Contract Name,Field Name,Snippet,Page Number,Confidence Level,Field Extracted Value,Imputed Value
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,Agreement Name,"9.19
Entire Agreement. This Agreement, including the Attachments each of which are
made a part of and incorporated into this Agreement, the Provider Manual and any addenda or
amendments comprises the complete agreement between the Parties and supersedes all previous
agreements and understandings (whether verbal or in writing) related to the subject matter of this
Agreement.
9.20 Headings. The various headings of this Agreement are provided for convenience only
and shall not affect the meaning or interpretation of this Agreement or any provision of it.
9.21
Interpretation. Both Parties have had the opportunity to review this Agreement with
legal counsel, and any ambiguity found in this Agreement shall not be construed in a Party's favor on
the basis that the other Party drafted the provision containing the ambiguity.
9.22
Survival. Any provision of this Agreement, including an Attachment that requires or",20,0.6402428150177002,"
not enough information",
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,Summary,"WHEREAS, Health Plan issues (or is pursuing a license allowing it to issue) health benefit plans and
seeks to include health care providers in one or more provider networks for such plans; and
WHEREAS, Contracted Provider provides health care items and services to the general public by
health care providers employed by Contracted Provider; and
WHEREAS, Health Plan and Contracted Provider desire to enter into this Agreement whereby
Contracted Provider will provide health care items and services to Health Plan's health benefit plan
enrollees in exchange for payments from Health Plan, all subject to and in accordance with the terms
and conditions of this Agreement;
NOW THEREFORE, the Parties agree as follows:
1.
Construction.
1.1
The base part of this Agreement is designed for use with a variety of providers and
Benefit Plans. Provisions specific to particular providers and Benefit Plans are included in
Attachments to the Agreement.
1.2",2,0.6668503284454346," The Agreement is between a Health Plan and a Contracted Provider for the provision of health care items and services to Health Plan's health benefit plan enrollees in exchange for payments. It includes provisions specific to particular providers and Benefit Plans, and all provisions are cumulative. The Health Plan is entitled to oversee the activities of Contracted Provider and its Providers and subcontractors and is accountable under the CMS Contract for such activities. The Agreement, including Attachments, the Provider Manual, and any addenda or amendments, constitutes the complete agreement between the Parties and supersedes all previous agreements and understandings. The Parties have had the opportunity to review the Agreement with legal counsels, and any ambiguity shall not be construed in a Party's favor.

The Agreement governs the Parties' rights and responsibilities related to the provision of Covered Services to Members under the Medicaid/FamilyCare Program. In the event of any inconsistent or contrary language, the provisions of Attachment B-1 shall prevail with respect to Benefit Plans under the Medicaid/FamilyCare Program. Any obligation of Contracted Provider in this Attachment shall apply to Providers to the same extent.",
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,Contract State,"from liability deriving or resulting from its insolvency or inability or failure to pay or
reimburse any other person, firm, or corporation furnishing or supplying work,
services, materials, or supplies in connection with the performance of this
Agreement/Subcontract.
3.
Contracted Provider/Subcontractor agrees further that it will indemnify and hold
harmless the State, its officers, agents, and employees, and the Members and their
eligible dependents from any and all claims for services for which Contracted
Provider/Subcontractor receives payment.
4.
Contracted Provider/Subcontractor agrees further to indemnify and hold harmless the
State, its officers, agents and employees, and the Members and their eligible
dependents, from all claims, damages, and liability, including costs and expenses, for
violation of any proprietary rights, copyrights, or rights of privacy arising out of the
publication, translation, reproduction, delivery, performance, use, or disposition of any",63,0.6559892892837524, New Jersey,
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,Provider State,"Medicaid or Medicaid/FamilyCare A, B and ABP Members. Personal contributions to care
for Medicaid/FamilyCare C Members and copayments for Medicaid/FamilyCare D Members
shall be collected in accordance with the applicable Benefit Plan.
Q.
INDEMNIFICATION BY PROVIDER/SUBCONTRACTOR
1.
Contracted Provider/Subcontractor agrees to indemnify and hold harmless the State,
its officers, agents and employees, and the Members and their eligible dependents from
any and all claims or losses accruing or resulting from its negligence in furnishing or
supplying work, services, materials, or supplies in connection with the performance of
this Agreement/Subcontract.
2.
