPW Benefit Plans, and Facility desires to contract with CHPW to provide such services. This <br />agreement is written in compliance with 42 CFR 434.6. <br />NOW. THEREFORE, in consideration of the recitals, mutual promises, covenants, and <br />agreements set forth herein, both parties agree as follows: <br />AGREEMENT <br />I. DEF'INITIONS <br />The following definitions shall apply to this Agreement, except to the extent that they may be <br />superseded by definitions that are specific to a particular health benefit plan on the applicable <br />Benefit Plan Exhibit in Exhibit B and/or available at www.CHPW.org. <br />l.L "Agreement" means this CHPW Facility Agreement entered into between CHPW and <br />Facility with all amendments, schedules and exhibits hereto. <br />2020 Facility Agmt - Template Page 1 of51 Contract #5908-662684