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HomeMy WebLinkAbout20172017RESOLUTION RE: APPROVE ANCILLARY SERVICES AGREEMENT AND AUTHORIZE CHAIR TO SIGN - CIGNA HEALTHCARE OF COLORADO, INC. 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 an Ancillary Services Agreement 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 Cigna Healthcare of Colorado, Inc., commencing July 1, 2017, 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 Ancillary Services Agreement 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 Cigna Healthcare of Colorado, Inc., 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 above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 10th day of July, A.D., 2017, pro nunc tunc July 1, 2017. ATTEST: datA44) 4deo; Weld County Clerk to the Board BY:C9- Q -i c puty Clerk to the Board APPR•. DAASST y A ttorney Date of signature: "1 ( @Co ( I BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO EL� Julie A. Cozad, Chair Steve Moreno, Pro -Tern Sean P. Conway 2017-2017 HL0049 Chloe Rempel From: Sent: To: Subject: Attachments: Tanya Geiser Tuesday, May 8, 2018 1:48 PM Kimberly Dewey; Chloe Rempel FW: Documents Pending Final Signatures 20172017.pdf; 20173877.pdf; 20173954.pdf; 20181094.pdf; 20181095.pdf Hello ladies, I have a status update for each below: Tanya Ext 2122 From: Kimberly Dewey Sent: Tuesday, May 8, 2018 9:58 AM To: Tanya Geiser <tgeiser@weldgov.com> Cc: Chloe Rempel <crempel@weldgov.com> Subject: Documents Pending Final Signatures Hello, This email serves as a status update for documents from the Commissioner's agenda that are pending final signatures from various sources. When final signatures are obtained, please remember to send a copy to the Clerk to the Board's Office to ensure the Commissioner's final resolution is signed, the resolution is distributed, and the complete document is finalized. The query included items pending as of today's date, so there are items from recent agendas that understandably may not have final signatures yet. 2017-2017 — Approve Ancillary Services Agreement — Cigna Healthcare we will NOT be getting anything back; Cigna lost the original contract in July of last year and when they finally found it, after months of delaying us when we followed -up, refused to sign the version that we signed because they said it was out of date. A new Cigna contract (see below: 2018-1095) was executed and sent to them in April. 2017-3877 - Task Order Contract for Women's Wellness Connection Clinical Services I believe I have this in a small stack and will get it to you. 2017-3954 — Task Order Contract #1 Prevention of Infertility and Management of STI I believe I have this in a small stack and will get it to you. 2018-1094 - Contract #6 for Nurse Home Visitor Program Issue with CDHS; at this time CDHS is refusing to sign, saying that the contract we executed (that they sent to us) had two typos in it and they want us to execute a new copy. I have been working with Esther the last few days on this one. 2018-1095 - Agreement for Ancillary Services — Cigna Healthcare Sent to Cigna in April; pending return from Cigna Thank you, Kim Dewey Deputy Clerk to the Board Weld County 1150 O Street Greeley, CO 80631 1 C'th1 l,D*fi�30 Memorandum TO: Julie A. Cozad, Chair Board of County Commissioners FROM: Mark E. Wallace, MD, MPH Executive Director Department of Public Health & Environment DATE: June 28, 2017 SUBJECT: Ancillary Services Agreement with Cigna Healthcare of Colorado For the Board's approval is an Ancillary Services Agreement ("Agreement") between Cigna Healthcare of Colorado, Inc. ("Cigna") and the Weld County Department of Public Health and Environment ("WCDPHE"). The invitation from Cigna to become a participating provider came from Cigna employer and customer feedback, expressing a need to have coverage for services we provide. We are committed to improving the health and well-being of patients who may experience health disparities that result from a variety of factors, including geographic availability, communication barriers, and cultural differences. We have been contracted with Blue Cross Blue Shield since November 1, 2012, primarily for immunizations. It has reduced the costs incurred by the county to keep our Weld county citizens immunized. This agreement will allow WCDPHE to receive payment from Cigna for the provision of covered services received by their members. Reimbursement for all covered services provided by the WCDPHE is made. by Cigna on a fee -for -service basis. This is not for new services, but services that we have historically provided for immunizations and family planning, and that are listed on our fee schedule that is approved annually by the Board. This agreement shall commence on July 1, 2017, or upon signature by both parties. This agreement was approved for placement on the Board's agenda via pass -around dated June 26, 2017. I recommend approval of the Ancillary Services Agreement with Cigna Healthcare of Colorado, Inc. 2017-2017 I-11- OO Ancillary Services Agreement This Ancillary Services Agreement ("Agreement") is between Cigna Healthcare of Colorado, Inc. ("Cigna") and Weld County Board of County Commissioners on behalf of Weld County Department of Public Health and Environment ("Provider") and is effective on July 1, 2017 (the "Effective Date"). SECTION 1. DEFINITIONS 1.1 Administrative Guidelines means the rules, policies and procedures adopted by Cigna or a Payor to be followed by Provider in providing services and doing business with Cigna and Payors under this Agreement. 1.2 Benefit Plan means a certificate of coverage, summary plan description or other document or agreement which specifies the health care services to be provided or reimbursed for the benefit of a Participant. 1.3 Cigna Affiliate means any subsidiary or affiliate of Cigna Corporation. 1.4 Coinsurance means a payment that is the financial responsibility of the Participant under a Benefit Plan for Covered Services that is calculated as a percentage of the contracted reimbursement rate for such services or, if reimbursement is on a basis other than a fee -for -service amount, as a percentage of a Cigna determined fee schedule or as a Cigna determined percentage of actual charges. 