HomeMy WebLinkAbout20251915.tiffResolution
Approve Primary Care Medical Provider Agreement for Renewal of Colorado
Accountable Care Collaborative Phase 3.0 Program for Tier I Foundational Primary
Care Services and Authorize Chair to Sign — Northeast Health Partners, LLC
Whereas, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
Whereas, the Board has been presented with a Primary Care Medical Provider
Agreement for Renewal of the Colorado Accountable Care Collaborative Phase 3.0
Program for Tier I Foundational Primary Care Services between the County of Weld,
State of Colorado, by and through the Board of County Commissioners of Weld County,
on behalf of the Department of Public Health and Environment, and Northeast Health
Partners, LLC, commencing July 1, 2025, and ending June 30, 2026, with further terms
and conditions being as stated in said agreement, and
Whereas, after review, the Board deems it advisable to approve said agreement, a copy
of which is attached hereto and incorporated herein by reference.
Now, therefore, be it resolved by the Board of County Commissioners of Weld County,
Colorado, that the Primary Care Medical Provider Agreement for Renewal of the Colorado
Accountable Care Collaborative Phase 3.0 Program for Tier I Foundational Primary Care
Services between the County of Weld, State of Colorado, by and through the Board of
County Commissioners of Weld County, on behalf of the Department of Public Health and
Environment, and Northeast Health Partners, LLC, be, and hereby is, approved.
Be it further resolved by the Board that the Chair be, and hereby is, authorized to sign
said agreement.
The Board of County Commissioners of Weld County, Colorado, approved the above
and foregoing Resolution, on motion duly made and seconded, by the following vote on
the 7th day of July, A.D., 2025, nunc pro tunc July 1, 2025:
Perry L. Buck, Chair: Aye
Scott K. James, Pro-Tem: Aye
Jason S. Maxey: Aye
Lynette Peppler: Aye
Kevin D. Ross: Excused
Approved as to Form:
Bruce Barker, County Attorney
Attest:
Esther E. Gesick, Clerk to the Board
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2025-1915
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BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
PASS -AROUND TITLE: PRIMARY CARE MEDICAL PROVIDER (PCMP) WITH NORTHEAST HEALTH
PARTNERS - TIER 1 ADDENDUM
DEPARTMENT: PUBLIC HEALTH AND ENVIRONMENT DATE: JUNE 24, 2025
PERSON REQUESTING: JASON CHESSHER, EXECUTIVE DIRECTOR
SHAUN MAY, PHS DIVISION DIRECTOR
Brief description of the problem/issue:
Weld County Department of Public Health and Environment (WCDPHE) participates as a Primary Care Medical Provider
(PCMP) in Colorado's Medicaid Accountable Care Collaborative (ACC) Phase 3.0 through an agreement with Northeast
Health Partners (NHP). By regulation, the Agreement must be renewed annually, and any change in our elected Value -
Based Payment tier must be memorialized in a new Addendum. For the July 1, 2025 renewal, we have elected to
participate at Tier 1 (Foundational Primary Care) at a $2.00 Per Member Per Month (PMPM) rate for both Weld County
practice sites. To become effective July 1, this Tier 1 selection requires BOCC signature on the attached PCMP Value
Based Payment Addendum.
What options exist for the Board?
• Approve the contract addendum as presented.
• Decline to approve the contract addendum.
Consequences:
Approval of this Addendum will allow WCDPHE to continue its role as a PCMP under ACC 3.0 at the Tier 1 rate of
$2.00 per member, per month, ensuring no interruption in our care -coordination services for Medicaid members.
Should the Board choose not to approve, WCDPHE would be unable to execute the Tier 1 Addendum, resulting in
the forfeiture of the enhanced PMPM payment and potential disruption to our administrative compliance and
associated Medicaid revenue streams.
Impacts:
This contract addendum carries no changes to our scope of services, reporting requirements, or overall provider
obligations; it solely updates our payment tier. By maintaining Tier 1 participation, we preserve the financial
structure that supports our integrated care model and sustains the coordination of services that benefit Weld
County's Medicaid population.
Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years):
There are no direct out-of-pocket costs to Weld County for this renewal. Renewing at the Tier 1 PMPM rate
continues that revenue stream under the updated payment structure.
Recommendation: I recommend approval to place this contract on a future agenda for formal consideration.
Support Recommendation Schedule
Place on BOCC Agenda Work Session Other/Comments:
Perry L. Buck
Scott K. James
Jason S. Maxey
Lynette Peppier
Kevin D. Ross
%1
2025-1915
H LU(758
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PRIMARY CARE MEDICAL PROVIDER AGREEMENT
This Primary Care Medical Provider Agreement ("Agreement") by and between Northeast Health Partners ("NHP")
and Weld County Department of Public Health ("Provider") for the Colorado Accountable Care Collaborative Phase
3.0 Program (the "ACC Phase 3.0 Program").
RECITALS
WHEREAS NHP was awarded the contract for Region 2 by the Colorado Department of Health Care Policy and
Financing (the "Department") in its Accountable Care Collaborative Phase 3 Program under which integration of
the principles of a member -centered Medical Home model is an integral component;
WHEREAS, Provider is certified by the Department as a provider in Health First Colorado ("Medicaid") and CHP+
Medical Homes for children program, or is a physician or an advanced practice nurse with a focus on primary care,
general practice, internal medicine, pediatrics, geriatrics or obstetrics and gynecology, and who meets all of the
Primary Care Medical Provider requirements established by the Department and set forth this Agreement;
WHEREAS, to the extent Provider is serving as a PCMP and Medical Home, the parties intend for this Agreement to
control the parties' respective obligations with regard to Provider serving as a PCMP and Medical Home;
NOW, THEREFORE, in consideration of the covenants, promises, representations and warranties set forth herein,
and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the
parties agree as follows:
1 Defined Terms. Capitalized terms in this Agreement have the meanings set forth where initially defined in the
'Whereas' clauses above, all of which are incorporated herein by reference, as defined throughout the
Agreement, or as otherwise set out below.
a. "ACC Phase 3.0 Program" means the Colorado Department of Health Care Policy and Financing's
Accountable Care Collaborative Phase 3 Program, designed to affordably optimize Member's health,
functioning, and self-sufficiency with the primary goals to improve member health, life outcomes, and use
state resources wisely.
b. "Behavioral Health Incentive Program" means an incentive program for the improvement of Behavioral
Health measures developed by the Department with performance measure specifications and available
funds are releases annually.
c. "CFR" means Code of Federal Regulations.
d. "HIPAA" means the federal Health Insurance Portability and Accountability Act of 1996, including without
limitation its privacy, security and administrative simplification provisions, and the statutes, rules and
regulations promulgated there under, each as may be amended from time to time, including but not limited
to the Health Information Technology for Economic and Clinical Health Act of 2009.
e. "Health First Colorado" or "Medicaid" means the Colorado Medicaid Program administered and
operated by the Department in accordance with the Colorado Medical Assistance Act and Title XIX of the
Social Security Act. Health First Colorado is annually funded from appropriations authorized by the
Colorado General Assembly and matched by federal funds in accordance with applicable federal rules and
regulations.
