Common use of Disenrollment Initiated by Contractor Clause in Contracts

Disenrollment Initiated by Contractor. The Contractor may not request disenrollment an Enrollee because of an adverse 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 Health Plan seriously impairs the Contractor’s ability to furnish services to either this particular Enrollee or other Enrollees).

Disenrollment Initiated by Contractor. The Contractor may not request disenrollment of an Enrollee because of an adverse 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 Health Plan PMHP seriously impairs the Contractor’s ability to furnish services to either this particular Enrollee or other Enrollees).