1.5 Copayment means a payment that is the financial responsibility of the Participant under a Benefit Plan for Covered Services that is calculated as a fixed dollar amount. 1.6 Covered Services means those health care services for which a Participant is entitled to receive coverage under the terms and conditions of the Participant's Benefit Plan. 1.7 Deductible means a payment for Covered Services calculated as a fixed dollar amount that is the financial responsibility of the Participant under a Benefit Plan prior to qualifying for reimbursement for subsequent health care costs under the terms of a Benefit Plan. 1.8 Medically Necessary/ Medical Necessity means services and supplies that satisfy the Medical Necessity requirements under the applicable Benefit Plan. No service is a Covered Service unless it is Medically Necessary. 1.9 Participant ANC2011 MCA. US Page 1 of 18 Version: 1 06/01/2012 means any individual, or eligible dependent of such individual, whether referred to as "Insured", "Subscriber", "Member", "Participant", "Enrollee", "Dependent", or similar designation, who is eligible and enrolled to receive Covered Services. 1.10 Participating Provider means a hospital, physician or group of physicians, or any other health care practitioner or entity that has a direct or indirect contractual arrangement with Cigna to provide Covered Services with regard to the Benefit Plan covering the Participant. 1.11 Payor means the person or entity obligated to a Participant to provide reimbursement for Covered Services under the Participant's Benefit Plan and which Cigna has agreed may access Provider's services under this Agreement. 1.12 Quality Management means the program described in the Administrative Guidelines relating to the quality of Covered Services provided to Participants. 1.13 Utilization Management means a process to review and determine whether certain health care services provided or to be provided are Medically Necessary and in accordance with the Administrative Guidelines. SECTION 2. DUTIES OF PROVIDER 2.1 Provider Services. Provider shall provide Covered Services to Participants upon the terms and conditions set forth in this Agreement and the Administrative Guidelines. 2.2 Standards. Provider shall provide Covered Services with the same standard of care, skill and diligence customarily used by similar providers in the community, the requirements of applicable law, and the standards of applicable accreditation organizations. Provider shall provide Covered Services to all Participants in the same manner, under the same standards, and with the same time availability as offered to other patients. Provider shall not differentiate or discriminate in the treatment of any Participant because of race, color, national origin, ancestry, religion, sex, marital status, sexual orientation, age, health status, veteran's status, handicap or source of payment. Provider shall assure that all health care providers who perform any of the services for which the Provider is responsible under this Agreement maintain all necessary licenses or certifications required by state and federal law. Provider shall immediately restrict, suspend, or terminate any such health care provider from providing services to Participants under this Agreement if such provider ceases to meet the licensing/certification requirements or other professional standards described in this Agreement. 2.3 Insurance/Application for Participation Information. ANC2011 MCA. US Page 2 of 18 Version: 1 06/01/2012 Provider shall maintain general and professional liability coverage in a form and amount acceptable to Cigna, give Cigna evidence of such coverage upon request and provide Cigna with immediate written notice of a material modification or termination of such insurance. Provider shall also notify Cigna in writing within 30 days of any material change in the information contained in Provider's application for participation with Cigna. 2.4 Administrative Guidelines. Provider shall comply with the Administrative Guidelines. Some or all Administrative Guidelines may be communicated in the form of a provider reference manual, in other written materials distributed by Cigna to Provider and/or at a website identified by Cigna. Administrative Guidelines may change from time to time. Cigna will give Provider advance notice of material changes to Administrative Guidelines. 2.5 Quality Management. Provider shall comply with the requirements of and participate in Quality Management as specified in the Administrative Guidelines. 2.6 Utilization Management. Provider shall comply with the requirements of and participate in Utilization Management as specified in this Agreement and the Administrative Guidelines. Payment may be denied for failure to comply with such Utilization Management requirements, and Provider shall not bill the Participant for any such denied payment. Cigna's Utilization Management requirements include, but are not limited to, the following: a) precertification must be secured from Cigna or its designee for those services and procedures for which it is required as specified in the Administrative Guidelines; b) Provider must provide Cigna or Cigna's designee with all of the information requested by Cigna or its designee to make its Utilization Management determinations within the timelines specified by Cigna or its designee in such request; and c) Provider will refer Participants to and/or use Participating Providers for the provision of Covered Services except in the case of an emergency or as otherwise required by law. 2.7 Records. Provider shall maintain medical records and documents relating to Participants as may be required by applicable law and for the period of time required by law. Medical records of Participants and any other records containing individually identifiable information relating to Participants will be regarded as confidential, and Provider and Cigna shall comply with applicable federal and state law regarding such records. Provider will obtain Participants' consent to or authorization for the disclosure of private and medical record information for any disclosures required under this Agreement if required by law. Upon request, Provider will provide Cigna with a copy of Participants' medical records and other records maintained by Provider relating to Participants. These records shall be provided to Cigna at no charge and within the timeframes requested by Cigna and will also be made available during normal business hours for inspection by Cigna, Cigna's designee, accreditation ANC2011 MCA. US Page 3 of 18 Version: 1 06/01/2012 organizations, or to any governmental agency that requires access to these records. This provision survives the termination of this Agreement. 