Common use of Cost Sharing Protections for Dual Eligible Members Clause in Contracts

Cost Sharing Protections for Dual Eligible Members. (a) The MA Dual SNP must notify its Network Providers (via a provider manual, provider bulletin, or other contractual document) that Network Providers: (1) will not hold a Dual Eligible Member liable for the Cost Sharing Obligations; and (2) will accept as payment in full the MA Dual SNP’s payment of the Cost Sharing Obligations and will not seek additional payment from HHSC or a Dual Eligible Member for healthcare services covered under the MA Product offered by the MA Dual SNP and provided to the Dual Eligible Member. The MA Dual SNP must provide the HHSC point-of-contact identified in Section 9.06 with a copy of such written notice. (b) The MA Dual SNP will not impose cost sharing on a Dual Eligible Member that exceeds the amount of cost sharing that would be permitted with respect to the Dual Eligible Member under Medicaid based on their level of eligibility if the Dual Eligible Member were not enrolled in an MA Product.

Cost Sharing Protections for Dual Eligible Members. (a) The MA Dual SNP must notify its Network Providers (via a provider manual, provider bulletin, or other contractual document) that Network Providers: (1) will not hold a Dual Eligible Member liable for the Cost Sharing Obligations; and (2) will accept as payment in full the MA Dual SNP’s payment of the Cost Sharing Obligations and will not seek additional payment from HHSC or a Dual Eligible Member for healthcare services covered under the MA Product offered by the MA Dual SNP and provided to the Dual Eligible Member. The MA Dual SNP must provide the HHSC point-of-contact identified in Section 9.06 with a copy of such written notice. (b) The MA Dual SNP will not impose cost sharing on a Dual Eligible Member that exceeds the amount of cost sharing that would be permitted with respect to the Dual Eligible Member under Medicaid based on their level of eligibility if the Dual Eligible Member were not enrolled in an MA Product.

Cost Sharing Protections for Dual Eligible Members. (a) The MA Dual SNP must notify its Network Providers (via a provider manual, provider bulletin, or other contractual document) that Network Providers: (1) will not hold a Dual Eligible Member liable for the Cost Sharing Obligations; and (2) will accept as payment in full the MA Dual SNP’s payment of the Cost Sharing Obligations and will not seek additional payment from HHSC or a Dual Eligible Member for healthcare services DocuSign Envelope ID: covered under the MA Product offered by the MA Dual SNP and provided to the Dual Eligible Member. The MA Dual SNP must provide the HHSC point-of-contact identified in Section 9.06 with a copy of such written notice. (b) The MA Dual SNP will not impose cost sharing on a Dual Eligible Member that exceeds the amount of cost sharing that would be permitted with respect to the Dual Eligible Member under Medicaid based on their level of eligibility if the Dual Eligible Member were not enrolled in an MA Product.