Communications with Covered Persons. Neither Subcontractor nor Health Plan shall prohibit or otherwise restrict Provider, when acting within the lawful scope of practice, from advising or advocating on behalf of a Covered Person for the following: (a) The Covered Person’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered; (b) Any information the Covered Person needs in order to decide among all relevant treatment options; (c) The risks, benefits, and consequences of treatment or non-treatment; or (d) The Covered Person’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions. Subcontractor and Health Plan also shall not prohibit a Provider from advocating on behalf of a Covered Person in any grievance system, utilization review process, or authorization process to obtain necessary health care services.
Appears in 6 contracts
Samples: Provider Agreement, Provider Agreement, Provider Agreement
Communications with Covered Persons. Neither Subcontractor nor Health Plan shall prohibit or otherwise restrict Provider, when acting within the lawful scope of practice, from advising or advocating on behalf of a Covered Person for the following:
(ai) The Covered Person’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered;
(bii) Any information the Covered Person needs in order to decide among all relevant treatment options;
(ciii) The risks, benefits, and consequences of treatment or non-treatment; or
(div) The Covered Person’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions. Neither Subcontractor and nor Health Plan also shall not prohibit a Provider from advocating on behalf of a Covered Person in any grievance system, utilization review process, or individual authorization process to obtain necessary health care services.
Appears in 5 contracts
Samples: Group Participating Provider Agreement, Ohio State Program Regulatory Requirements Appendix, Provider Agreement
Communications with Covered Persons. Neither Subcontractor nor Health Plan and/or Subcontractor shall not prohibit or otherwise restrict Provider, when acting within the lawful scope of practice, from advising or advocating on behalf of a Covered Person for the following:
(a) The Covered Person’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered;
(b) Any information the Covered Person needs in order to decide among all relevant treatment options;
(c) The risks, benefits, and consequences of treatment or non-treatment; or
(d) The Covered Person’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions. Subcontractor and Health Plan and/or Subcontractor also shall not prohibit a Provider from advocating on behalf of a Covered Person in any grievance system, utilization review process, or individual authorization process to obtain necessary health care services.
Appears in 3 contracts
Samples: Maryland Medicaid Regulatory Requirements Appendix, Arizona CRS State Program Regulatory Requirements Appendix, Arizona Long Term Care Program Regulatory Requirements Appendix
Communications with Covered Persons. Neither Subcontractor nor Health Plan shall not prohibit or otherwise restrict Provider, when acting within the lawful scope of practice, from advising or advocating on behalf of a Covered Person for the following:
(ai) The Covered Person’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered;
(bii) Any information the Covered Person needs in order to decide among all relevant treatment options;
(ciii) The risks, benefits, and consequences of treatment or non-treatment; or
(div) The Covered Person’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions. Subcontractor and Health Plan also shall not prohibit a Provider from advocating on behalf of a Covered Person in any grievance system, utilization review process, or individual authorization process to obtain necessary health care services.
Appears in 3 contracts
Samples: Medicaid and Chip Regulatory Requirements Appendix, Arizona Acc Medicaid and Chip Program Regulatory Requirements Appendix, Downstream Provider Agreement
Communications with Covered Persons. Neither Subcontractor nor Health Plan and Subcontractor shall not prohibit or otherwise restrict Provider, when acting within the lawful scope of practice, from advising or advocating on behalf of a Covered Person for the following:
(a) The Covered Person’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered;
(b) Any information the Covered Person needs in order to decide among all relevant treatment options;
(c) The risks, benefits, and consequences of treatment or non-treatment; or
(d) The Covered Person’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions. Subcontractor and Health Plan and/or Subcontractor also shall not prohibit a Provider from advocating on behalf of a Covered Person in any grievance system, utilization review process, or individual authorization process to obtain necessary health care services.
Appears in 3 contracts
Samples: Downstream Provider Medicaid Program Regulatory Requirements Appendix, Downstream Provider Medicaid Program Regulatory Requirements Appendix, Downstream Provider Medicaid Program Regulatory Requirements Appendix
Communications with Covered Persons. Neither Subcontractor nor and Health Plan shall not prohibit or otherwise restrict Provider, when acting within the lawful scope of practice, from advising or advocating on behalf of a Covered Person for the following:
(a) The Covered Person’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered;
(b) Any information the Covered Person needs in order to decide among all relevant treatment options;
(c) The risks, benefits, and consequences of treatment or non-treatment; or
(d) The Covered Person’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions. Subcontractor and Health Plan also shall not prohibit a Provider from advocating on behalf of a Covered Person in any grievance system, utilization review process, or individual authorization process to obtain necessary health care services.