2.8 Cooperation with Cigna and Cigna Affiliates. Provider shall cooperate with Cigna in the implementation of Cigna's Participant appeal procedure. Provider shall also cooperate with Cigna and Cigna Affiliates in implementing those policies and programs as may be reasonably requested by Cigna or a Cigna Affiliate for purposes of Cigna's or the Cigna Affiliate's business operations or required by Cigna or a Cigna Affiliate to comply with applicable law or accreditation requirements. SECTION 3. DUTIES OF CIGNA 3.1 Payors, Benefit Plan Types, Notice of Changes to Benefit Plan Types. Cigna may allow Payors to access Provider's services under this Agreement for the following Benefit Plan types: a) Benefit Plans where Participants are offered a network of Participating Providers and are required or given the option to select a Primary Care Physician; b) Benefit Plans where Participants are offered a network of Participating Providers and are not required or given the option to select a Primary Care Physician; and c) Benefit Plans where Participants are not offered a network of Participating Providers from which they may receive Covered Services. Benefit Plans may include workers' compensation plans. Cigna will give Provider advance notice if Cigna changes this list of Benefit Plan types for which Payors may access Provider's services under this Agreement. 3.2 Benefit Information. Cigna will give Provider access to benefit information concerning the type, scope and duration of benefits to which a Participant is entitled as specified in the Administrative Guidelines. 3.3 Participant and Participating Provider Identification. Cigna will establish a system of Participant identification and will identify Participating Providers to those Payors and Participants who are offered a network of Participating Providers. However, Cigna makes no representations or guarantees concerning the number of Participants that will be referred to Provider as a result of this Agreement and reserves the right to direct Participants to selected Participating Providers and/or influence a Participant's choice of Participating Provider. SECTION 4. COMPENSATION 4.1 Payments. Payments for Covered Services will be the lesser of the billed charge or the applicable fee under Exhibit A , subject to the Administrative Guidelines and minus any applicable Copayments, Coinsurance and Deductibles. The rates in this Agreement will be payment in full for all services furnished to Participants under this Agreement. Provider shall submit claims for Covered Services at the location identified by Cigna and in the manner and format specified in this Agreement and the Administrative ANC2011 MCA. US Page 4 of 18 Version: 1 06/01/2012 Guidelines. Claims for Covered Services must be submitted within 90 days of the date of service or, if Payor is the secondary payor, within 90 days of the date of the explanation of payment from the primary payor. Claims received after this 90 day period may be denied except as provided in the Administrative Guidelines, and Provider shall not bill Cigna, the Payor or the Participant for those denied services. Amounts due and owing under this Agreement with respect to complete claims for Covered Services will be payable within the timeframes required by applicable law. 4.2 Underpayments. If Provider believes a Covered Service has been underpaid, Provider must submit a written request for an appeal or adjustment with Cigna or its designee within 180 days from the date of Payor's payment or explanation of payment. The request must be submitted in accordance with Cigna's dispute resolution process set out in the Administrative Guidelines. Requests for appeals or adjustments submitted after this date may be denied for payment, and Provider will not be permitted to bill Cigna, the Payor or the Participant for those services. 4.3 Copayments, Coinsurance and Deductibles. Provider may charge Participants applicable Copayments, Coinsurance and Deductibles in accordance with the process set out in the Administrative Guidelines. 4.4 Limitations On Billing Participants. Provider shall not bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against Participants or persons other than the applicable Payor for Covered Services or for any amounts denied or not paid under this Agreement due to Provider's failure to comply with the requirements of Cigna's or its designee's Utilization Management Program or other Administrative Guidelines, failure to file a timely claim or appeal. This provision does not prohibit collection of any applicable Copayments, Coinsurance and Deductibles. This provision survives termination of this Agreement, is intended to be for the benefit of Participants, and supersedes any oral or written agreement to the contrary now existing or hereafter entered into between Provider and a Participant or persons acting on the Participant's behalf. Modifications to this section will become effective no earlier than the date permitted by applicable law. 4.5 Billing Patients Who Cease to Be Participants. Provider may bill a patient directly for any services provided following the date that patient ceases to be a Participant, and Payor has no obligation to pay for services for such patients. 