Common use of Health Home Participant Re-Assignment or Termination Clause in Contracts

Health Home Participant Re-Assignment or Termination. The parties recognize that there are many ways in which Health Home Participant status may change that may result in re-Assignment or De-Activation. MCO shall have the authority to De-Activate a Health Home Participant or re-Assign Health Home Participants to another designated health home if Health Home is not effectively providing or managing Health Home Services to the Member, not achieving quality goals, not adhering to the MCO’s protocols, or not meeting specific Members needs, as determined by the MCO. In addition, MCO may re-Assign a Health Home Participant to another health home if the Member: a) requests re-Assignment, b) relocates, or c) transfers to a Primary Care Provider who is affiliated with another health home. The MCO will De-Active a Health Home Participant from the Health Home if the Member is no longer enrolled in the MCO or the MCO determines, in consultation with the Health Home, that the Member is not engaged in the Health Home Services or adhering to the plan of care.

Health Home Participant Re-Assignment or Termination. The parties recognize that there are many ways in which Health Home Participant status may change that may result in re-Re- Assignment or De-Activation. Upon prior reasonable notice to Health Home, MCO shall have the authority to De-Activate a Health Home Participant or reRe-Assign Health Home Participants to another designated health home if the Health Home is not effectively providing or managing Health Home Services to the Member, not achieving quality goals, not adhering to the MCO’s protocols, or not meeting specific Members needs, as determined by the MCOMCO after consultation with the Health Home. In addition, MCO may reRe-Assign a Health Home Participant to another health home Health Home if the Member: a) requests reRe-Assignment, b) relocates, or c) transfers to a Primary Care Participating Provider who is affiliated with another health home. The MCO will De-Active De- Activate a Health Home Participant from the Health Home if the Member is no longer enrolled in the MCO or upon a determination by the MCO determinesMCO, in consultation with the Health Home, that the Member is not engaged engaging in the Health Home Services or adhering to the plan of care.

Health Home Participant Re-Assignment or Termination. The parties recognize that there are many ways in which Health Home Participant status may change that may result in re-Re- Assignment or De-Activation. Upon prior reasonable notice to Health Home, MCO shall have the authority to De-Activate a Health Home Participant or reRe-Assign Health Home Participants to another designated health home if the Health Home is not effectively providing or managing Health Home Services to the Member, not achieving quality goals, not adhering to the MCO’s protocols, or not meeting specific Members needs, as determined by the MCOMCO after consultation with the Health Home. In addition, MCO may reRe-Assign a Health Home Participant to another health home Health Home if the Member: a) requests reRe-Assignment, b) relocates, or c) transfers to a Primary Care Participating Provider who is affiliated with another health home. The All such reassignments shall be subject to any applicable fair hearing or appeal rights. MCO will De-Active De- Activate a Health Home Participant from the Health Home if the Member is no longer enrolled in the MCO or upon a determination by the MCO determinesMCO, in consultation with the Health Home, Home that the Member is not engaged engaging in the Health Home Services or adhering to the plan of care.

Health Home Participant Re-Assignment or Termination. The parties recognize that there are many ways in which Health Home Participant status may change that may result in reRe-Assignment or De-Activation. Upon prior reasonable notice to Health Home, MCO shall have the authority to De-Activate a Health Home Participant or reRe-Assign Health Home Participants to another designated health home Health Home if the Health Home is not effectively providing or managing Health Home Services to the Member, not achieving quality goals, not adhering to the MCO’s protocols, or not meeting specific Members needs, as determined by the MCOMCO after consultation with the Health Home. In addition, MCO may reRe-Assign a Health Home Participant to another health home Health Home if the Member: a) requests reRe-Assignment, b) relocates, or c) transfers to a Primary Care Participating Provider who is affiliated with another health home. The All such reassignments shall be subject to any applicable fair hearing or appeal rights. MCO will De-Active Activate a Health Home Participant from the Health Home if the Member is no longer enrolled in the MCO or upon a determination by the MCO determinesMCO, in consultation with the Health Home, Home that the Member is not engaged engaging in the Health Home Services or adhering to the plan of care.