Enrollee Rights. The Contractor must have written policies regarding the Enrollee rights specified in this appendix, as well as written policies specifying how information about these rights will be disseminated to Enrollees. Enrollees must be notified of these rights and protections at least annually, and in a manner that takes in to consideration cultural considerations, Functional Status, and language needs. The Contractor must comply with any applicable federal and State laws that pertain to Enrollee rights. Enrollee rights include, but are not limited to, those rights and protections provided by 42 C.F.R. § 438.100, 42 C.F.R. § 422 Subpart C, and the State Memorandum of Understanding (MOU). Specifically, Enrollees must be guaranteed: The right to be treated with dignity and respect. The right to be afforded Privacy and confidentiality in all aspects of care and for all health care information, unless otherwise required by law. The right to be provided a copy of his or her medical records, upon request, and to request corrections or amendments to these records, as specified in 45 C.F.R. part 164. The right to receive information on available treatment options and alternatives, presented in a manner appropriate to the Enrollee’s condition, Functional Status, and language needs. The right not to be discriminated against based on race, ethnicity, national origin, religion, sex, gender identity, age, sexual orientation, medical or claims history, mental or physical disability, genetic information, or source of payment. The right to have all plan options, rules, and benefits fully explained, including through use of a qualified interpreter if needed. Access to an adequate network of primary and specialty providers who are appropriately qualified and capable of meeting the Enrollee’s needs with respect to physical access, and communication and scheduling needs, and are subject to ongoing assessment of clinical quality including required reporting, as well as access to an ongoing source of primary care. The right to receive a second opinion on a medical procedure and have the Contractor pay for the second opinion consultation visit. The right to choose a plan and provider at any time, including a plan outside of the Demonstration, and have that choice be effective the first calendar day of the following month. The right to have a voice in the governance and operation of the integrated system, provider or health plan, as detailed in this three-way Contract. The right to be fur...
Enrollee Rights. The MCO shall have written policies regarding the rights of Enrollees and shall comply with any applicable Federal and State laws that pertain to Enrollee rights. When providing services to Enrollees, the MCO must ensure that its staff and Network Providers consider the Enrollee’s rights to the following:
(A) Receive information pursuant to 42 CFR § 438.10.
(B) Be treated with respect and with due consideration for the Enrollee's dignity and privacy.
(C) Receive information on available treatment options and alternatives, presented in a manner appropriate to the Enrollee's condition and ability to understand.
(D) Participate in decisions regarding his or her health care, including the right to refuse treatment.
(E) Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other Federal regulations on the use of restraints and seclusion.
(F) Request and receive a copy of his or her medical records pursuant to 45 CFR §§ 160 and 164, subparts A and E, and request to amend or correct the record as specified in 45 CFR §§ 164.524 and 164.526.
(G) Be provided with services under this Contract in accordance with 42 CFR §§ 438.206 through 438.210.
(H) Freedom to exercise his or her rights and that exercising these rights will not adversely affect the way the Enrollee is treated.
Enrollee Rights. The MCO shall have written policies regarding the rights of Enrollees and shall comply with any applicable Federal and state laws that pertain to Enrollee rights.