4.6 NonMedically Necessary Services. Provider shall not charge a Participant for a service that is not Medically Necessary unless, in advance of providing the service, Provider has notified the Participant that the particular service will not be covered and the Participant acknowledges in writing that he or she will be responsible for payment for such service. 4.7 Reimbursement of Amounts Collected In Error. ANC2011 MCA. US Page 5 of 18 Version: 1 06/01/2012 If Provider collects payment from a Participant when not permitted to collect under either this Agreement or the Administrative Guidelines, Provider must repay the amount within 2 weeks of a request from Cigna or the Participant or of the date Provider has knowledge of the error. If Provider fails to make the repayments, then Cigna may (but is not obligated to) reimburse the Participant the amount inappropriately paid and then withhold this amount from future payments. 4.8 Overpayments. Provider shall refund to Cigna any excess payment made by a Payor to Provider if Provider is for any reason overpaid for health care services or supplies. Cigna may, at its option, deduct the excess payment from other amounts payable, and Provider will be notified of any such deduction as specified in the Administrative Guidelines. 4.9 Audits. Upon reasonable notice and during regular business hours, Cigna or its designee will have the right to review and make copies of all records maintained by Provider with respect to all payments received by Provider from all sources for Covered Services provided to Participants. Cigna or its designee will have the right to conduct audits of such records and may audit its own records to determine if amounts have been properly paid under this Agreement. Any amounts determined to be due and owing as a result of such audits must be promptly paid or, at the option of the party to whom such amounts are owed, offset against amounts due and owing by such party hereunder. This provision survives the termination of this Agreement. 4.10 Coordination of Benefits. Certain claims for Covered Services are claims for which another payor may be primarily responsible under coordination of benefit rules. Provider may pursue those claims in accordance with the process set out in the Administrative Guidelines. When a Participant's coverage under a Benefit Plan is secondary, Payor will pay an amount no greater than that which, when added to amounts payable from other sources under applicable coordination of benefits rules, equals 100% of the reimbursement for Covered Services under this Agreement, but may be less as determined by the terms of the Participant's Benefit Plan. 4.11 Applicability of the Rates. The rates in this Agreement apply to all services rendered to Participants in the Benefit Plan types covered by this Agreement, including services covered under a Participant's in -network or out -of -network benefits, and whether the Payor or Participant is financially responsible for payment. 4.12 Excluded Services. This Agreement excludes services that Cigna has elected to obtain under an arrangement between Cigna or a Cigna Affiliate and a national or regional vendor or provider or a capitated provider, except as otherwise agreed by Cigna. Provider will not be reimbursed and will not bill Participants for any such excluded services. If Cigna notifies Provider that it no longer chooses to exclude a particular service from ANC2011 MCA. US Page 6 of 18 Version: 1 06/01/2012 this Agreement, that service will no longer be excluded and those services will be reimbursed as specified in Exhibit A . 4.13 Provider Facilities. This Agreement shall specifically exclude those services rendered at Provider facilities other than those facilities agreed upon and utilized as of the Effective Date unless otherwise agreed in writing by Cigna. SECTION 5. TERM AND TERMINATION 5.1 Term of This Agreement. This Agreement begins on the Effective Date and continues from year to year unless terminated as set forth below. 5.2 How This Agreement Can Be Terminated. Either Provider or Cigna can terminate this Agreement at any time by providing at least 60 days advance written notice. Either Provider or Cigna can terminate this Agreement immediately if the other becomes insolvent. Cigna can terminate this Agreement immediately (or upon such longer notice required by applicable law, if any) if Provider no longer maintains the licenses required to perform its duties under this Agreement, Provider is disciplined by any licensing, regulatory, accreditation organization, or any other professional organization with jurisdiction over Provider, or if Provider no longer satisfies Cigna's credentialing requirements. Upon termination of this Agreement for any reason, the rights of each party terminate, except as provided in this Agreement. Termination will not release Provider or Cigna from obligations under this Agreement prior to the effective date of termination. 5.3 Services Upon Termination. If this Agreement is terminated without cause, Provider shall continue to provide Covered Services for those Participants suffering from a chronic condition requiring continuity of care for whom an alternative means of receiving necessary care was not arranged at the time of such termination. Provider shall continue to provide Covered Services to such Participants so long as the Participant retains eligibility under a Benefit Plan, until the earlier of completion of such services or the assumption of treatment by another provider. Payment for Covered Services provided to any such Participant after termination of this Agreement shall be in accordance with the terms of the Participant's Benefit Plan. If, after termination of this Agreement, Provider determines that Cigna has not used due diligence to arrange for alternative care, Provider may terminate the provider -patient relationship. Provider has no obligation under this Agreement to provide services to individuals who cease to be Participants. SECTION 6. GENERAL PROVISIONS 6.1 Confidentiality. As a result of this Agreement, Provider may have access to certain of Cigna's confidential and proprietary information. Provider shall hold such information, including the terms of this Agreement, in confidence and will not use or disclose such ANC2011 MCA. US Page 7 of 18 Version: 1 06/01/2012 information to any person without the prior written consent of Cigna except as may be required by law. This provision does not prohibit communications necessary or appropriate for the delivery of health care services, communications about coverage and coverage appeal rights or any other communications specifically protected under applicable law. This provision survives the termination of this Agreement. 