2016-590-E County Mgr - UNC Hospitals for substance abuse counseling

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DocuSign Envelope ID:887F5093-0A4D-497B-B4F7-702D1 E76D390 program to allow ASAP to disclose the individual's attendance at ASAP sessions for invoice purposes. In the event the MDP terminates an individual's participation in the MDP, MDP will immediately notify ASAP, and ASAP will no longer provide services to that individual under this Agreement. 3. MDP Responsibilities. MDP will provide ASAP with a referral form that includes relevant client information, including medical and payment information when available. In addition, MDP will pay ASAP the fee of$120 per case accepted by ASAP. The amount of the fee will not vary based upon the amount of services provided by ASAP to MDP as long as ASAP provided at least one therapy session to the individual. The MDP understands that ASAP will pay all third party payors, including private insurance payors and governmental payors such as Medicaid. ASAP will not consider the existence of a third party payor when deciding whether to accept a referral of a MDP client and will base such decisions on clinical information only. Due to the nature and purpose of MDP, ASAP agrees that it will waive all amounts that would otherwise be the responsibility of the patient or the patient's family, including without limitation copays. 4. Confidentiality. Except as otherwise subject to North Carolina Public Records Law ASAP will treat all records relating to the services it provides under this Agreement as confidential patient records. MDP understands that ASAP will maintain all records related to the services it provides under this Agreement as it would all other patient records and those records will be stored in ASAP's electronic medical record system. Patient participation in MDP should remain confidential. 5. Duration of Services. This Agreement will continue until terminated by either party. Either party may terminate this Agreement at any time upon written notice to the other party. In the event of a termination, all individuals already accepted by ASAP under referral by MDP will continue to be subject to this Agreement. 6. Amendments. Any amendment to this Agreement shall not be valid unless made in a writing signed by both parties. 7. Indemnification. Provider will be responsible for its own negligence and the negligence of its employees. 8. Additional Provisions. The County, through MDP, and the Provider each bind themselves, their successors, assigns and legal representatives to the terms of this Agreement. Neither the County, through MDP, nor the Provider shall assign or transfer its interest in this Agreement without the written consent of the other. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all anti- discrimination laws. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes and that they certify they have not been identified nor utilized the services of any subcontractor on the list created by the State Treasurer pursuant to G.S. § 147-86.58. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be valid and binding upon the Parties. 2