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f. Key Performance Indicators or "KPI(s)" means incentive programs administered by the Department that
enable PCMPs to earn incentive payments based on achieving quality target thresholds. The Department
also administers an incentive program for RAEs based on achieving regional target thresholds.
g. "Medical Home" means an approach to providing comprehensive primary care that facilitates
partnerships between individual members, their providers, and, where appropriate, the member's family.
h. "Medicaid Management Information Systems" or "MMIS" means the Department's automated
computer systems that process Medicaid and CHP+ claims and other pertinent information as required
under federal regulations.
i. "Member" means any individual enrolled in the Colorado Medicaid program, Colorado's CHP+ program or
the Colorado Indigent Care Program, as determined by the Department.
j. "Practice Assessment Tool" means a standardized tool approved by the Department to assess and tier
PCMPs and establish level of care standards for serving Members with health care needs of increasing
complexity. Compensation for PCMPs will be based on the practice assessment tier as well as the
complexity of the Members they serve.
k. "Practice Transformation" means strategies and activities focused on PCMP Practice Sites to integrate
behavioral and physical health care delivery, to incorporate community health workers into the Medicaid
delivery system, to implement Value -Based Payment models, and to achieve Department quality and cost
savings targets.
I. "Primary Care Medical Provider" or "PCMP" means a primary care provider contracted with a RAE to
participate in the Accountable Care Collaborative as a network provider.
m. "PCMP Practice Site" means a single "brick and mortar" physical location where services are delivered to
Members under a single Medicaid billing Provider identification number.
n. "Per Member Per Month" or "PMPM" means an administrative payment for managing active Members.
This rate is paid monthly to providers based on the contracted tier level.
o. "Protected Health Information" or "PHI" means 'individually identifiable health information' as defined in
45 CFR§160.103 and/or applicable state law, and/or 'patient identifying information' as defined in 42 CFR
Part 2.
p. "Regional Accountable Entity", "RAE" means a single regional entity responsible for implementing the
Accountable Care Collaborative Phase 3.0 Program within its region. For purposes of this Agreement, NHP
is the RAE.
2. Relationship. None of the provisions of this Agreement are intended to create, nor shall be deemed or
construed to create any relationship between NHP and Provider other than that of independent entities
contracting with each other solely for the purpose of effecting the provisions of this Agreement. Except as
specifically provided for in this Agreement, the parties agree that neither NHP nor Provider will be liable for the
activities of the other nor their representative agents or employees, including without limitation, any liabilities,
losses, damages, injunctions, lawsuits, fines, penalties, claims or demands of any kind or nature by or on behalf
of any person, party or government agency arising out of or related to this Agreement; however, any rights to
indemnification that may be available to either party at law or in equity are not affected by execution of this
Agreement.
a. Provider acknowledges that Provider is an independent contractor, and not an agent or employee of NHP,
and further that Provider is not authorized to act on behalf of NHP, and that none of Provider's employees,
agents or contractors is an employee of NHP or entitled to any NHP employment rights or benefits. Provider
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further acknowledges and agrees that the Provider waives any and all rights the Provider has, or may have,
against NHP under the Employee Retirement Security Act of 1974 and the rules and regulations
promulgated thereunder, each as may be amended from time to time.
b. Provider represents and warrants that Provider is authorized to negotiate and execute contracts on
Provider's behalf, including this Agreement, and to bind itself and all employees and contractors to the
terms and conditions of this Agreement. Whenever in this Agreement the term "PCMP" is used to describe
an obligation or duty, such duty or obligation shall also be the responsibility of each individual PCMP
Practice Site, the Provider, practitioners and/or clinicians affiliated with Provider, owner, employee, or
contractor, as the context may require.
c. Provider acknowledges that care coordination, case management and medical management activities
performed and/or made available by NHP will change over the course of the term of this Agreement as
necessary to address changes in the ACC Phase 3.0 Program, including without limitation implementation
of health improvement initiatives and enhanced outcomes measurement activities.
d. Provider shall provide NHP accurate Provider contact information and PCMP Practice Site information prior
to execution of this Agreement and within thirty (30) days of any change in such information. The PCMP
Practice Site information to include at a minimum: the legal name of PCMP Practice Site(s) along with
respective Provider Type and Provider Designation (i.e. FQHC or RHC), Provider Location ID, and National
Provider Identifier (NPI). PCMP Practice Site(s) full address, telephone numbers and email contact. Provide
a list of the names of all clinicians and practitioners within PCMP Practice Site(s), areas of specialty
services available from PCMP Practice Site(s), maximum number of Members willing to accept at PCMP
Practice Site(s), and whether PCMP Practice Site or any practitioner is accepting new Members.
e. Provider warrants that it, as a PCMP, and all of its individual practitioners and contractors: (i) have all
necessary licenses, certificates, approvals and/or permits including Colorado Medicaid enrollment; (ii) are
not excluded, suspended, debarred, or otherwise ineligible to participate in any state or federal health care
program; (iii) no proceedings or investigations are currently pending or threatened by any state or federal
agency seeking to exclude Provider or its individual practitioners and contractors from any state or federal
health care program; and' (iv) are not otherwise barred from being awarded a contract or subcontract or
from contracting with a unit or agency of federal, state or local government as a result of a violation of a
law, rule or regulation.
f. Provider shall maintain at Provider's expense, privacy liability coverage, malpractice or professional liability
coverage, liability insurance coverage for bodily injury, death and property loss and damage, contractual
liability and personal injury liability covering Provider for damages arising out of provision of services to
Members and/or its performance under this Agreement, Provider, and any negligent or otherwise wrongful
acts or omissions by Provider or any owner, employee or agent of Provider.
g. Nothing in this Agreement shall change or alter any clinical relationship, which exists or may come to exist
between Provider and any Member(s). Provider (i) shalt have the same duties, liabilities and responsibilities
to Members as exist generally between a PCMP and member; (ii) shall always exercise its best medical
judgment in the treatment of Members; and (iii) is not an agent of NHP and shall not hold itself out as an
agent of NHP.
h. Provider understands that NHP does not, by this Agreement or future patterns of practice promise or
guarantee any minimum volume of referrals of Members to Provider by NHP, the Health First Colorado
enrollment broker, or the Department.
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i. Provider represents that Provider has not made, is not obligated to make, and will not make any improper
payment or provide any remuneration to any third party in return for NHP entering into this Agreement or for
any business transacted under this Agreement.
j. Nothing in this Agreement is intended by either party to be nor shall be interpreted to be an inducement for
referrals or to reduce, limit or withhold access to medically necessary health services to individuals.
k. The parties will work cooperatively to achieve greater program efficiencies and improved outcomes. Any
savings shared by the Department with NHP or Provider are ancillary to continued cooperation, and some
are not in any way an inducement to limit medically necessary care and treatment for Members.