6.2 Independent Parties. Provider is an independent contractor. Cigna and Provider do not have an employer - employee, principal -agent, partnership, or similar relationship. Nothing in this Agreement, including Provider's participation in Quality Management and Utilization Management programs, nor any coverage determination made by Cigna or a Payor, is intended to interfere with or affect Provider's independent judgment in providing health care services to its patients. 6.3 Internal Dispute Resolution. Disputes that might arise between the parties regarding the performance or interpretation of the Agreement must first be resolved through the applicable internal dispute resolution process outlined in the Administrative Guidelines. In the event the dispute is not resolved through that process, either party can request in writing that the parties attempt in good faith to resolve the dispute promptly by negotiation between designated representatives of the parties who have authority to settle the dispute. If the matter is not resolved within 60 days of such a request, either party may initiate arbitration by providing written notice to the other. With respect to a payment or termination dispute, Provider must submit a request for arbitration within 12 months of the date of the letter communicating the final decision under Cigna's internal dispute resolution process unless applicable law specifically requires a longer time period to request arbitration. If arbitration is not requested within that 12 month period, Cigna's final decision under its internal dispute resolution process will be binding on Provider, and Provider shall not bill Cigna, Payor or the Participant for any payment denied because of the failure to timely submit a request for arbitration. 6.4 Arbitration. If the dispute is not resolved through Cigna's internal dispute resolution process, the controversy shall be resolved through binding arbitration. The arbitration shall be conducted in 60 days in accordance with the American Health Lawyers Association Alternative Dispute Resolution Service Rules of Procedure for Arbitration, and which to the extent of the subject matter of the arbitration, shall be binding not only on all parties to the agreement, but on any other entity controlled by, in control of or under common control with the party to the extent that such affiliate joins in the arbitration, and judgment on the award rendered by the arbitrator may be entered in any court having jurisdiction thereof. Each party shall assume its own costs, but the compensation and expenses of the mediator and any administrative fees or costs shall be borne equally by the parties. The decision of the arbitrator shall be final, conclusive and binding, and no action at law or in equity may be instituted by either party other than to enforce the award of the arbitrator. The parties intend this alternative dispute resolution procedure to be a private undertaking and agree that an arbitration ANC2011 MCA. US Page 8 of 18 ! 06/01/2012 Version: 1 conducted under this provision shall not be consolidated with an arbitration involving other hospitals or third parties, and that the arbitrator shall be without power to conduct an arbitration on a class basis. Judgment upon the award rendered by the arbitrator may be entered in any court of competent jurisdiction. 6.5 Material Adverse Change Amendments. For amendments that are a material adverse change in the terms of this Agreement, Cigna can amend this Agreement by providing 90 days advance written notice except if a shorter notice period is required to comply with changes in applicable law. The change will become effective at the end of the 90 day notice period or, if applicable, the shorter notice period required to comply with changes in applicable law. If Provider objects to the material adverse change and notifies Cigna of its intent to terminate within 30 days of the date of the notice of amendment, the termination will be effective at the end of the 90 day notice of the material adverse change or, if applicable, at the end of the shorter notice period required to comply with changes in applicable law, unless Cigna agrees to retract the amendment, in which case the Agreement will remain in force without the proposed amendment. 6.6 All Other Amendments. For amendments that are not material adverse changes in the terms of this Agreement, Cigna can amend this Agreement by providing 30 days advance written notice to Provider. Alternatively, both parties can agree in writing to amend this Agreement. 6.7 Assignment and Delegation. Neither Cigna nor Provider may assign any rights or delegate any obligations under this Agreement without the written consent of the other party; provided, however, that any reference to Cigna includes any successor in interest and Cigna may assign its duties, rights and interests under this Agreement in whole or in part to a Cigna Affiliate or may delegate any and all of its duties to a third party in the ordinary course of business. 