2021-350-EMS-E-WellCare Health Plans of NC Inc-Medicaid managed care

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Page 16 of 48 that such individual agrees to assume responsibility for providing inpatient Covered Services to Covered Persons who are patients of the applicable Practitioner. 2.2 Acceptance of New Patients. To the extent that Practitioner is accepting new patients, such Practitioner must also accept new patients who are Covered Persons with respect to the Products in which such Practitioner participates. Practitioner shall notify Company in writing 45 days prior to such Practitioner’s decision to no longer accept Covered Persons with respect to a particular Product. In no event will an established patient of any Practitioner be considered a new patient. 2.3 Preferred Drug List/Drug Formulary. If applicable to the Covered Person’s coverage, Practitioners shall use commercially reasonable efforts, when medically appropriate under the circumstances, to comply with formulary or preferred drug list when prescribing medications for Covered Persons. 2.4 National Committee for Quality Assurance (“NCQA”) Accreditation of WellCare’s Standards. Each Practitioner agrees to: i) cooperate with Quality Management and Improvement (“QI”) activities; ii) maintain the confidentiality of a Covered Persons information and records pursuant to the Agreement; and iii) allow the Company to use Practitioner’s performance data. 3 Ancillary Providers. If Provider or Contracted Provider is an ancillary provider (including but not limited to a home health agency, durable medical equipment provider, sleep center, pharmacy, ambulatory surgery center, nursing facility, laboratory or urgent care center)(“Ancillary Provider”), the following provisions apply. 3.1 Acceptance of New Patients. To the extent that Ancillary Provider is accepting new patients, such Ancillary Provider must also accept new patients who are Covered Persons with respect to the Products in which such Ancillary Provider participates. Ancillary Provider shall notify Company in writing 45 days prior to such Ancillary Provider’s decision to no longer accept Covered Persons with respect to a particular Product. In no event will an established patient of any Ancillary Provider be considered a new patient. 3.2 National Committee for Quality Assurance (“NCQA”) Accreditation of WellCare’s Standards. Each ancillary provider agrees to: i) cooperate with Quality Management and Improvement (“QI”) activities; ii) maintain the confidentiality of a Covered Persons information and records pursuant to the Agreement; and iii) allow the Company to use ancillary provider’s performance data. 4 FQHC. If Provider or a Contracted Provider is a federally qualified health center (“FQHC”), the following provisions apply. 4.1 FQHC Insurance. To the extent FQHC’s employees are deemed to be federal employees qualified for protection under the Federal Tort Claims Act (“FTCA”) and WellCare has been provided with documentation of such status issued by the U.S. Department of Health and Human Services (such status to be referred to as “FTCA Coverage”), Section 5.1 of this Agreement will not apply to those Contracted Providers with FTCA Coverage. FQHC shall provide evidence of such FTCA Coverage to WellCare at any time upon request. FQHC shall promptly notify WellCare if, any time during the term of this Agreement, any Contracted Provider is no longer eligible for, or if FQHC becomes aware of any fact or circumstance that would jeopardize, FTCA Coverage. Section 5.1 of this Agreement will apply to a Contracted Provider immediately upon such Contracted Provider’s loss of FTCA Coverage for any reason. 5 Facility Providers. If Provider or a Contracted Provider is a facility (including but not limited to Clinic, FQHC, LTAC, Nursing Home, Rehab, Rural Health Clinic, Skilled Nursing) (“Facility Provider”) the following provision applies. 5.1 National Committee for Quality Assurance (“NCQA”) Accreditation of WellCare’s Standards. Each facility agrees to: i) cooperate with Quality Management and Improvement (“QI”) DocuSign Envelope ID: 2EC1F0FD-FAF9-4B42-B52E-D419F55A6210