Common use of Additional Required Staff Clause in Contracts

Additional Required Staff. In addition to the Key Personnel identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Utilization Review Staff Responsible for Prior Authorization and current reviews. This staff shall include but is not limited to licensed psychologists, clinical social workers, nurses, Physicians and/or physician's assistants. Required 07/01/2018 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions and overall adjudication of Claims. 07/01/2018 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter data and reports. 07/01/2018 Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program (QAPI). The QAPI staff shall be accountable for Quality outcomes in all of the CONTRACTOR's own network Providers, as well as Subcontracted Providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 Case Management Staff Located in South Carolina and provide Care Coordination and for Members with special health care needs. Required 07/01/2018 Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures for preventing and detecting potential Fraud and Abuse activities. 07/01/2018 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider reviews as necessary in relation to this contract 1 Required 07/01/2018 Notes: 1Additional staff position identified within this contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.

Additional Required Staff. In addition to the Key Personnel identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 POSITIONS1 POSITION DESCRIPTION REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION LOCATION LICENSURE FTE2 Number IN-STATE3 Number South Carolina Specific to Profession IN-STATE3 Profession South Carolina Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions and overall adjudication of Claims. 07/01/2018 Utilization Review Staff Responsible for Prior Authorization and current reviews. This staff shall include but is not limited to licensed psychologists, clinical social workers, nurses, Physicians and/or physician's assistants. Required 07/01/2018 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions and overall adjudication of Claims. 07/01/2018 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter data and reports. 07/01/2018 Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program (QAPI). The QAPI staff shall be accountable for Quality outcomes in all of the CONTRACTOR's own network Providers, as well as Subcontracted Providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 Case Management Staff Located in South Carolina and provide Care Coordination and for Members with special health care needs. Required 07/01/2018 Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures for preventing and detecting potential Fraud and Abuse activities. 07/01/2018 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider reviews as necessary in relation to this contract 1 Required 07/01/2018 Notes: 1Additional staff position identified within this contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.

Additional Required Staff. In addition to the Key Personnel identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, include but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 2021 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Utilization Review Staff Responsible for Prior Authorization and current reviews. This staff shall include but is not limited to appropriately licensed psychologists, clinical social workers, nurses, Physicians and/or physician's assistantsstaff. Required 07/01/2018 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions and overall adjudication of Claims. 07/01/2018 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter data and reports. 07/01/2018 07/01/2021 Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program (QAPI). The QAPI staff shall be accountable for Quality outcomes in all of the CONTRACTOR's own in network Providers, as well as Subcontracted out of network Providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 07/01/2021 Case Management Staff Located The CONTRACTOR shall have staff located in South Carolina and provide Care Coordination and for Members with special health care needs. Required 07/01/2018 07/01/2021 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity Integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures for preventing and detecting potential Fraud and Abuse activities. 07/01/2018 07/01/2021 Program Integrity Coordinator The CONTRACTOR must provide a staff member, with hands on knowledge and decision-making capabilities regarding program integrity, to coordinate Fraud, Waste & Abuse (FWA) activities and efforts with the Department’s Program Integrity/SUR Division. This position may count as one of the two Investigative/Review staff indicated below. 1 Required 07/01/2021 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider reviews as necessary in relation to this contract 1 Required 07/01/2018 Notes: 1Additional staff position identified within this contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.

Additional Required Staff. In addition to the Key Personnel identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, include but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 2021 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Utilization Review Staff Responsible for Prior Authorization and current reviews. This staff shall include but is not limited to licensed psychologists, clinical social workers, nurses, Physicians and/or physician's assistants. Required 07/01/2018 07/01/2021 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 07/01/2021 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 07/01/2021 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions resubmissions, and overall adjudication of Claims. 07/01/2018 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina 07/01/2021 Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter data and reports. 07/01/2018 07/01/2021 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program (QAPI). The QAPI staff shall be accountable for Quality outcomes in all of the CONTRACTOR's own network Providers, as well as Subcontracted Providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 07/01/2021 Case Management Staff Located in South Carolina and provide Care Coordination and for Members with special health care needs. Required 07/01/2018 07/01/2021 Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity Integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures for preventing and detecting potential Fraud and Abuse activities. 07/01/2018 07/01/2021 Program Integrity Coordinator The CONTRACTOR must provide a staff member, with hands on knowledge and decision-making capabilities regarding program integrity, to coordinate Fraud, Waste & Abuse (FWA) activities and efforts with the Department’s Program Integrity/SUR Division. 1 Required 07/01/2021 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider reviews as necessary in relation to this contract 1 Required 07/01/2018 Notes: 1Additional staff position identified within this contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.