6.8 Sale of Business/Change in Management. If, during the term of this Agreement, Provider desires (i) to sell, transfer or convey its business or any substantial portion of its business assets to another entity, whether through a stock or asset transaction, or (ii) enter into a management contract with another entity, Provider shall so advise Cigna in writing at least 120 days prior to the sale, transfer or contract effective date. Provider warrants and covenants that this Agreement will be part of the transfer, and will be assumed by the new entity and that the new entity will honor and be fully bound by the terms and conditions of this Agreement unless the new entity already has an agreement with Cigna or a Cigna Affiliate, in which case Cigna, in its sole discretion, will determine which Agreement will prevail. Notwithstanding the above, if Cigna, in its sole discretion, is of the opinion that the Agreement cannot be satisfactorily performed by the assuming entity or does not want to do business with that entity for whatever reason, Cigna may terminate this Agreement by giving Provider 60 days written notice, notwithstanding any other provision in the Agreement. ANC2011 MCA. US Page 9 of 18 Version: 1 06/01/2012 6.9 Use of Name. Provider agrees that Cigna may include descriptive information about Provider in literature distributed to existing or potential Participants, Participating Providers and Payors. That information will include, but not be limited to, Provider's name, telephone number, address, and specialties. Provider may identify itself as a Participating Provider with respect to those Benefit Plan types in which Provider participates with Cigna. Provider's use of Cigna's name or a Cigna Affiliate's name, or any other use of Provider's name by Cigna will be upon prior written approval or as the parties may agree. 6.10 Notices. Any notice required under this Agreement must be in writing and sent by United States mail, postage prepaid, to Cigna and Provider at the addresses below. Cigna may also notify Provider by sending an electronic notice with automatic receipt verification to Provider's e-mail address below. Either party can change the address for notices by giving written notice of the change to the other party in the manner just described. 6.11 Governing Law/Regulatory Addenda. Applicable federal law and the law of the jurisdiction where Provider is domiciled governs this Agreement. One or more regulatory addenda may be attached to the Agreement setting out provisions that are required by law with respect to Covered Services rendered to certain Participants (i.e. Participants under an insured plan). These provisions are incorporated into this Agreement to the extent required by law and as specified in such Addenda. ANC2011 MCA. US Page 10 of 18 Version: 1 06/01/2012 6.12 Waiver of Breach/Severability/Entire Agreement/Copy of Original Agreement. If any party waives a breach of any provision of this Agreement, it will not operate as a waiver of any subsequent breach. If any portion of this Agreement is unenforceable for any reason, it will not affect the enforceability of any remaining portions. This Agreement, including any exhibits to this Agreement, contains all of the terms and conditions agreed upon and supersedes all other agreements between the parties, either oral or in writing, regarding the subject matter. A copy of this fully executed Agreement is an acceptable substitute for the original fully executed Agreement. AGREED AND ACCEPTED BY: Weld County Board of County Commissioners on behalf of the Weld County Department of Public Health and Enviroment Address: 1555 North 17th Avenue, Greeley, CO 80631 Email Address: NA By: Printed Name: Julie Cozad Title: Chair, Board of County Commissioners Date Signed: July 10, 2017 Federal Tax ID: 84-6000813 National Provider Identifier: 1174515258 Cigna HealthCare of Colorado, Inc. Address: 8505 East Orchard Road 2T1 Greenwood Village, CO 80111 Attention: AVP of Provider Contracting By: Printed Name: Title: Date Signed: ANC2011 MCA. US Page 11 of 18 Version: 1 06/01/2012 Qoti-aOn ADDENDUM TO ANCILLARY AGREEMENT FOR THE STATE OF COLORADO The provisions set forth in this Addendum are being added to the Agreement to comply with legislative and regulatory requirements of the State of Colorado regarding provider contracts with providers rendering health care services in the State of Colorado. To the extent that such Colorado laws and regulations are applicable and/or not otherwise preempted by federal law, the provisions set forth in this Addendum shall apply and, to the extent of a conflict with a provision in the Agreement, shall control. The provisions set forth in this Addendum do not apply with regard to Covered Services rendered to Participants covered under self -funded plans. (1) The definition for Emergency Services, if any, shall comply with Colorado laws and regulations to the extent applicable. (2) Provider shall receive payments for Covered Services as set forth in the Agreement. Colorado law prohibits the use of financial disincentives or the withholding of full compensation to Provider because of the number or type of referrals made by Provider to Participating Providers in accordance with applicable Utilization Management requirements concerning the provision of Covered Services to Participants. (3) Pursuant to the requirements of Section 10-16-704 (4.5), Colorado Revised Statutes, to the extent applicable: With respect to services reimbursed on a fee -for -service basis, if Provider believes Provider has been underpaid for a Covered Service Provider must submit a written request for an appeal or adjustment with Cigna or its designee within 12 months after the date of the original payment or explanation of benefits. With respect to services reimbursed on a fee -for -service basis, Payor may only retroactively adjust reimbursement made to Provider during the 12 month period after the date of the original explanation of benefits. Adjustments to claims related to coordination of benefits with federally funded health benefit plans, including Medicare and Medicaid, shall be made within 36 months after the date of service. (4) Neither Provider nor Cigna shall be prohibited from protesting or expressing disagreement with a medical decision, medical policy or medical practice of Provider or Cigna. ANC.AMD.CO.2012 01/01/2013 ANC2011 MCA. US Page 12 of 18 Version: 1 06/01/2012 (5) Cigna shall not