3.8.1 When providing services to Enrollees, the MCO must ensure that its staff and Network Providers consider the Enrollee's rights to the following: • Receive information pursuant to 42 CFR §438.10. • Be provided with services under this Contract and, as applicable, Home and Community- Based Services, in accordance with 42 CFR §§438.206 through §438.210, and to be annually provided with the information contained in the pamphlet, DHS-4134, titled “For Older Minnesotans -- Know Your Rights About Services.” • Be treated with respect and with due consideration for the Enrollee's dignity and privacy. [42 CFR §438.100(b)(2)(ii)] • Receive information on available treatment options and alternatives, presented in a manner appropriate to the Enrollee's condition and ability to understand. [42 CFR §438.100(b)(2)(iii)] • Participate in decisions regarding his or her health care, including the right to refuse treatment. [42 CFR §438.100(b)(2)(iv)] • Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other Federal regulations on the use of restraints and seclusion. [42 CFR §438.100(b)(2)(v)] • Request and receive a copy of his or her medical records and request to amend or correct the record.[45 CFR §§160 and 164, subparts A and E] • Have freedom to exercise his or her rights. The exercise of these rights must not adversely affect the way the Enrollee is treated. [42 CFR §438.100(c)] • The MCO shall not specify confidential services, as defined by the STATE, in materials sent to the Enrollee including but not limited to EOBs, and must not be sent to the Enrollee if the only service furnished was confidential. State and federal privacy law including HIPAA and Minnesota Statutes, Ch. 144, apply. For minors, privacy law includes Minnesota Statutes, §§144.341 through 347, and §253B.04. [42 CFR §433.116(f)(2)]. • Assistance in identifying services needed to maintain the Enrollees who receive LTCCs in the most inclusive environment [Minnesota Statutes, §256B.0911, subd. 1a, (1)] • To be offered choices in types of Home and Community Based services, including choices of settings, wherever possible within a system of identified Providers. [42 CFR §441.301(c)(4); Minnesota Statutes, §256B.0911, subd. 1a, (f)]
Enrollee Rights. The MCO shall have written policies regarding the rights of Enrollees and shall comply with any applicable Federal and state laws that pertain to Enrollee rights. When providing services to Enrollees, the MCO must ensure that its staff and Network Providers consider the Enrollee's rights to the following: Receive information pursuant to 42 CFR § 438.10. Be treated with respect and with due consideration for the Enrollee's dignity and privacy. Receive information on available treatment options and alternatives, presented in a manner appropriate to the Enrollee's condition and ability to understand. Participate in decisions regarding his or her health care, including the right to refuse treatment. Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other Federal regulations on the use of restraints and seclusion.
Enrollee Rights. 1. To permit each Enrollee to choose his or her network provider to the extent possible and appropriate, as set forth in COMAR 10.67.05.05 (Appendix M).
2. To provide practice guidelines to Enrollees and potential Enrollees upon request.
3. To accord Enrollees all the rights available to them under 42 CFR 438.100; to require their network providers to also respect those rights; and to develop written policies governing the protection of those rights.
4. To refrain from discriminating against or using any policy or practice that has the effect of discriminating against Enrollees on the basis of age, sex, gender identity, race, creed, color, marital status, sexual orientation, national origin, physical or mental handicap, health status, or need for health services.
5. Not to prohibit or otherwise restrict the advice that a health care professional, with a contractual, referral, or other arrangement with the MCO, gives to an Enrollee who is a patient of the professional about the health status of the individual or medical care or treatment for the individual’s condition or disease, regardless of whether benefits for such care or treatment are provided under this Agreement, if the professional is acting within the lawful scope of practice.
6. To comply with the requirements governing Enrollee appeals and grievances set forth in COMAR 10.67.09 (Appendix M) and 42 CFR 438, subpart F.
7. To provide the MCO enrollee services phone number on the identification card required in COMAR 10.67.04.02E (3).
Enrollee Rights. The MCO shall have written policies regarding the rights of Enrollees and shall comply with any applicable Federal and State laws that pertain to Enrollee rights. When providing services to Enrollees, the MCO must ensure that its staff and affiliated Providers consider the Enrollee's right to the following:
(A) Receive information pursuant to 42 CFR § 438.10.
(B) Be treated with respect and with due consideration for the Enrollee's dignity and privacy.
(C) Receive information on available treatment options and alternatives, presented in a manner appropriate to the Enrollee's condition and ability to understand.
(D) Participate in decisions regarding his or her health care, including the right to refuse treatment.
(E) Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other Federal regulations on the use of restraints and seclusion.
(F) Request and receive a copy of his or her medical records pursuant to 45 CFR §§ 160 and 164, subparts A and E, and request to amend or correct the record as specified in 45 CFR § 164.524 and § 164.526.
(G) Be provided with health care services and, as applicable, Home and Community- Based Services, in accordance with 42 CFR § 438.206 through § 438.210, and to be provided with the information contained in the pamphlet, DHS-4134, “Know Your Rights About Services For Older Minnesotans.”
(H) The freedom to exercise his or her rights and that the exercise of these rights will not adversely affect the way the Enrollee is treated.
(I) Assistance, in identifying services needed to maintain the Enrollees who receive LTCCs in the most inclusive environment, pursuant to M.S. § 256B.0911, subd. 1a(1).