1. The Department will enroll Members into the ACC Phase 3.0 Program in accordance with its existing
policies and procedures. The Department will allow any Member to elect to disenroll with the PCMP, in
accordance with 42 CFR 438.56(c). The Department will notify all Members who have selected the Provider
as their Medical Home, of the Provider's termination in the ACC Phase 3.0 Program if the Provider stops its
participation in the ACC Phase 3.0 Program for any reason.
m. The Department and/or NHP may include Provider and individual primary care practitioner names,
addresses, hours of operation, specialty, or ancillary services available in published PCMP or provider
directories or marketing.
n. Should NHP, in its sole discretion, elect to sub -delegate any administrative or care coordination activities
or functions to Provider, any such sub -delegation: (i) is subject to the prior approval of the Department; (ii)
shall be in writing and accordance with applicable delegation requirements set forth in Health First
Colorado and more specifically ACC Phase 3.0 Program rules and regulations; (iii) shall specify the
delegated activities and reporting responsibilities; (iv) shall include provisions for monitoring and oversight
by NHP and the Department; and (v) shall provide for corrective action measures, up to and including
without limitation termination or revocation of the delegated activities or functions or other correction or
remedy if the Department or the Centers for Medicare and Medicaid Services determines that such
activities were not performed satisfactorily.
o. In the event of any conflict between Provider's agreements with clinicians and practitioners in Provider's
practice and the terms of this Agreement, this Agreement shall control with respect to the subject matter
hereof. Upon reasonable request and where necessary to meet regulatory and/or government contract
requirements and/or where necessary to confirm payment for services rendered to Members, Provider
agrees to provide NHP, the Department and/or other authorized government agency, with access to copies
of such written agreements.
p. NHP does not prohibit, or otherwise restrict health care professionals, acting within the lawful scope of
practice, from advising or advocating on behalf of the Member who is the provider's patient, for following:
i. The Member's health status, medical care or treatment options, including any alternative
treatment that may be self-administered.
ii. Any information the Member needs in order to decide among all relevant treatment options.
iii. The risks, benefits, and consequences of treatment or non -treatment.
iv. The Member's right to participate in decisions regarding his or her health care, including the right
to refuse treatment, and to express preferences about future treatment decisions.
3. PCMP Requirements and Responsibilities:
a. Provider meets qualifications as a PCMP set by the Department:
i. Be actively enrolled as a Colorado Medicaid provider.
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ii. Licensed and able to practice in the State of Colorado.
iii. Provider's practitioners for PCMP purposes each hold a Doctor of Medicine (MD), Doctor of
Osteopathic Medicine (DO), or Nurse Practitioner (NP) provider license.
iv. Provider's practitioners are licensed as one of the following specialties: pediatrics, internal
medicine, family medicine, obstetrics and gynecology, or geriatrics.
1. Behavioral Health Entities (as defined/licensed by the Colorado Behavioral Health
Administration) and HIV/infectious disease practitioners may qualify as PCMPs with NHP's
approval if all other PCMP criteria are met.
v. The Provider, and/or individual practitioners, as applicable, render services utilizing one of the
following Medicaid provider types: Physician (Code 05), Osteopath (Code 26), FQHC (Code 32),
RHC (Code 45), School Health Services (Code 51), Family/Pediatric Nurse Practitioner (Code 41),
Clinic -Practitioner Group (Code 16), Non -physician Practitioner Group (Code 25).
b. Provider shall additionally meet all requirements to serve Members as a PCMP and Medical Home in ACC
Phase 3.0 Program.
i. Provider shall prohibit discrimination of the Members which the Provider accepts are based on the
Member's health status or need for health care services or the Member's race, color, or national
origin. Provider shall not use any policy or practice that has the effect of discriminating on the
basis of ethnicity, ancestory, sex, gender, sexual orientation, gender identity or expressions,
religion, creed, political beliefs or disability.
ii. Provider shall accept attributed Members in the order in which they enrolled, up to the maximum
number of Members that the Provider is willing to accept.
1. Provider shall accept all Members attributed to the PCMP Practice Site(s) in accordance
with the Department's policies and procedures.
2. Provider shall immediately notify NHP of any changes which may impact Members
attributed to the PCMP Practice Site(s). This includes, but is not limited to, Provider's
decision to close any PCMP Practice Site(s).
3. A Member may voluntarily select the Provider as their PCMP, and the Provider shall accept
all Members who select the Provider to be their PCMP up to the maximum number of
Members that the Provider is willing to accept.
4. Allow any Member to obtain services from any other provider regardless of whether the
Provider referred the Member for those services.
iii. Provider agrees to follow the terms of the Member Dismissal policy as it pertains to any Member.
c. Provider shall adhere to PCMP Practice Site operation requirements set forth in the provider section of the
NHP website at _w_ww.nhprae2org, which may be updated and/or amended from time to time. This
includes but is not limited to:
i. Adherence to the standards of appointment availability and PCMP Practice Site hours. Provide
24/7 phone coverage with access to a clinician that can triage the Member's health need. Provide
for reasonable and adequate hours of operation, including 24 -hour availability of information,
referral, and treatment for emergency medical conditions.
ii. Adherence to requirements to maintain and share, as appropriate, a Member treatment/health
record in accordance with professional standards. This includes data -sharing, access to medical
records when requested, including with other providers/organizations involved in the Member's
care.
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iii. Has adopted and regularly uses universal screening tools including behavioral health screenings,
uniform protocols, and guidelines/decision trees/algorithms to support Members in accessing
necessary treatments.
iv. Compliance with applicable federal and state privacy, confidentiality, and security laws, rules,
and/or regulations, including without limitation HIPAA, and 42 CFR Part 2, as applicable. Provider
is responsible to retain and maintain a release of information, compliant with 42 CFR g 2.31,
authorizing the provider to disclose information related to the member and his or her receipt of
substance use disorder (as defined by 42 CFR 2.11) services for claims payment purposes. Such
consent shall additionally authorize the re -disclosure of such information by the RAE to the
Department, as required by and for the purposes set forth in RAE's contracts with the Department.
d. Each PCMP Practice Site shall adhere to the requirements of its respective participating tier (as further
described in Section 4) set forth in the provider section of the NHP website at www.nhprae2.org. PCMP
Practice Sites may be subject to audits by NHP to oversee participating tier requirements are met.
e. Provider shall adhere to Member care coordination requirements based on PCMP Practice Site
participating tier set forth in the provider section on the NHP website at www.nhprae2.org. This includes
but is not limited to:
i. Cooperate with NHP and or NHP's delegated entity during the performance of care management
and transitions of care activities and functions as part of transitions. Use an electronic health
record or other agreed upon system to share data. Provide primary point of contact responsive to
correspondence regarding sharing of Member information for purposes of coordinating Member
care.