terminate the Agreement because: a) Provider expresses disagreement with Cigna's decision to deny or limit benefits to a Participant or assists the Participant to seek reconsideration of Cigna's decision; or b) Provider discusses with a current, former or prospective patient any aspect of the patient's medical condition, any proposed treatments or treatment alternatives, whether covered by Cigna or not, policy provisions of a plan or Provider's personal recommendation regarding selection of a health plan based on the Provider's personal knowledge of the health needs of such patients. (6) In the event of termination of the Agreement and to the extent applicable, the provisions of Section 10-16-705(4) of the Colorado Statutes shall apply. (7) Agreements for less than 2 years in duration may be terminated without cause by Cigna or Provider with 90 days advance written notice to the other party. Notwithstanding the foregoing, to the extent that the Agreement provides for a longer notification period with respect to termination of the Agreement by Provider or Cigna, such longer notification period will apply. (8) Agreements for 2 or more years in duration may be terminated without cause in accordance with the terms set forth in the Agreement. (9) Cigna can terminate the Agreement immediately (or upon such longer notice required by applicable law, if any) if Provider no longer maintains the licenses required to perform his/her duties under the Agreement, Provider is disciplined by any licensing, regulatory, accreditation organization, or any other professional organization with jurisdiction over Provider, or if Provider no longer satisfies Cigna's credentialing requirements. (10) Cigna or Provider can terminate the Agreement if the other becomes insolvent. (11) Any termination notice must be in writing and sent by United States mail, postage prepaid, to Cigna at the addresses below. Cigna may also notify Provider by sending an electronic notice with automatic receipt verification to Provider's e-mail address. Either party can change the address for notices by giving written notice of the change to the other party in the manner just described. Cigna HealthCare of Colorado, Inc. Attention: Manager of Contracting 8505 East Orchard Road 2T1 Greenwood Village, CO 80111 ANC.AMD.CO.2012 01/01/2013 ANC2011 MCA. US Page 13 of 18 Version: 1 06/01/2012 (12) Payment terms shall not survive the termination of the Agreement except as required by law or as agreed upon by Provider. (13) Cigna shall provide Provider with at least 90 days written notice of the effective date of a Material Change to the Agreement. Such notice will be conspicuously entitled "NOTICE OF MATERIAL CHANGE TO CONTRACT." "Material Change" means a change to an Agreement that: a) decreases the provider's payment or compensation; b) changes the administrative procedures in a way that may reasonably be expected to significantly increase the providers administrative expense; c) replaces the maximum allowable cost list used with a new and different maximum allowable cost list by a person or entity for reimbursement of generic prescription drugs; or d) adds a new category of coverage. A Material Change does not include: a) a decrease in payment or compensation resulting solely from a change in a published fee schedule upon which the payment or compensation is based and the date of applicability is clearly identified in the Agreement; b) a decrease in payment or compensation resulting from a change in an Agreement for pharmacy services such as a change in a fee schedule based on average wholesale price or maximum allowable cost; c) a decrease in payment or compensation that was anticipated under the terms of the Agreement, if the amount and date of applicability of the decrease is clearly identified in the Agreement; d) an administrative change that may significantly increase the provider's administrative expense, the specific applicability of which is clearly identified in the contract; e) changes to an existing prior authorization, precertification, notification or referral program that do not substantially increase the provider's administrative expense; or changes to an edit program or to specific edits. If Provider objects in writing to the material change within 15 days and there is no resolution of the objection, Cigna or Provider may terminate the Agreement upon written notice to the other party but no later than 60 days prior to the effective date of the material change. If Provider does not object to the material change within 15 days, the change shall be effective as specified in the notice. If the material change is the addition of a new category of coverage and Provider objects within 15 days, the material change shall not be effective and Cigna may not terminate Provider for this reason. ANC.AMD.CO.2012 01/01/2013 ANC2011 MCA. US Page 14 of 18 Version: 1 06/01/2012 Notwithstanding anything in this section, Cigna may modify the Agreement by operation of state or federal law or regulation and Cigna may make such notification to Provider by any reasonable means. (14) Intermediary Contracts. If Provider is an Intermediary as defined by C.R.S.A. § 10-16-102(25.5) and 3 Colo. Code of Regs. § 4.2-15(IV)(B), or any other applicable law, Provider as an Intermediary agrees to the following: (a) If contracted to perform utilization management, utilization review, provider credentialing, administration of health insurance benefits, setting or negotiation of reimbursement rates, payment to providers, network development, disease management programs, or any other program subject to Section 10-16-705(6.5) C.R.S., Intermediary shall comply with the same standards, guidelines, medical policies, and benefit terms as Cigna. (b) If contracted to perform utilization management, utilization review, provider credentialing, administration of health insurance benefits, setting or negotiation of reimbursement rates, payment to providers, network development, disease management programs, or any other program subject to Section 10-16-705(10.5)(a) C.R.S., Intermediary