Additional Required Staff. In addition to the Key Personnel identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, include but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 2021 POSITIONS1 POSITION DESCRIPTION REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION LOCATION LICENSURE FTE2 Number IN-STATE3 Number South Carolina Specific to Profession IN-STATE3 Profession South Carolina Utilization Review Staff Responsible for Prior Authorization and current reviews. This staff shall include but is not limited to licensed psychologists, clinical social workers, nurses, Physicians and/or physician's assistants. Required 07/01/2018 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 07/01/2021 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions and overall adjudication of Claims. 07/01/2018 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina 07/01/2021 Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter data and reports. 07/01/2018 07/01/2021 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2021 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions, and overall adjudication of Claims. 07/01/2021 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program (QAPI). The QAPI staff shall be accountable for Quality outcomes in all of the CONTRACTOR's own network Providers, as well as Subcontracted Providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 07/01/2021 Case Management Staff Located in South Carolina and provide Care Coordination and for Members with special health care needs. Required 07/01/2018 07/01/2021 Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures for preventing and detecting potential Fraud and Abuse activities. 07/01/2018 07/01/2021 Program Integrity Coordinator The CONTRACTOR must provide a staff member, with hands on knowledge and decision making capabilities regarding program integrity, to coordinate Fraud, Waste & Abuse (FWA) activities and efforts with the Department’s Program Integrity/SUR Division. 07/01/2021 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider reviews as necessary in relation to this contract 1 Required 07/01/2018 Notes: 1Additional staff position identified within this contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.

Additional Required Staff. In addition to the Key Personnel key staff identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 2016 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Utilization Review Staff Responsible for Prior Authorization prior authorization and current reviews. This staff shall include but is not limited to licensed psychologists, clinical social workers, nurses, Physicians physicians and/or physician's assistants. Required 07/01/2018 07/01/2016 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 07/01/2016 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 07/01/2016 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claimsclaims, resubmissions and overall adjudication of Claimsclaims. 07/01/2018 07/01/2016 REQUIREMENTS LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION LOCA FTE2 Number TION IN-STATE3 South Carolina LICENS Specific to Profession URE IN-STATE3 South Carolina EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter encounter data and reports. 07/01/2018 07/01/2016 Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program program (QAPI). The QAPI staff shall be accountable for Quality quality outcomes in all of the CONTRACTOR's own network Providersproviders, as well as Subcontracted Providerssubcontracted providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 07/01/2016 Case Management Staff Located in South Carolina and provide Care Coordination care coordination and for Members members with special health care needs. Required 07/01/2018 07/01/2016 Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity Integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures procedures for preventing and detecting potential Fraud fraud and Abuse abuse activities. 07/01/2018 07/01/2016 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 07/01/2016 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. 1.0/100000 07/01/2016 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider provider reviews as necessary in relation to this contract 1 Required 07/01/2018 07/01/2016 Notes: 1Additional staff position identified within this contract Contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.

