REQUIRED ATTACHMENTS/APPENDICES. This Contract consists of this master document and the following Appendices and Attachments, all of which are incorporated herein by reference: Appendix A Consolidated Federal Certifications and Disclosures Appendix C Mixed Services Protocol Appendix D Insurance Requirements Appendix E Electronic Provider Portal Access/ User Addendum Attachment A Medicaid Direct Required Provider Contract Terms Attachment A-1 (Health/Hospital Systems Providers ONLY) Health System Medicaid Contract Services (Electronically Published at xxxxx://xxx.xxxxxxxxxxxxxxxxxx.xxx/providers/publications-forms-documents/) Attachment A-2 Medicaid Direct Contracted Sites Attachment J Medicaid Direct Required Contract Terms APPENDIX A: CONSOLIDATED FEDERAL CERTIFICATIONS AND DISCLOSURES The undersigned states that:
REQUIRED ATTACHMENTS/APPENDICES. Appendix A Business Associate Agreement Appendix B Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction Appendix C Certification Regarding Drug-Free Workplace Requirements Appendix D Certification Regarding Lobbying Appendix E Certification Regarding Environmental Tobacco Smoke Appendix F Mixed Services Payment Protocol Appendix G Agency Addendum Attachment A Contracted Service Codes Signature Page Between: Alliance Behavioral Healthcare and Enter Provider Name