ii. Conduct care coordination, case management, and medical management activities and functions
recommended to Provider by NHP or NHP's delegated entity as best practices and taking into
account what is clinically appropriate for Provider's Members as determined by Provider as PCMP.
iii. Tracks the status of referrals to specialty care providers and provides the clinical reason for the
referral along with pertinent clinical information.
iv. Uses available data (e.g., Department claims data, clinical information) to identify special
Member populations who may require extra services and support for health or social reasons. The
Provider must also have procedures to proactively address the identified health needs.
v. Collaborates with Member, family, or caregiver to develop an individual care plan for Members
with complex needs.
f. NHP may amend, from time to time, its policies and procedures for Providers on the provider section of the
NHP website www.nhprae2.org. NHP may implement changes in the policies and procedures effective as
of the date they are posted to NHP's website without Provider's consent if such change is applicable to all
or substantially all PCMPs and is not a material change. If a change is a material change, NHP will provide
90 days' notice before the effective date of such material change. If Provider objects in writing to the
material change within 15 days and there is no resolution of the objection, either party may terminate the
contract upon written notice of termination provided to the other party not later than 60 days before the
effective date of the material change. If Provider does not object to the material change, it shall be effective
as specified in the notice. To the extent there is any conflict between the policies and procedures and this
Agreement, the terms of this Agreement shall control.
g. Provider must provide services and care in a patient right -focused, non-discriminatory and culturally and
linguistically appropriate manner to Members in accordance with nationally recognized standards, Health
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First Colorado and ACC Phase 3.0 Program rules and requirements, and all applicable state and federal
laws, rules and/or regulations. Accordingly, Provider, agrees:
i. To understand that Provider may accept and act on recommendations or advice given by NHP as
part of care coordination, case management or medical management activities, but all decisions
regarding any Member's care and treatment are determined by the treating provider regardless of
any such care coordination, case management and/or medical management activities.
ii. To provide all information requested by NHP or NHP's delegated entity relating to Members care
and treatment and referrals to complete required reporting by the Department.
iii. To allow timely access to treatment records requested by NHP or NHP's delegated entity while
managing Member's care, meeting contract requirements with the Department or participating in
program initiatives.
iv. To comply with the terms and conditions of Provider's contract or other written arrangement with
the Department designating Provider as a Primary Care Medical Provider and Medical Home in the
ACC Phase 3.0 Program.
v. To contact NHP for questions regarding administrative Health First Colorado requirements,
policies and procedures, coverage policies, prior authorization, and referral requirements, claims
and billing procedures, eligibility and enrollment processes, and other operational components of
Health First Colorado or the ACC Phase 3.0 Program.
vi. Use administrative and practice support tools and resources made available by NHP, either
directly, through a subcontractor or affiliate, or through the NHP website.
h. Provider shall comply with NHP's quality improvement activities, projects, or programs available in the NHP
website or otherwise communicated to the Provider. This includes but is not limited to:
i. PCMP Practice Sites shall actively engage in Key Performance Indicators (KPIs) and/or other
performance incentive programs set by the Department.
ii. PCMP Practice Sites shall actively engage in the Practice Transformation program set by NHP
and/or the Department.
i. Provider agrees to comply with NHP's policies, programs and procedures and such other administrative
policies and procedures (as may be amended from time to time), and any specific policies and procedures
from the Department made available to the Provider through the NHP website. In the event of any conflict
between the terms of this Agreement and the terms of the policy and procedures available on the provider
section of the NHP website, the provisions of this Agreement shall control. Otherwise, the terms of the
NHP's policies and procedures are in addition to the terms of this Agreement.
j. Upon reasonable written request, Provider agrees that NHP or NHP's delegated entity shall have the right to
audit and other reasonable access, including without limitation the opportunity to examine, copy, excerpt
and transcribe at no charge during normal business hours, on at least forty-eight (48) hours' advance
notice, or such shorter period of time as may be imposed on NHP, or by a federal or state regulatory agency
or accreditation organization, the facilities, billing and financial books, records (including but not limited to
Member's treatment records), Provider or PCMP Practice Site policies and procedures, and operations of
Provider, PCMP Practice Sites, Practitioners, any individual or entity performing services for or on behalf of
Provider, or any related organization or entity, as they apply to the obligations of Provider under this
Agreement. The purpose of this requirement is to permit NHP to assure compliance by Provider with all
obligations, financial, operational, quality assurance and other obligations under this Agreement, including
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PCMP Practice Site tier levels and ACC Phase 3.0 requirements, as well as Provider's continuing ability to
meet such obligations.
k. Provider agrees to cooperate with administrative oversight in the form of annual monitoring to verify that
members have access to routine, non-urgent/symptomatic, and urgent care within the required
timeframes.
4. Practice Assessment
a. Provider acknowledges that the Department has promulgated a Practice Assessment Tool (as defined or
set forth by the Department) required to be used in the ACC Phase 3.0 Program. PCMP agrees to complete
a Practice Assessment Tool for each of the PCMP Practice Sites that are part of this Agreement.
b. The Practice Assessment Tool will document the capabilities of the PCMP Practice Site to meet the
requirements set forth by the Department. The Practice Assessment Tool will be scored based on the
responses recorded for each PCMP Practice Site. The score dictates the highest tier for which a PCMP
Practice Site qualities, or they can opt to participate at a lower tier.
i. The participating tier will determine the payment for each PCMP Practice Site. Providers with
multiple PCMP Practice Sites may have individual PCMP Practice Sites at different tiers based on
the PCMP Practice Sites' respective scores.
c. The Practice Assessment will be conducted at least once per State fiscal year. Additionally, a PCMP
Practice Site must submit a new, updated Practice Assessment if there are significant changes that impact
its operations or quality of care. Provider must notify NHP and submit new Practice Assessment within 30
calendar days of the significant change to reflect the current structure and capabilities of the PCMP
Practice Site.
i. The PCMP Practice Site tier will be determined by the Practice Assessment score and the level of
Care Coordination activities the practice chooses to perform as available on the provider section of
the NHP website at www.nhprae2.org. PCMP Practice Sites have the option to participate at the
highest Care Coordination tier for which they qualify or they can opt to participate at a lower tier.
1. Tier 1 practices will be focused on foundational primary care, including access to care,
prevention, screenings, and referrals. Tier 2 practices will be focused on implementing
population management tools, evaluating continuity of care, and developing care
coordination and services. Tier 3 practices will be operating advanced primary care
models and full care coordination services. Tier 3+ practices will be operating at the
highest level and will be delegated the care coordination scope of work.
ii. Each PCMP Practice Site's score and participating tier shall be documented in an addendum, titled
PCMP Value Based Payment Addendum to Primary Care Medical Provider Agreement (the
"Addendum"), which shall be attached to and incorporated by reference into this Agreement.