Additional Required Staff. In addition to the Key Personnel key staff identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 2016 POSITIONS1 POSITION DESCRIPTION REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION LOCATION LICENSURE FTE2 Number IN-STATE3 Number South Carolina Specific to Profession IN-STATE3 Profession South Carolina Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2016 Network Management Claims Processing Staff Ensure the timely and accurate processing of original claims, resubmissions and overall adjudication of claims. 07/01/2016 Utilization Review Staff Responsible for Prior Authorization prior authorization and current reviews. This staff shall include but is not limited to licensed psychologists, clinical social workers, nurses, Physicians physicians and/or physician's assistants. Required 07/01/2018 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 07/01/2016 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions and overall adjudication of Claims. 07/01/2018 07/01/2016 REQUIREMENTS LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION LOCA FTE2 Number TION IN-STATE3 South Carolina LICENS Specific to Profession URE IN-STATE3 South Carolina EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter encounter data and reports. 07/01/2018 07/01/2016 Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program program (QAPI). The QAPI staff shall be accountable for Quality quality outcomes in all of the CONTRACTOR's own network Providersproviders, as well as Subcontracted Providerssubcontracted providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 07/01/2016 Case Management Staff Located in South Carolina and provide Care Coordination care coordination and for Members members with special health care needs. Required 07/01/2018 07/01/2016 Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity Integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures procedures for preventing and detecting potential Fraud fraud and Abuse abuse activities. 07/01/2018 07/01/2016 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 07/01/2016 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. 1.0/100000 07/01/2016 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider provider reviews as necessary in relation to this contract 1 Required 07/01/2018 07/01/2016 Notes: 1Additional staff position identified within this contract Contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.

Additional Required Staff. In addition to the Key Personnel identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, include but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 2021 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Utilization Review Staff Responsible for Prior Authorization and current reviews. This staff shall include but is not limited to licensed psychologists, clinical social workers, nurses, Physicians and/or physician's assistants. Required 07/01/2018 07/01/2021 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 07/01/2021 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 07/01/2021 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions resubmissions, and overall adjudication of Claims. 07/01/2018 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina 07/01/2021 Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter data and reports. 07/01/2018 07/01/2021 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program (QAPI). The QAPI staff shall be accountable for Quality outcomes in all of the CONTRACTOR's own network Providers, as well as Subcontracted Providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 07/01/2021 Case Management Staff Located in South Carolina and provide Care Coordination and for Members with special health care needs. Required 07/01/2018 07/01/2021 Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures for preventing and detecting potential Fraud and Abuse activities. 07/01/2018 07/01/2021 Program Integrity Coordinator The CONTRACTOR must provide a staff member, with hands on knowledge and decision making capabilities regarding program integrity, to coordinate Fraud, Xxxxx & Abuse (FWA) activities and efforts with the Department’s Program Integrity/SUR Division. 07/01/2021 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider reviews as necessary in relation to this contract 1 Required 07/01/2018 Notes: 1Additional staff position identified within this contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.

Additional Required Staff. In addition to the Key Personnel identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 POSITIONS1 POSITION DESCRIPTION REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION LOCATION LICENSURE FTE2 Number IN-STATE3 Number South Carolina Specific to Profession IN-STATE3 Profession South Carolina Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions and overall adjudication of Claims. 07/01/2018 Utilization Review Staff Responsible for Prior Authorization and current reviews. This staff shall include but is not limited to licensed psychologists, clinical social workers, nurses, Physicians and/or physician's assistants. Required 07/01/2018 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions and overall adjudication of Claims. 07/01/2018 REQUIREMENTS LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION LOCA FTE2 Number TION IN-STATE3 South Carolina LICENS Specific to Profession URE IN-STATE3 South Carolina EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter data and reports. 07/01/2018 Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program (QAPI). The QAPI staff shall be accountable for Quality outcomes in all of the CONTRACTOR's own network Providers, as well as Subcontracted Providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 Case Management Staff Located in South Carolina and provide Care Coordination and for Members with special health care needs. Required 07/01/2018 Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures for preventing and detecting potential Fraud and Abuse activities. 07/01/2018 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider reviews as necessary in relation to this contract 1 Required 07/01/2018 Notes: 1Additional staff position identified within this contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.