Contracted Provider/Subcontractor agrees to indemnify and hold harmless the State,
its officers, agents, and employees, and the Members and their eligible dependents
from liability deriving or resulting from its insolvency or inability or failure to pay or
reimburse any other person, firm, or corporation furnishing or supplying work,",63,0.658284068107605," CMS
",
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,TIN,"27
PO Box Address: (For Corporation)
IRS ID/Other Tax ID: (For Corporations)
All business location addresses: (For Corporations)
Relationship to other persons with Ownership or Control Interest. List all.
2.
Name:
Relationship:
Percent of Ownership:
Date of Birth: (For
Primary Address:
Individuals)
SSN: (For Individuals)
PO Box Address: (For Corporation)
IRS ID/Other Tax ID: (For Corporations)
All business location addresses: (For Corporations)
Relationship to other persons with Ownership or Control Interest. List all.
3.
Name:
Relationship:
Percent of Ownership:
Date of Birth: (For
Primary Address:
Individuals)
SSN: (For Individuals)
PO Box Address: (For Corporation)
IRS ID/Other Tax ID: (For Corporations)
All business location addresses: (For Corporations)
Relationship to other persons with Ownership or Control Interest. List all.
B.
Please list below the information requested for any Medicaid provider, fiscal agent or",28,0.5072042942047119, IRS ID/Other Tax ID.,
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,Effective Date,"the post expiration or termination transition period described herein, as follows:
9.25.1 The Party is a corporation or other legally recognized entity duly incorporated
or organized, validly existing and in good standing under the laws of the State in which it is
incorporated, organized or operating and it has the authority to transact business in each State in which
it operates.
9.25.2 The Party has the corporate or company power and legal authority to, and has
taken all necessary corporate or other action on its part to, authorize the execution and delivery of this
Agreement and the performance of its obligations hereunder.
9.25.3 This Agreement has been duly executed and delivered by the Party, and
constitutes a legal, valid, and binding agreement that is enforceable against such Party in accordance
with its terms, except as limited by applicable bankruptcy, reorganization, moratorium and similar
Laws affecting the enforcement of creditors' rights.",21,0.6296658515930176, 8/25/2020,
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,Termination Date,"the post expiration or termination transition period described herein, as follows:
9.25.1 The Party is a corporation or other legally recognized entity duly incorporated
or organized, validly existing and in good standing under the laws of the State in which it is
incorporated, organized or operating and it has the authority to transact business in each State in which
it operates.
9.25.2 The Party has the corporate or company power and legal authority to, and has
taken all necessary corporate or other action on its part to, authorize the execution and delivery of this
Agreement and the performance of its obligations hereunder.
9.25.3 This Agreement has been duly executed and delivered by the Party, and
constitutes a legal, valid, and binding agreement that is enforceable against such Party in accordance
with its terms, except as limited by applicable bankruptcy, reorganization, moratorium and similar
Laws affecting the enforcement of creditors' rights.",21,0.6552231311798096, 180 days.,
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,Agreement Type,"9.19
Entire Agreement. This Agreement, including the Attachments each of which are
made a part of and incorporated into this Agreement, the Provider Manual and any addenda or
amendments comprises the complete agreement between the Parties and supersedes all previous
agreements and understandings (whether verbal or in writing) related to the subject matter of this
Agreement.
9.20 Headings. The various headings of this Agreement are provided for convenience only
and shall not affect the meaning or interpretation of this Agreement or any provision of it.
9.21
Interpretation. Both Parties have had the opportunity to review this Agreement with
legal counsel, and any ambiguity found in this Agreement shall not be construed in a Party's favor on
the basis that the other Party drafted the provision containing the ambiguity.
9.22
Survival. Any provision of this Agreement, including an Attachment that requires or",20,0.6122592091560364, Agreement,
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,Contract Type,"proposed treatments or treatment alternatives, whether covered by Health Plan or not,
policy provisions of Health Plan, or the Contracted Provider's/Subcontractor's
personal recommendation regarding selection of a health plan based on Contracted
Provider's/Subcontractor's personal knowledge of the health needs of such patients.
2.
Because Contracted Provider/Subcontractor engaged in medical communications,
either explicit or implied, with a patient about medically necessary treatment options,
or because Contracted Provider/Subcontractor practiced its profession in providing the
most appropriate treatment required by its patients and provided informed consent
within the guidelines of the law, including possible positive and negative outcomes of
the various treatment modalities.
H.