Notwithstanding anything to the contrary in this Agreement, NHP shall unilaterally amend the
Addendum, if needed, following NHP's receipt of changes in Provider's Practice Assessment or
audit results.
iii. Each PCMP Practice Site may be subject to audit of their Practice Assessment and/or adherence to
requirements for participating tier. Failure to adhere to the requirements of the participating tier
may result in change of the participating tier.
iv. If the Provider believes there has been an error or oversight in the process, or if disagree with the
determination of participating tier or audit results, the Provider shall notify NHP of its dispute within
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thirty (30) days of the receipt of the determination or results. NHP shall review calculation or
determination and may make the changes based on this review within thirty (30) days of the receipt
of any dispute in writing from Provider. The determination or calculation results from NHP shall be
final.
5. Payment
a. Provider agrees to continue to bill for services rendered to Members in accordance with the rules and
regulations of Health First Colorado. Provider further agrees and understands that NHP is not a fee -for -
service payor and no bills or claims for services should be submitted to, or will be paid by, NHP.
b. The following types of payments may be paid to Provider:
i. Provider shall be paid a Per Member Per Month (PMPM) Payment for identified subsets of the
attributed Members to PCMP Practice Site(s) for which NHP has received the funds under its contract
with the Department and who were enrolled in the ACC Phase 3.0 Program as of the first day of the
month for which NHP is making the PMPM Payment. NHP shall calculate the number of the attributed
Members for the PCMP Practice Site based on the information in MMIS. The PMPM payment amount
for each PCMP Practice Site shall be based on the PCMP Practice Site's respective participating tier
per the then -current Addendum.
ii. PCMPs shall have the ability to earn performance incentives ("Incentive Payment") based on
performance calculations from the Department against goals determined by the Department. These
incentives include Key Performance Indicators (KPIs) and the Behavioral Health Incentive Program, as
directed and defined by the Department.
c. NHP shall remit PMPM Payments to the Provider within thirty (30) days of the end of the month for which
payment is being made. Incentive Payments shall also be paid within thirty (30) days of being
achieved/earned, provided that such payments are contingent on NHP's receipt of funds (and the
corresponding data) for such payments.
d. PMPM Payments shall commence in the first full month in which the Provider is enrolled with the
Department as a PCMP, contracted with NHP, and the Provider has attributed Members and continue for all
subsequent months until the termination of this Agreement.
e. If the Provider believes that the calculation or determination of any Incentive Payment or PMPM Payment is
incorrect by a margin of 10% or more, the Provider shall notify NHP of its dispute within thirty (30) days of
the receipt of the payment. NHP shall review calculation or determination and may make the changes
based on this review within thirty (30) days of the receipt of any dispute in writing from Provider. The
determination or calculation results from NHP shall be final. No disputed payment shall be made until after
NHP has concluded its review.
6. Term & Termination
a. The initial term of this Agreement is limited to one (1) year period commencing on the Effective Date
defined below, unless terminated earlier by either party as provided for below. Thereafter, the Agreement
shall automatically renew for terms of one (1) year unless either party provides written notice of non -
renewal at least ninety (90) calendar days prior to the end of the initial term or any renewal terms
thereafter, or the Agreement is terminated in accordance with the provisions below.
b. This Agreement may be terminated for cause on sixty (60) calendar days' prior written notice by the
nonbreaching party if the other party breaches any provision of this Agreement and either the breach
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cannot be cured or, if the breach can be cured, it is not cured by the breaching party with thirty (30)
calendar days after the notice. Should the breaching party cure such breach to the reasonable satisfaction
of the nonbreaching party on or before the end of the above referenced thirty (30) day period, then this
Agreement shall remain in full force and effect.
c. Either party may terminate this Agreement without cause by giving the other party at least ninety (90)
calendar days prior written notice.
d. In addition, this Agreement may be terminated:
i. By NHP immediately upon written notice to Provider: (1) in the event of actual or potential threat to
member safety; (2) upon notice from any state or federal government agency; or (3) should the
arrangement described hereunder be determined in any way to be contrary to or in violation of any
state or federal law, rule or regulation. By the Department immediately upon notice if the
Department determines that Provider has failed to: (1) carry out the substantive terms of its
PCMP's contractual obligations; or (2) meet applicable requirements in sections 1932, 1903(m)
and 1905(t) of the Social Security Act (42 U.S.C. 401).
e. Automatically without notice upon any one of the following events: (1) Provider's (inclusive of any owner or
employee of Provider) conviction of a felony or other crime involving dishonesty; (2) debarment or exclusion
of Provider or any owner, employee or contractor/subcontractor of Provider from participation in or
contracting with any state or federal government unit or agency; (3) Provider's willful, knowing or reckless
breach of any material term of this Agreement; or (4) Provider or any of its practitioners' loss of professional
liability coverage. At the option of a party, on the date or within sixty (60) calendar days of the other party
becomes insolvent, is generally unable to pay or fails to pay its debts as they become due, is adjudicated
as a bankrupt entity, has its business come into the possession or control of a trustee in bankruptcy, has a
receiver appointed for it, or makes a general assignment for the benefit of creditors. If any of these events
occurs: (i) no interest in the Agreement may be deemed as an asset of creditors; (ii) no interest in this
Agreement may be deemed an asset or liability of NHP; and (iii) no interest in this Agreement may pass by
the operation of law without the consent of the other party.
f. In the event of termination of this Agreement, the parties will mutually agree upon a reasonable transition
period for cessation of services, not to exceed thirty (30) calendar days following the date of such notice of
termination.
g. Regardless of any provision to the contrary, the parties acknowledge and agree that continuation and any
renewal of this Agreement is contingent upon renewal of NHP's contract with the Department, continuation
of the ACC Phase 3.0 Program, and continued federal and state funds being appropriated, budgeted, and
otherwise made available by the Department. In the event the Department does not receive continued
federal and state funds or any part thereof, and the Department terminates its contract with NHP, NHP may
terminate this Agreement immediately upon notice without liability, including any liability for termination
costs.
h. Upon receipt of the termination notice, Provider shall give Members enrolled with Provider notice of the
termination and information, consistent with 42 CFR §438.10 as applicable to Primary Care Medical
Providers, on their options for receiving Health First Colorado services following the effective date of
termination.
i. To the extent NHP and/or the Department commenced an audit or investigation prior to the effective date of
expiration or termination of this Agreement, Provider agrees to continue to cooperate with such audit or
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investigation and to provide access to documents and records reasonably requested during such audit or
investigation.