(J) To be offered choices in types of Home and Community Based services wherever possible within a system of identified Providers.
Enrollee Rights. The MCO shall have written policies regarding the rights of Enrollees and shall comply with any applicable Federal and State laws that pertain to Enrollee rights.
3.10.1 When providing services to Enrollees, the MCO must ensure that its staff and Network Providers consider the Enrollee’s rights to the following: • Receive information pursuant to 42 CFR §438.10. • Be provided with services under this Contract in accordance with 42 CFR §§438.206 through 438.210. • Be treated with respect and with due consideration for the Enrollee's dignity and privacy. [42 CFR §438.100(b)(2)(ii)] • Receive information on available treatment options and alternatives, presented in a manner appropriate to the Enrollee's condition and ability to understand. [42 CFR §438.100(b)(2)(iii)] • Participate in decisions regarding his or her health care, including the right to refuse treatment. [42 CFR §438.100(b)(2)(iv)] • Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other Federal regulations on the use of restraints and seclusion. [42 CFR §438.100(b)(2)(v)] • Be free from any form of aversion or deprivation procedures as described in Minnesota Rules, parts 9525.2700 through 9525.2810. • Request and receive a copy of his or her medical records and request to amend or correct the record. [45 CFR §§160 and 164, subparts A and E] • Have freedom to exercise his or her rights The exercise of these rights must not adversely affect the way the Enrollee is treated. [42 CFR §438.100(c)] • The MCO shall not specify confidential services, as defined by the STATE, in materials sent to the Enrollee, including but not limited to EOBs, and materials must not be sent to the Enrollee if the only service furnished was confidential. State and federal privacy law including HIPAA and Minnesota Statutes, Ch. 144, apply. For minors, privacy law includes Minnesota Statutes, §§144.341 through 347, and §253B.04. [42 CFR §433.116(f)(2)].
Enrollee Rights. 1. To permit each Enrollee to choose his or her network provider to the extent possible and appropriate, as set forth in COMAR 10.67.05.05 (
Enrollee Rights. The MCO shall have written policies regarding the rights of Enrollees and shall comply with any applicable Federal and State laws that pertain to Enrollee rights. When providing services to Enrollees, the MCO must ensure that its staff and Network Providers consider the Enrollee’s rights to the following: Receive information pursuant to 42 CFR § 438.10. Be treated with respect and with due consideration for the Enrollee's dignity and privacy. Receive information on available treatment options and alternatives, presented in a manner appropriate to the Enrollee's condition and ability to understand. Participate in decisions regarding his or her health care, including the right to refuse treatment. Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other Federal regulations on the use of restraints and seclusion. Be free from any form of aversion or deprivation procedures as described in Minnesota Rules, parts 9525.2700 through 9525.2810. Request and receive a copy of his or her medical records pursuant to 45 CFR §§ 160 and 164, subparts A and E, and request to amend or correct the record as specified in 45 CFR §§ 164.524 and 164.526. Be provided with services under this Contract in accordance with 42 CFR §§ 438.206 through 438.210. The freedom to exercise his or her rights and that exercising these rights will not adversely affect the way the Enrollee is treated.
Enrollee Rights. The MCO shall have written policies regarding the rights of Enrollees and shall comply with any applicable Federal and State laws that pertain to Enrollee rights. When providing services to Enrollees, the MCO must ensure that its staff and affiliated Providers consider the Enrollee's right to the following:
3.7.1 Receive information pursuant to 42 CFR § 438.10.
3.7.2 Be treated with respect and with due consideration for the Enrollee's dignity and privacy.
3.7.3 Receive information on available treatment options and alternatives, presented in a manner appropriate to the Enrollee's condition and ability to understand.
3.7.4 Participate in decisions regarding his or her health care, including the right to refuse treatment.
3.7.5 Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other Federal regulations on the use of restraints and seclusion.
3.7.6 Be free from any form of aversion or deprivation procedures as described in Minnesota Rules, parts 9525.2700 through 9525.2810.
3.7.7 Request and receive a copy of his or her medical records pursuant to 45 CFR
3.7.8 Provided with adequate access to health care services in accordance with 42 CFR
3.7.9 Freedom to exercise his or her rights and that exercising these rights will not adversely affect the way the Enrollee is treated.
