Common use of Disenrollment Initiated by the Contractor Clause in Contracts

Disenrollment Initiated by the 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 special needs (except when continued enrollment in the PMHP seriously impairs the Contractor’s ability to furnish services to either this particular Enrollee or other Enrollees).