7. Governing Law & Compliance
a. nth respect to the contractual rights between NHP and Provider, this Agreement shall be governed by, and
construed in accordance with, the laws of the State of Colorado, excluding any conflicts of law, rules or
principles that might otherwise refer the same to the law of another jurisdiction, except to the extent
otherwise pre-empted by applicable federal law.
b. Throughout the term of this Agreement, the parties agree to comply with all applicable state and/or federal
laws, rules, and regulations. Except to the extent otherwise specifically provided for in this Agreement, the
alleged failure by either party to comply with applicable state and/or federal laws, rules or regulations shall
not be construed as allowing either party a private right of action against the other in any legal or
administrative proceeding in matters in which such right is not recognized by such law, rule or regulation.
i. Provider is and remains responsible for compliance with all applicable provisions of state and
federal law addressing the Provider "s performance, rights, duties, and obligations hereunder and/or
as related to participation in Health First Colorado and/or the ACC Phase 3.0 Program. This includes
without limitation compliance with all legal reporting and disclosure requirements and laws, rules
and regulations related to Provider (and its practitioners and clinicians) licensure, fraud, waste, and
abuse, prescribing of pharmaceuticals, informed consent, treatment records standards and
requirements, the standard of care, practitioner/member relationship, confidentiality, and privacy
of member information, or the quality of care.
ii. Provider assumes full responsibility for Provider's (inclusive of Provider's employees, agents and/or
contractors) acts and omissions, and for compliance with all applicable federal, state and local
laws, rules and/or regulations, including without limitation those related to income tax, city
business license, licensure, registration and/or certification, employment, unemployment
compensation, and worker's compensation, and shall not make any declaration or take any position
for any matter to the contrary.
iii. Provider represents that none of Provider, PCMP Practice Site(s) or Provider's practitioner(s),
clinicians or other employees or agents: (1) are not presently debarred, suspended, proposed for
disbarment, declared ineligible, or voluntarily excluded from covered transactions; (2) have not
within the ten (10) year period preceding execution of this Agreement been convicted of or had a
civil judgment rendered against them for: (A) commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public (federal, state or local)
transaction or contract under a public transaction; (B) violation of federal or state antitrust statutes
or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records; (C)
making false statements; or (D) receiving stolen property; (3) is not presently under investigation for,
indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local)
with commission of any of the offenses identified in subsection (2) above; and (4) has not within the
ten (10) year period preceding execution of this Agreement had one or more public transactions
(federal, state or local) terminated for cause or default.
iv. NHP is responsible for compliance with all applicable provisions of state and/or federal taws
addressing NHP's certification (as applicable), duties and obligations respecting performance by
NHP under this Agreement.
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c. The ACC Program and care coordination activities thereunder are subject to the applicable federal
requirements in 42 CFR § 438 as applicable to Primary Care Medical Providers.
d. Neither party shall knowingly direct the other to act or refrain from acting in any way that would violate any
applicable law, rule, or regulation. Neither party shall knowingly behave in any way that is intended to
implicate or involve the other in a violation of these laws.
e. Provider and NHP respectively represent that neither knowingly employs or contracts with individuals or
entities excluded from or ineligible for participation in any government sponsored health care program.
f. The parties understand that the terms of this Agreement may be subject to the review and approval of the
Department and/or other state or federal government agencies. Subject to Section 9(i) below, any changes
requested or required by a governmental agency will be negotiated in good faith between the parties.
8. Venue
The parties expressly consent to the exclusive jurisdiction and venue of the District Court for the City and
County of Denver or the United States District Court for the District of Colorado for any legal action or
proceeding arising out of or relating to this Agreement. The parties hereby waive any objections on the
grounds of venue, forum non conveniens or any similar grounds. EACH PARTY, TO THE EXTENT
ENFORCEABLE UNDER APPLICABLE LAW, WAIVES ITS RIGHT TO ATRIAL BY JURY IN CONNECTION WITH
ANY ACTION OR PROCEEDING ARISING OUT OF THIS AGREEMENT.
9. Miscellaneous Provisions
a. Record Maintenance and Inspection
i. Provider shall: (i) prepare and maintain all appropriate administrative, billing and treatment records
regarding services rendered to Members in accordance with prudent record -keeping procedures
and the requirements of Health First Colorado; and (ii) retain all such records for such time periods
as required by applicable state and/or federal laws, rules, or regulations.
ii. Provider agrees to allow NHP reasonable review of any data and other records it maintains on
services rendered to Members that relate to this Agreement.
iii. The parties shall retain a copy of this Agreement and information related to services provided
and/or performance pursuant to this Agreement as part of their respective records during the term
of this Agreement and for the greater of the: (1) time required by applicable federal or state law; or
(2) five (5) year period, following the effective date of non -renewal or termination of this Agreement.
iv. Subject to any legal privilege or restriction, the parties acknowledge that this Agreement and the
books and records of Provider may be subject to examination, audit and inspection by state and
federal regulators with jurisdiction over NHP, including the Department, the U.S. Department of
Health and Human Services, the Comptroller General of the United States, or other authorized
state or federal regulatory agencies or entities to the extent required by law.
v. Upon reasonable written request, Provider agrees that payors and NHP, and their respective
designee(s), shall have the right to audit and other reasonable access consistent with Section 3(j) of
this Agreement. Without limiting the generality or scope of the foregoing, Providers shall cooperate
with treatment record reviews and audits conducted by payors and NHP, by, amongst other actions,
providing access to Member medical records related thereto. The purpose of the foregoing
requirements is to permit payor and NHP to assure compliance by Provider with financial,
operational, quality assurance, medical necessity, concurrent review, appropriateness of care,
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claims payment rules, accuracy of claims coding and payment, and all other obligations of
Practitioner under applicable laws, regulations and NHP or Department policies or rules, this
Agreement and Provider's continuing ability to meet such obligations. Provider acknowledges that
failure to submit records in accordance with this provision and/or the applicable Medicaid provider
manual(s) may result, amongst other consequences, in a denial of a claim for payment under
review, whether on pre -payment or post -payment review, or a payment retraction on a paid claim,
and Provider further acknowledges that Provider is prohibited from balance billing the Member in
any of the foregoing circumstances. Provider further acknowledges and agrees that refusal to
cooperate with the audit and access requirements set forth in this Agreement may adversely affect
the Provider's continued network participation status or result in sanctions up to and including
termination of network participation status. Nothing in this paragraph shall be construed to limit or
prevent payor or NHP from conducting unannounced audits to investigate concerns related to
potential fraud, waste, or abuse or from conducting medical record review for quality, risk
adjustment or risk management initiatives.
b. No Clinical Interference
i. The parties acknowledge and agree that: (i) nothing contained in this Agreement is intended to
interfere with or hinder communications between providers of care and Members regarding their
respective medical or behavioral health condition or available treatment options; and (ii) all
member care and related decisions are the sole responsibility of the treating practitioners/providers
and the Member and that neither NHP nor the Department dictate or control clinical decisions with
respect to the medical and/or behavioral health care or treatment of Members by Provider.
c. Member Relationship
i. Nothing in this Agreement shall change or alter any clinical relationship that exists or may come to
exist between Provider and any individual Member who is attributed to the Provider. Provider: (i)
shall have the same duties, liabilities and responsibilities to members as exist generally between
Provider and Member; (ii) shall always exercise its best medical judgment in the treatment of
Member; and (iii) is not an agent of NHP and shall not hold itself out as an agent of NHP.
d. Conflict
i. In the event of any conflict between the terms of this Agreement and the terms of any separate
provider participation or provider services agreement or Member contract of Provider, the terms of
this Agreement shall control with respect to Provider's PCMP participation with NHP as a Medical
Home and NHP care coordination activities with Provider under the ACC Phase 3.0 Program.
