Change in Health Status. Contractor may not request disenrollment because of a change in the Enrollee's health status, or because of the Enrollee's utilization of medical services, diminished mental capacity, or uncooperative or disruptive behavior resulting from his or her special needs (except when his or her continued enrollment in the LIHP seriously impairs the entity's ability to furnish services to either this particular Enrollee or other Enrollees) . Contractor will include the following additional benefits to its core benefits for the MCE and HCCI components of the LIHP as follows: Covered Health Care Services MCE HCCI Adult Immunizations Services and supplies for routine immunizations as recommended by the most recent Advisory Committee on Immunization Practices (ACIP) immunization schedule. Patients can also access the immunization clinics of the Local Health Department without prior authorization. Examples of Covered Benefits: Influenza vaccine (flu shot) given in accordance with the most recent Centers for Disease Control and Prevention (CDC) recommendations as published in the most recent Morbidity and Mortality Weekly Report (MMWR). NA Ambulatory Surgery Center Services Outpatient surgical and therapeutic procedures at contracting hospital and outpatient surgical centers, in lieu of inpatient care, are covered subject to prior authorization. Examples of Covered Benefits Medically necessary, elective outpatient surgery and/or therapeutic procedures when authorized. NA