Appears in 3 contracts
Samples: Medicaid and Chip Regulatory Requirements Appendix, Iowa State Programs Regulatory Requirements Appendix, Provider Agreement
Communications with Covered Persons. Neither Subcontractor nor and/or Health Plan shall not prohibit or otherwise restrict Provider, when acting within the lawful scope of practice, from advising or advocating on behalf of a Covered Person for the following:
(a) The Covered Person’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered;
(b) Any information the Covered Person needs in order to decide among all relevant treatment options;
(c) The risks, benefits, and consequences of treatment or non-treatment; or
(d) The Covered Person’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions. Subcontractor and and/or Health Plan also shall not prohibit a Provider from advocating on behalf of a Covered Person in any grievance system, utilization review process, or individual authorization process to obtain necessary health care services.
Appears in 2 contracts
Samples: Provider Agreement, Provider Agreement
Communications with Covered Persons. Neither Subcontractor nor Health Plan and/or Subcontractor shall not prohibit or otherwise restrict Provider, when acting within the lawful scope of practice, from advising or advocating on behalf of a Covered Person for the following:
(ai) The Covered Person’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered;
(bii) Any information the Covered Person needs in order to decide among all relevant treatment options;
(ciii) The risks, benefits, and consequences of treatment or non-treatment; or
(div) The Covered Person’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions. Subcontractor and Health Plan and/or Subcontractor also shall not prohibit a Provider from advocating on behalf of a Covered Person in any grievance system, utilization review process, or individual authorization process to obtain necessary health care services.
Appears in 2 contracts
Samples: Arizona Medicaid Developmentally Disabled Program Regulatory Requirements Appendix, Arizona Medicaid and Chip Program Regulatory Requirements Appendix
Communications with Covered Persons. Neither Subcontractor nor Health Plan and Subcontractor shall not prohibit or otherwise restrict Provider, when acting within the lawful scope of practice, from advising or advocating on behalf of a Covered Person for the following:
(ai) The Covered Person’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered;
(bii) Any information the Covered Person needs in order to decide among all relevant treatment options;
(ciii) The risks, benefits, and consequences of treatment or non-treatment; or
(div) The Covered Person’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions. Subcontractor and Health Plan and Subcontractor also shall not prohibit a Provider from advocating on behalf of a Covered Person in any grievance system, utilization review process, or individual authorization process to obtain necessary health care services.
Appears in 2 contracts
Samples: Provider Agreement, Provider Agreement
Communications with Covered Persons. Neither Subcontractor nor or Health Plan shall prohibit or otherwise restrict Provider, when acting within the lawful scope of practice, from advising or advocating on behalf of a Covered Person for the following:
(a) The Covered Person’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered;
(b) Any information the Covered Person needs in order to decide among all relevant treatment options;
(c) The risks, benefits, and consequences of treatment or non-treatment; or
(d) The Covered Person’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions. Subcontractor and Health Plan also shall not prohibit a Provider from advocating on behalf of a Covered Person in any grievance system, utilization review process, or individual authorization process to obtain necessary health care services.
Appears in 1 contract
Samples: Ohio State Program Regulatory Requirements Appendix
Communications with Covered Persons. Neither Carrier nor Subcontractor nor Health Plan shall prohibit or otherwise restrict Provider, when acting within the lawful scope of practice, from advising or advocating on behalf of a Covered Person for the following:
(a) The Covered Person’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered;
(b) Any information the Covered Person needs in order to decide among all relevant treatment options;
(c) The risks, benefits, and consequences of treatment or non-treatment; or
(d) The Covered Person’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions. Carrier and Subcontractor and Health Plan also shall not prohibit a Provider from advocating on behalf of a Covered Person in any grievance system, utilization review process, or individual authorization process to obtain necessary health care services.
Appears in 1 contract
Samples: Washington State Programs Regulatory Requirements Appendix