Confidentiality
i. The parties agree to: (i) have and implement procedures designed to preserve the privacy and
confidentiality of Member records; and (ii) maintain, retain, use and/or disclose such Member
records and any Protected Health Information in accordance with HIPAA, 42 CFR Part 2, as
applicable, and all applicable other federal and state laws, rules and regulations regarding the
confidentiality, privacy and/or security of Protected Health Information and/or medical/behavioral
health/alcohol-substance abuse records and any Member consent required there under. Provider
shall also ensure that any records maintained electronically meet all applicable federal and state
laws and regulations related to the storage, transmission, and maintenance of such records.
f. Proprietary Information
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i. The parties agree that confidential and proprietary information of each parry may not be disclosed,
except as provided below, without the express written approval of the other party. Further,
confidential, and proprietary information may be disclosed only to those persons who have a need
to know, and only to the extent necessary, in order to carry out the terms of this Agreement.
Confidential and proprietary information may not be used in any way not specifically allowed under
this Agreement, including in each party's own business, whether or not competitive with the other
parry. Each party will: (i) safeguard all confidential and proprietary information of the other using a
reasonable degree of care, but not less than that degree of care used in safeguarding its own similar
information or material; and (ii) notify the other of any loss or accidental or unauthorized disclosure
of the other's confidential and proprietary information; and (iii) notify the other of any disclosure or
release of the owning party's confidential and/or proprietary information under a valid subpoena or
court order.
ii. All confidential and proprietary information shall remain the sole and exclusive property of
disclosing party. Except as specifically provided for herein, no license is hereby granted to the
receiving party, by estoppel or otherwise, under any patent, trademark, copyright, trade secret or
other proprietary rights of the disclosing party.
iii. The parties recognize that no remedy of law may be adequate to compensate a party for a breach of
the provisions of this provision; therefore, the parties agree that a party may seek temporary or
permanent injunctive relief against the party breaching this provision, in addition to all other
remedies to which either is otherwise entitled, and this provision in no way limits such other
remedies of the parties. Such temporary or permanent injunctive relief may be granted without
bond, which each party waives.
iv. Unless prohibited by law or legal obligation of a party to maintain such records or data, upon the
request, each party shall promptly collect and surrender (or, at the requesting parry's option,
confirm the destruction or non -recoverable data erasure of computerized data of) all of the
requesting party's confidential and proprietary information and all memoranda, notes, records,
drawings, manuals, records, and other documents or materials (and all copies of same, including
"copies" that have been converted to computerized media in the form of image, data or word
processing files either manually or by image capture) pertaining to or including the requesting
party's confidential and proprietary information.
g. Audits
i. Provider agrees to submit documentation reasonably requested by NHP in accordance with a
timeframe established by the Department or NHP.
h. Assignment
i. This Agreement, being intended to secure the services of the parties hereto, shall not in any
manner be assigned (by operation of law or otherwise), delegated, or transferred by either party
without the prior written consent of the other parry; provided, however, that NHP may assign this
Agreement to any entity that controls, is controlled by, or is under common control with NHP. The
parties acknowledge that any assignment of this Agreement may require the prior written approval
of the Department.
i. Amendment
i. Except as otherwise specifically provided in Section 3.f. and 4.c.i., this Agreement may be amended
only with the mutual written agreement of the parties, provided, however, that NHP may unilaterally
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amend this Agreement by giving Provider prior written notice setting forth the terms of the proposed
amendment where the proposed amendment is required under NHP's agreement with the
Department. Provider shall then have thirty (30) days from the receipt of NHP's notice to reject the
proposed amendment by written notice of rejection to NHP. If NHP does not receive such written
notice of rejection within that thirty (30) day period, the proposed amendment shall be deemed
accepted by and shall be binding upon Provider, effective as of the end of such thirty (30) day
period. If Provider rejects a proposed amendment in compliance with the aforementioned
obligations, either party may, in its discretion, elect to terminate this Agreement upon thirty (30)
days written notice to the other party.
j. Waiver
i. Waiver, whether express or implied, of any breach of any provision of this Agreement shall not be
deemed to be a waiver of any other provision or a waiver of any subsequent or continuing breach of
the same provision. In addition, waiver of one of the remedies available to either party in the event
of a default or breach of this Agreement by the other parry shall not at anytime be deemed a waiver
of a party's right to elect such remedy(ies) at any subsequent time if a condition of default
continues or recurs.
k. Third Party Beneficiaries
i. Nothing in this Agreement is intended to nor does create or provide for any third -party beneficiaries.
1. Notices
i. Any notice required by this Agreement shall be given in writing to the liaison person designated by a
party, sent by United States mail, return receipt requested, or by Federal Express, UPS, or other
overnight mail service, with postage prepaid and addressed to each party at the addresses set forth
on the signature page, or at any other address of which a party has given notice in accordance with
this Section. Notice shall be deemed given on the date of delivery or refusal as shown on the return
receipt if delivered by mail or the date upon which such notice is personally delivered in writing to
the designated liaison person.
m. News Release & Use of Name
i. Except as provided for in this Agreement, no party will advertise or utilize any marketing materials,
logos, trade names, service marks, or other materials created or owned by the other parties without
their respective prior written consent. No party shall acquire any right or title in or to the marketing
materials, logos, trade names, service marks or other materials of the other parties, respectively.
Notwithstanding the above, NHP may include the name of Provider's practice, the names of all
clinicians and practitioners in Provider's practice, PCMP Practice Site and telephone numbers,
areas of specialty services available from Provider's practice, and whether Provider or any
individual primary care provider in PCMP is accepting new Members, in listings of participating
Primary Care Medical Providers and Medical Homes and other marketing and documents used to
describe same.
ii. Any communications, publications or marketing developed or to be made available by Provider that
reference or identify NHP must be approved by NHP prior to any use or disclosure of same.
n. Force Majeure
i. Neither party shall be held responsible for delay or failure to perform hereunder when such delay or
failure is due to fire, flood, epidemic, strikes, acts of God or the public enemy, acts of terrorism, acts
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of war, unusually severe weather, legal acts of public authorities, or delays or defaults caused by
public carriers, or other circumstances which cannot reasonably be forecast or provided against.