Additional Required Staff. In addition to the Key Personnel identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Utilization Review Staff Responsible for Prior Authorization and current reviews. This staff shall include but is not limited to licensed psychologists, clinical social workers, nurses, Physicians and/or physician's assistants. Required 07/01/2018 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions and overall adjudication of Claims. 07/01/2018 REQUIREMENTS LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION LOCA FTE2 Number TION IN-STATE3 South Carolina LICENS Specific to Profession URE IN-STATE3 South Carolina EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter data and reports. 07/01/2018 Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program (QAPI). The QAPI staff shall be accountable for Quality outcomes in all of the CONTRACTOR's own network Providers, as well as Subcontracted Providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 Case Management Staff Located in South Carolina and provide Care Coordination and for Members with special health care needs. Required 07/01/2018 Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures for preventing and detecting potential Fraud and Abuse activities. 07/01/2018 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider reviews as necessary in relation to this contract 1 Required 07/01/2018 Notes: 1Additional staff position identified within this contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.

Additional Required Staff. In addition to the Key Personnel key staff identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 2016 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Utilization Review Staff Responsible for Prior Authorization prior authorization and current reviews. This staff shall include but is not limited to licensed psychologists, clinical social workers, nurses, Physicians physicians and/or physician's assistants. Required 07/01/2018 07/01/2016 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 07/01/2016 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 07/01/2016 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claimsclaims, resubmissions and overall adjudication of Claimsclaims. 07/01/2018 07/01/2016 REQUIREMENTS LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION LOCA FTE2 Number TION IN-STATE3 South Carolina LICENS Specific to Profession URE IN-STATE3 South Carolina EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter encounter data and reports. 07/01/2018 07/01/2016 Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program program (QAPI). The QAPI staff shall be accountable for Quality quality outcomes in all of the CONTRACTOR's own network Providersproviders, as well as Subcontracted Providerssubcontracted providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 07/01/2016 Case Management Staff Located in South Carolina and provide Care Coordination care coordination and for Members members with special health care needs. Required 07/01/2018 07/01/2016 Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity Integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures procedures for preventing and detecting potential Fraud fraud and Abuse abuse activities. 07/01/2018 07/01/2016 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 07/01/2016 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. 1.0/10000 0 07/01/2016 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider provider reviews as necessary in relation to this contract 1 Required 07/01/2018 07/01/2016 Notes: 1Additional staff position identified within this contract Contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.

Additional Required Staff. In addition to the Key Personnel identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, include but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 2021 POSITIONS1 POSITION DESCRIPTION REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION LOCATION LICENSURE FTE2 Number IN-STATE3 Number South Carolina Specific to Profession IN-STATE3 Profession South Carolina Utilization Review Staff Responsible for Prior Authorization and current reviews. This staff shall include but is not limited to licensed psychologists, clinical social workers, nurses, Physicians and/or physician's assistants. Required 07/01/2018 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 07/01/2021 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions and overall adjudication of Claims. 07/01/2018 REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina 07/01/2021 Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter data and reports. 07/01/2018 07/01/2021 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2021 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions, and overall adjudication of Claims. 07/01/2021 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program (QAPI). The QAPI staff shall be accountable for Quality outcomes in all of the CONTRACTOR's own network Providers, as well as Subcontracted Providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 07/01/2021 Case Management Staff Located in South Carolina and provide Care Coordination and for Members with special health care needs. Required 07/01/2018 07/01/2021 Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity Integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures for preventing and detecting potential Fraud and Abuse activities. 07/01/2018 07/01/2021 Program Integrity Coordinator The CONTRACTOR must provide a staff member, with hands on knowledge and decision-making capabilities regarding program integrity, to coordinate Fraud, Waste & Abuse (FWA) activities and efforts with the Department’s Program Integrity/SUR Division. 1 Required 07/01/2021 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider reviews as necessary in relation to this contract 1 Required 07/01/2018 Notes: 1Additional staff position identified within this contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.

