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

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Page 27 of 48 1.6 Dispute Resolution. Participating Provider shall utilize the applicable dispute resolution procedures outlined in the Agreement to resolve disputes between WellCare and Participating Provider. (Section VII, G(1)(q)). 1.7 Reporting Requirements. Participating Provider shall promptly provide WellCare with the data and information that WellCare requests in order to meet its reporting requirements under the State Contract. (Section VII, J. Table 1). 1.8 Hours of Operation. Participating Provider will offer hours of operation to Covered Persons that are not less than the hours of operation offered to commercial members or comparable to Medicaid fee -for-service, if Participating Provider serves only Medicaid or NC Health Choice members. (Section V, D(1)(d)(iii)). 2. Entire Agreement. The Agreement identifies the documents that constitute the entire contract between the parties. (Section VII, G(1)(a)). 3. Hold Harmless. Participating Provider agrees to hold the Covered Person harmless for charges for any Covered Service. Participating Provider agrees not to bill a Covered Person for Medically Necessary Services covered by WellCare so long as the Covered Person is eligible for coverage. (Section VII, G(3)(b)). Participating Provider will not hold Covered Person’s responsible for any of the following: (a) WellCare’s debts in the event of its insolvency; (b) Covered Services provided to the Covered Person for which: (i) NC DHHS does not pay WellCare, or (ii) NC DHHS, or WellCare, does not pay the Participating Provider; (c) payments for Covered Services furnished under a contract, referral or other arrangement, to the extent that those payments are in excess of the amount that the Covered Person would owe if WellCare covered the services directly. 42 C.F.R. § 438.106. (Section V, C(1)(i)(iii) and Section V, C(2)(r)(iii)). 4. Liability. Participating Provider understands and agrees that NC DHHS does not assume liability for the actions of, or judgments rendered against, WellCare, Payors, its employees, agents or subcontractors. Further, Participating Provider understands and agrees that there is no right of subrogation, contribution, or indemnification against NC DHHS for any duty owed to Participating Provider by WellCare or Payor or any judgment rendered against WellCare or Payor. (Section VII, G(3)(c)). 5. Non-Discrimination. 5.1 Equitable Treatment of Covered Persons. Participating Provider agrees to render provider services to Covered Persons with the same degree of care and skills as customarily provided to Participating Provider’s patients who are not Covered Persons, according to generally accepted standards of medical practice. Participating Provider and WellCare agree that Covered Persons and non-Covered Persons should be treated equitably. Participating Provider agrees not to discriminate against Covered Persons on the basis of race, color, national origin, age, sex, gender, or disability. (Section VII, G(3)(d)). 5.2 Interpreting and Translation Services. Participating Provider shall provide qualified sign language interpreters if closed captioning is not the appropriate auxiliary aid for the Covered Person. Participating Provider shall ensure that Participating Provider’s staff are trained to appropriately communicate with patients with various types of hearing loss. Participating Provider shall report to WellCare, in a format and frequency determined by WellCare, whether hearing loss accommodations are needed and provided and the type of accommodation provided. (Section VII, G(1)(t)). 6. Term; Termination. 6.1 Term. This Attachment is coterminous with the Agreement, unless otherwise agreement by the parties, but in no event will the term of this Attachment exceed the term of the State Contract (including, for avoidance of doubt, any renewals of the State Contract) (Section VII, G(1)(c)). DocuSign Envelope ID: 2EC1F0FD-FAF9-4B42-B52E-D419F55A6210