HomeMy WebLinkAboutAgreements/Contracts - RenewK21-019
COMMUNITY HEALTH PLAN OF WASHINGTON
PROVIDER AGREEMENT
This Agreement ("Agreement") is made by and between Community Health Plan of
Washington ("CHPW"), a not for profit Washington Corporation, and Grant Integrated
Services ("Contractor") and is effective ("Effective Date").
RECITALS
A. Community Health Plan of Washington ("CHPW") is a 501(c)(4) tax exempt entity,
accredited by the National Committee on Quality Assurance ("NCQA") and certified as a
health care services contractor, organized and operating under the laws of the State of
Washington to provide or arrange for provision of covered health care services to
individuals enrolled in its Benefit Plans ("Members");
B. CHPW arranges for provision of covered health services to Members pursuant to its
contracts with state and federal agencies, including Washington State Health Care
Authority ("HCA"), and Centers for Medicare and Medicaid Services ("CMS"), that
sponsor various health programs (collectively, "state and federal sponsored health
programs");
C. Contractor has employed or contracted with duly licensed providers of health care services
located in the State(s) in which it provides health care services and has met CHPW's
criteria to be a provider of health care services for Members; and
D. CHPW desires to contract with Contractor to provide Covered Services to Members
pursuant to this Agreement and CHPW Benefit Plans, and Contractor desires to contract
with CHPW to provide such services. This Agreement is written in compliance with 42
CFR 434.6.
NOW, THEREFORE, in consideration of the recitals, mutual promises, covenants, and
agreements set forth herein, both parties agree as follows:
AGREEMENT
1. DEFINITIONS
2020_NegAgmt Grant Page 1 of 54 Contract #7967-366925
The undersigned have executed this Agreement as of the date and year written below.
Community Health Plan of Washington Grant Integrated Services
1111 Third Avenue, Suite 400 840 E Plum Street
Seattle, WA 98101-3292 Moses Lake, WA 98837
Phone: (206) 521-8833 Phone: (509) 765-9239
Sign:
Name: Abie Castillo
Title: Chief External Relations Officer
Date:
Sign:
Name: Cindy Carter, BOCC Chair
Title:
Date:
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2020_NegAgmt Grant Page 29 of 54 Contract #7967-366925