TERMINATION OF AGREEMENT/SUBCONTRACT - STATE
Contracted Provider/Subcontractor understands and agrees that the State may order the
termination of this Agreement/Subcontract if it is determined that Contracted",45,0.4833456873893738, Professional,
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,Gold Carded,"Health Services and the Department of Banking and Insurance.
4.2.3
Credentialing. All Providers must meet the Credentialing Criteria. Subject to
Laws and Program Requirements, (a) Health Plan conducts credentialing of providers before they
begin providing Covered Services and re-credentialing from time to time thereafter as required for
Health Plan's compliance with Laws, Program Requirements and accreditation standards, and
Providers shall consent to and cooperate with such credentialing/re-credentialing, which may include
site reviews, and (b) until successful completion of credentialing of a provider by Health Plan, (i) the
provider shall not be added as a Participating Provider under this Agreement, and (ii) the provision
of, and payment for, Health Plan authorized Covered Services to Members by the provider shall be
subject to Health Plan's policies and procedures for non-participating providers.
4.3",7,0.48558712005615234,"
no
",
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,Value-Based Contract,"Requirements and equitably adjust payments to the Provider until the Provider resumes its
performance under this Agreement.
9.17
Severability. When possible, each provision of this Agreement shall be interpreted in
such manner as to be effective, valid and enforceable under Laws. If any provision of this Agreement
is held to be prohibited by, or invalid or unenforceable under Laws, such provision shall be ineffective
only to the express extent of such prohibition, unenforceability or invalidity, without invalidating the
remainder of this Agreement.
9.18 Waiver. No waiver shall be effective unless in writing and signed by the waiving
Party. A waiver by a Party of a breach or failure to perform this Agreement shall not constitute a
waiver of any subsequent breach or failure.
9.19
Entire Agreement. This Agreement, including the Attachments each of which are
made a part of and incorporated into this Agreement, the Provider Manual and any addenda or",20,0.5014163255691528, No.,
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,National Contract,"the service or supply from Health Plan (directly or through a secondary contractor) is made in
accordance with the reimbursement provision of the Agreement, or is otherwise inadequate.
3.5
Members shall not be held harmless for payment of required copayments, deductibles
or coinsurance, if any.
3.6
Contracted Provider shall not balance bill Members who have obtained Covered
Services or supplies through Health Plan's provider network mechanism.
3.7
Health Plan's contractual agreement with a secondary contractor shall provide that the
secondary contractor's contract with its network providers shall include a provision whereby the
provider is required to hold Members harmless for the cost of any service or supply covered by Health
Plan, whether or not the provider believes the compensation received is adequate.
New Jersey - Rutgers Health Group - 8/25/2020 3:11 PM
Contract # 166294
Page 36 of 80
5809666v.3",37,0.6284259557723999,"
No",
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,Create Date,"20
DocuSign Envelope ID: 86A03D83-00DE-4D11-8084-A43F77EB059B
9.23 Rights Cumulative. Except as set forth herein, all rights and remedies of a Party in
this Agreement are cumulative, and in addition to all legal rights and remedies available to such Party.
9.24 Counterparts Electronic Signature. This Agreement may be executed in any number
of counterparts. The exchange of copies of this Agreement and of signature pages by facsimile
transmission or electronic mail shall constitute effective execution and delivery of this Agreement as
to the parties and may be used in lieu of the original Agreement for all purposes.
9.25
Warranties and Representations. Each Party warrants and represents, as of the
Effective Date and continuously thereafter throughout the entire term of this Agreement and during
the post expiration or termination transition period described herein, as follows:
9.25.1 The Party is a corporation or other legally recognized entity duly incorporated",21,0.5807241797447205, 8/25/2020 3:11 PM,
22-3146927_ICMProviderAgreement_273971_1 MU.pdf,Modify Date,"Plan of any change in the information 30 days prior to the date of such change.
4.2
Providers. Contracted Provider warrants and represents that it has provided Health
Plan with the information listed on Attachment A-3 titled ""Information for Providers"" for itself and
its employed Providers as of the Effective Date in a mutually agreeable form and format. Contracted
Provider shall use best efforts to provide notice to Health Plan of any change in the information within
30 days but in no event later than 90 days of the change.
4.2.1 Employed Providers. Contracted Provider shall maintain and enforce binding
internal policies and procedures or agreements with its employed Providers that are consistent with
and require adherence to this Agreement. Contracted Provider shall provide Health Plan with such
information requested by Health Plan, or as required by a Governmental Authority or accreditation
body, necessary to verify the employment of its employed Providers.",6,0.5739633440971375, 90 days,