shall indicate the name of Intermediary and the company for which it is conducting the work when making any payment to a health care provider on behalf of Cigna. (c) Intermediary will comply, and shall require Subcontracted Providers to comply, with all of the applicable requirements of Section 10-16-705, C.R.S. (d) Cigna is responsible for ensuring that Subcontracted Providers have the capacity and legal authority to furnish Covered Services. (e) Cigna has the right to approve or disapprove participation status of Subcontracted Providers in its own or a contracted network for the purpose of delivering Covered Services to its Participants. (f) Intermediary shall provide Cigna with copies of Subcontracted Providers' contracts in accordance with Applicable Law and Cigna shall maintain copies of all such contracts. (g) As applicable, Intermediary shall transmit utilization documentation and claims paid documentation to Cigna. Cigna shall monitor the timeliness and appropriateness of payments made to providers and health care services rendered to Participants. ANC.AMD.CO.2012 01/01/2013 ANC2011 MCA.US Page 15 of 18 Version: 1 06/01/2012 (h) As applicable, Intermediary shall maintain books, records, financial information, and documentation of services provided to Participants at the Intermediary's place of business in the State of Colorado. (i) Intermediary agrees to allow the Commissioner of the Division of Insurance for the State of Colorado access to the Intermediary's books, records, financial information and any documentation of services provided to Participants as necessary to determine compliance with the law. (j) Cigna shall have the right, in the event of Intermediary's insolvency, to require the assignment to Cigna of the provisions of a Subcontracted Provider's contract addressing the provider's obligations to furnish Covered Services. ANC.AMD.CO.2012 01/01/2013 ANC2011 MCA. US Page 16 of 18 Version: 1 06/01/2012 Cigna HealthCare Exhibit C Fee Schedule and Reimbursement Terms This is an Exhibit to an Agreement between: Provider: Weld County Department of Public Health and Enviroment CIGNA Party: CIGNA HealthCare of Colorado, Inc. Effective Date: July 1, 2017 This Rate Exhibit: Applies to: Weld County Department of Public Health and Environment Federal Tax ID: 84-6000813 National Provider Identifier: 1174515258 Effective Date: July 1, 2017 I. DEFINITIONS CIGNA Standard Fee Schedule means the standard CIGNA fee schedule in effect at the time of service and applicable to this Agreement for certain Covered Services provided to Participants. The CIGNA Standard Fee Schedule is subject to change. For workers' compensation Benefit Plans, the CIGNA Standard Fee Schedule shall not exceed the state fee schedule. CIGNA Resource Based Relative Value Scale or CIGNA RBRVS means the methodology designated by CIGNA to produce the allowable fee for certain Covered Services rendered to Participants that uses the components of Relative Value Units (RVU's), geographic practice cost indices (GPCI's), conversion factor and base relativity factors, as defined by CIGNA. II. FEE FOR SERVICE REIMBURSEMENT A. Except as otherwise provided below, Covered Services will be reimbursed at the lesser of billed charges or the CIGNA RBRVS allowable fee, less applicable Copayments, Deductibles and Coinsurance. The CIGNA RBRVS allowable fees are updated by CIGNA periodically to reflect new information regarding RVU's, GPCI's, conversion factor, and the addition of new codes and services. The GPCI locality used for this Agreement is Colorado . B. CIGNA will apply the following base relativity factors in its CIGNA RBRVS calculation to the services specified below: CPT4 Procedure Code Group Base Relativity Factor Surgery Codes 115 % Evaluation & Management Codes 115 % Medicine Codes 115 % ANC2011 MCA. US Page 17 of 18 Version: 1 06/01/2012 C. The following services are excluded from the reimbursement methodology described above, and such Covered Services will be reimbursed at the lesser of billed charges or the fee listed below, less applicable Copayments, Deductibles and Coinsurance: Procedure Code (s)/Modifiers Description Maximum Allowable Fee 59400 Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care $2,050.00 59510 Routine obstetric care including antepartum care, cesarean delivery and postpartum care $2,050.00 59610 Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and /or forceps) and postpartum care, after previous cesarean delivery $2,050.00 59618 Routine obstetric care including antepartum care, cesarean delivery and postpartum care, following attempted vaginal delivery after previous cesarean delivery $2,050.00 D. The following services are excluded from the reimbursement methodology described above, and such Covered Services will be reimbursed at the lesser of billed charges or the applicable fee under the CIGNA Standard Fee Schedule, less applicable Copayments, Deductibles and Coinsurance. 1. Injectable drugs, immunizations, immunization administration, vaccines, toxoids; physical therapy, pathology, radiology and laboratory services and routine venipuncture as defined within the Current Procedural Terminology (CPT) coding system and published by the American Medical Association and as defined within the Healthcare Common Procedure Coding System (HCPCS) and published by the Centers for Medicare & Medicaid Services. 2. All procedure codes for Covered Services for which reimbursement has not been established above, including but not limited to those for unlisted procedures as well as new Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS) and/or American Society of Anesthesiologists (ASA) procedure codes, until such time as the applicable RVU's have been loaded into the appropriate claims systems. E. Notwithstanding anything to the contrary set forth above, those services that are excluded from this Agreement under the Excluded Services section of the Agreement shall not be reimbursed and Participants shall not be billed for such services. ANC2011 MCA. US Page 18 of 18 Version: 1 06/01/2012 Hello