Additional Required Staff. In addition to the Key Personnel key staff identified in Exhibit 1, CONTRACTOR shall employ sufficient staff to effectively manage operations. Such staff shall include, but is in no way limited to the staff identified in Exhibit 2. Exhibit 2. Additional Required Staff, July 1, 2018 2016 POSITIONS1 POSITION DESCRIPTION REQUIREMENTS LOCATION LICENSURE EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION LOCATION LICENSURE FTE2 Number IN-STATE3 Number South Carolina Specific to Profession IN-STATE3 Profession South Carolina Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2016 Network Management Claims Processing Staff Ensure the timely and accurate processing of original claims, resubmissions and overall adjudication of claims. 07/01/2016 Utilization Review Staff Responsible for Prior Authorization prior authorization and current reviews. This staff shall include but is not limited to licensed psychologists, clinical social workers, nurses, Physicians physicians and/or physician's assistants. Required 07/01/2018 Member Services Staff Responsible for enabling prompt resolution to member inquiries/problems. 07/01/2018 07/01/2016 Provider Services Staff Located in South Carolina and capable of ensuring those Providers receive prompt responses and assistance. Required 07/01/2018 Network Management Claims Processing Staff Ensure the timely and accurate processing of original Claims, resubmissions and overall adjudication of Claims. 07/01/2018 07/01/2016 REQUIREMENTS LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION LOCA FTE2 Number TION IN-STATE3 South Carolina LICENS Specific to Profession URE IN-STATE3 South Carolina EFFECTIVE DATE (MM/DD/YYYY) POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Network Management Encounter Processing Staff Ensure the timely and accurate processing and submission to the Department of Encounter encounter data and reports. 07/01/2018 07/01/2016 Quality Assessment and Performance Improvement Staff Sufficient staff qualified by training and experience to be responsible for the operation and success of the Quality Assessment and Performance Improvement Program program (QAPI). The QAPI staff shall be accountable for Quality quality outcomes in all of the CONTRACTOR's own network Providersproviders, as well as Subcontracted Providerssubcontracted providers, as stated in 42 CFR §§ 438.200 – 438.242 07/01/2018 07/01/2016 Case Management Staff Located in South Carolina and provide Care Coordination care coordination and for Members members with special health care needs. Required 07/01/2018 07/01/2016 Compliance/Program Integrity Staff The CONTRACTOR shall have adequate staffing and resources to fulfill the Program integrity Integrity and Compliance requirements of this contract, to investigate all reported incidents, and to develop and implement the necessary systems and Procedures procedures for preventing and detecting potential Fraud fraud and Abuse abuse activities. 07/01/2018 07/01/2016 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina Program Integrity Coordinator The CONTRACTOR must provide for a management official to coordinate Fraud, Waste & Abuse (FWA) efforts with the Department’s Program Integrity/SUR Division. 07/01/2018 07/01/2016 Post-Payment Review Staff The CONTRACTOR must furnish a minimum of 2.0/100000 07/01/2018 two (2) FTEs for Post-Payment Review for the initial initial 100,000 members enrolled with an MCO. 100,000 One (1) additional FTE is required for each members additional 100,000 members enrolled with the MCO. 1.0/each additional Of the two (2) FTEs referenced above the 100,000 CONTRACTOR shall dedicate at least one full time members Reviewer, who shall possess the minimum qualifications of a Registered Nurse (RN), for the purposes of post payment reviews of Providers. In addition, at least one of the Post-Payment Review staff must be actively certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) or actively possess Professional Certification as a Certified Coding Specialist- Physician-based (CCS-P®) through The American Health Information Management Association (AHIMA). The same FTE may hold both credentials and meet the contract standard. 1.0/10000 0 07/01/2016 REQUIREMENTS EFFECTIVE DATE (MM/DD/YYYY) LOCATION LICENSURE POSITIONS1 POSITION DESCRIPTION FTE2 Number IN-STATE3 South Carolina Specific to Profession IN-STATE3 South Carolina On-site Post-Payment Review Staff Staff readily available to conduct on-site post payment Provider provider reviews as necessary in relation to this contract 1 Required 07/01/2018 07/01/2016 Notes: 1Additional staff position identified within this contract Contract 2FTE# = Full-Time Employee (aka FTE) and is defined as an employee that works a minimum of thirty-two (32) hours per week. 3In the Column titled “Located In-State” a designation of “Required” means that the position must be located within the State of South Carolina.