Severability
i. Any term or provision of this Agreement that is invalid, illegal, or unenforceable in any situation in
any jurisdiction shall not affect the validity, legality or enforceability of the offending term or
provision in any other situation or in any other jurisdiction. If such invalidity, illegality or
unenforceability is caused by length of time or size of area, or both, the otherwise invalid provision
shall be, without further action by the parties, automatically amended to such reduced period or
area as would cure such invalidity, illegality or unenforceability; provided, however, that such
amendment shall apply only with respect to the operation of such provision in the particular
jurisdiction in which such determinations is made.
p. Notice of Complaint & Indemnity
i. Provider and NHP will promptly notify one another of any complaint or litigation of which each
becomes aware in connection with any transaction covered by this Agreement. Within forty-eight
(48) hours of receipt, each will forward to the other any notice of litigation or document referencing
litigation or any complaint letter from any state insurance department or other governmental body.
ii. Provider shall indemnify, defend, and hold harmless NHP and its officers, director, agents and
employees from and against any and all third party liabilities, costs, claims, suits, actions,
proceedings, demands, losses and liabilities of any kind (including court costs and reasonable
attorneys' fees) brought by a third party, arising from or relating to the acts or omissions of Provider
or any of its officers, director, agents and employees, without regard to any limitation provision
otherwise set forth in this Agreement.
q. Survival
i. Rights and obligations under this Agreement, which by their nature should survive, including
without limitation any compliance with laws, warranties, ownership/intellectual property,
indemnities, limitation of liabilities, confidentiality, and payment obligations. In addition, the
following provisions survive any expiration or termination of this Agreement, regardless of the
cause: 2, 2.a, 2.b} 2.f, 2.g. 2.j, 2.n, 3.c(iv), 4.c.iii, 5.e, , 6.a, Section 7 and all its subparts, Section 8
and all its subparts, 9.a, 9.d, 9.e, 9.f. 9.g, 9.1.9.0.9.p. 9.q and 9_,r.
r. Interpretation
i. The parties hereto agree that this Agreement is the product of negotiation between sophisticated
parties and individuals, all of whom were represented by, or had an opportunity to be represented
by legal counsel, and each of whom had an opportunity to participate in, the drafting of each
provision hereof. Accordingly, ambiguities in this Agreement, if any, shall not be construed strictly in
favor of or against any party hereto but rather shall be given a fair and reasonable construction.
s. Entire Agreement
i. This Agreement represents the entire Agreement between the parties and supersedes all previous
written or oral agreements or understandings regarding the participation by Provider with NHP and
cooperation by Provider with NHP care coordination activities.
t. Counterparts/Facsimile Execution/Captions
i. This Agreement may be executed and delivered: (i) in any number of counterparts, each of which
will be deemed an original, but all of which together will constitute one and the same instrument;
and/or (ii) by facsimile, in which case the instruments so executed and delivered shall be binding
NHP PCMP Agreement Phase 3.0
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and effective for all purposes. The captions in this Agreement are for reference purposes only and
shall not affect the meaning of terms and provisions herein.
The parties have caused their respective duly authorized representatives to execute this Agreement to be effective
on date noted below.
Effective Date: July 1, 2025
Provider:
Name of Organization: Weld County Department of Public Health
FederIdentification: 84-6000813
Attest:
35EA45CE-CB7714BC. _ . _
Esther E. Gesick, Clerk to the Board
7/7/2025
Date:
Date:
Provider Address for Notice:
Board of weld County Commissioners
1150 O Street
Greeley, CO 80634
NHP:
Board of County Commissioners
Weld County, Colorado
l
Signed by:
gY• • (z, &wk.
‘.-404FDFDC361 F44F
Perry L. Buck, Chair
7/7/2025
Signatory Prirt Name: Kari L. Snelson Title: Chief Executive Officer
Signature:
DocuSigned by:
SvitisOtAd
Address for Notice:
Northeast Health Partner
710 11th Avenue Suite L-75
Greeley, CO 80631
Attention: Network Department
Signature Date: 5/28/2025
NHP PCMP Agreement Phase 3.0
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zol5"-- 19Is
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411•11-11D
710 11th Ave, Ste. L-75
Greeley, CO 80631
PCMP Value Based Payment Addendum to Primary Care Medical Provider Agreement
This POMP Value Based Payment Addendum is attached to and made a part of that certain Primary
Care Medical Provider Agreement ("Agreement") effective July 1, 2025 by and between Northeast
Health Partners (NHP) and the Provider identified below:
Provider Name: Weld County Health Department
Federal Tax ID Number: 84-6000813
Addendum Effective Date: July 1, 2025
As of the Addendum Effective Date set forth above, the practice assessment score and
participating tier for the respective Provider PCMP Practice Site(s) is as follows:
Practice Site 1
Practice Site 2
N
PI
1174515258
1598359218
Provider ID
9000119877
04421095
Name
Weld
W
and
Health
Environment/Weld
County
Dept
Dept
of
Public
County
Health
Weld
and
Environment/Weld
Dept
County
Dept
of
County
Public
Health
Health
DBA
N/A
N/A
Address
1555
N
17th
Ave
2960 9th
Street
City, Zip
Greeley,
80631
Fort
Lupton, 80621
Score
68
68
Participating
Tier
1
1
The PMPM amounts for each participating tier are as follows:
Tier
Tier
Tier
Tier 3+
PMPM
Amount
Maximum
(up
to)
$2.00
$4.50
$7.00
$10.00
This Addendum does not otherwise modify, supersede, or otherwise alter the provisions of the
Agreement.
Contract Fare
Entity Information
Entity Name* Entity ID
NORTHEAST HEALTH PARTNERS @00040552
LLC
Q New Entity?
Contract Name* Contract ID
PRIMARY CARE MEDICAL PROVIDER (PCMP) WITH 9692
NORTHEAST HEALTH PARTNERS - TIER 1 ADDENDUM
Contract Status
CTB REVIEW
Contract Lead
BFRITZ
Contract Lead Email
bfritz@weld.gov;Health-
Contracts@weld.gov
Parent Contract ID
Requires Board Approval
YES
Department Project #
Contract Description
PRIMARY CARE MEDICAL PROVIDER (PCMP) WITH NORTHEAST HEALTH PARTNERS - TIER 1 ADDENDUM
Contract Description 2
Contract Type" Department
AGREEMENT HEALTH
Amount*
$0.00
Renewable*
YES
Automatic Renewal
YES
Grant
IGA
Department Email
CM-Health@weld.gov
Department Head Email
CM-Health-
DeptHead@weld.gov
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM -
CO U NTYATTO R N EY@W EL
D.GOV
If this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
Requested BOCC Agenda Due Date
Date* 06/28/2025
07/02/2025
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be
included?
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts
are not in OnBase
Contract Dates
Effective Date
Termination Notice Period
Contact Information
Review Date*
06/01/2026
Committed Delivery Date
Renewal Date*
07/02/2026
Expiration Date
Contact Info
Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2
Purchasing
Purchasing Approver Purchasing Approved Date
Approval Process
Department Head
JASON CHESSHER
DH Approved Date
06/26/2025
Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
07/07/2025
Finance Approver
CHERYL PATTELLI
Legal Counsel
BYRON HOWELL
Finance Approved Date Legal Counsel Approved Date
06/27/2025 06/27/2025
Tyler Ref #
AG 070725
Originator
BFRITZ
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