Common use of Length of Confidentiality Requirements Clause in Contracts

Length of Confidentiality Requirements. TABLE OF CONTENTS October 1, 2004 5 TABLE OF CONTENTS FOR MODEL CONTRACT Section 21 Participating Providers 21.1 Network Requirements a. Sufficient Number b. Absence of Appropriate Network Provider c. Suspension of Enrollee Assignments to Providers d. Notice of Provider Termination 21.2 Credentialing a. Licensure b. Minimum Standards c. Credentialing/Recredentialling Process d. Application Procedure 21.3 SDOH Exclusion or Termination of Providers 21.4 Evaluation Information 21.5 Payment In Full 21.6 Choice/Assignment of PCPs 21.7 PCP Changes 21.8 Provider Status Changes 21.9 PCP Responsibilities 21.10 Member to Provider Ratios 21.11 Minimum Office Hours a. General Requirements b. Medical Residents 21.12 Primary Care Practitioners a. General Limitations b. Specialists and Sub-specialists as PCPs c. OB/GYN Providers as PCPs d. Certified Nurse Practitioners as PCPs e. Registered Physician's Assistants as Physician Extenders 21.13 PCP Teams a. General Requirements b. Medical Residents 21.14 Hospitals a. Tertiary Services b. Emergency Services 21.15 Dental Networks 21.16 Presumptive Eligibility Providers 21.17 Mental Health and Chemical Dependence Services Providers 21.18 Laboratory Procedures 21.19 Federally Qualified Health Centers (FQHCs) 21.20 Provider Services Function Section 22 Subcontracts and Provider Agreements 22.1 Written Subcontracts 22.2 Permissible Subcontracts 22.3 Provision of Services Through Provider Agreements 22.4 Approvals TABLE OF CONTENTS October 1, 2004 6 TABLE OF CONTENTS FOR MODEL CONTRACT 22.5 Required Components 22.6 Timely Payment 22.7 Restrictions on Disclosure 22.8 Transfer of Liability 22.9 Termination of Health Care Professional Agreements 22.10 Health Care Professional Hearings 22.11 Non-Renewal of Provide Agreements 22.12 Physician Incentive Plan Section 23 Fraud and Abuse Prevention Plan Section 24 Americans With Disabilities Act Compliance Plan Section 25 Fair Hearings 25.1 Enrollee Access to Fair Hearing Process 25.2 Enrollee Rights to a Fair Hearing 25.3 Contractor Notice to Enrollees 25.4 Aid Continuing 25.5 Responsibilities of SDOH 25.6 Contractor's Obligations

Length of Confidentiality Requirements. TABLE OF Of CONTENTS October 1, 2004 5 TABLE OF CONTENTS FOR MODEL CONTRACT Section 21 Participating Providers 21.1 Network Requirements a. Sufficient Number b. Absence of Appropriate Network Provider c. Suspension of Enrollee Assignments to Providers d. Notice of Provider Termination 21.2 Credentialing a. Licensure b. Minimum Standards c. Credentialing/Recredentialling Recredentialing Process d. Application Procedure 21.3 SDOH Exclusion or Termination of Providers 21.4 Evaluation Information 21.5 Payment In Full 21.6 Choice/Assignment of PCPs 21.7 PCP Changes 21.8 Provider Status Changes 21.9 PCP Responsibilities 21.10 Member to Provider Ratios 21.11 Minimum Office Hours a. General Requirements b. Medical Residents 21.12 Primary Care Practitioners a. General Limitations b. Specialists and Sub-specialists as PCPs c. OB/GYN Providers as PCPs d. Certified Nurse Practitioners as PCPs e. Registered Physician's Assistants as Physician Extenders 21.13 PCP Teams a. General Requirements b. Medical Residents 21.14 Hospitals a. Tertiary Services b. Emergency Services 21.15 Dental Networks 21.16 Presumptive Eligibility Providers 21.17 Mental Health and Chemical Dependence Services Providers 21.18 Laboratory Procedures 21.19 Federally Qualified Health Centers (FQHCs) 21.20 Provider Services Function Section 22 Subcontracts and Provider Agreements 22.1 Written Subcontracts 22.2 Permissible Subcontracts 22.3 Provision of Services Through Provider Agreements 22.4 Approvals TABLE OF CONTENTS October 1, 2004 6 TABLE OF CONTENTS FOR MODEL CONTRACT 22.5 Required Components 22.6 Timely Payment 22.7 Restrictions on Disclosure 22.8 Transfer of Liability 22.9 Termination of Health Care Professional Agreements 22.10 Health Care Professional Hearings 22.11 Non-Renewal of Provide Provider Agreements 22.12 Physician Incentive Plan Section 23 Fraud and Abuse Prevention Plan Section 24 Americans With Disabilities Act Compliance Plan Section 25 Fair Hearings 25.1 Enrollee Access to Fair Hearing Process 25.2 Enrollee Rights to a Fair Hearing 25.3 Contractor Notice to Enrollees 25.4 Aid Continuing 25.5 Responsibilities of SDOH 25.6 Contractor's Obligations

Length of Confidentiality Requirements. TABLE OF CONTENTS October OCTOBER 1, 2004 5 TABLE OF CONTENTS FOR MODEL CONTRACT Section 21 Participating Providers 21.1 Network Requirements a. Sufficient Number b. Absence of Appropriate Network Provider c. Suspension of Enrollee Assignments to Providers d. Notice of Provider Termination 21.2 Credentialing a. Licensure b. Minimum Standards c. Credentialing/Recredentialling Recredentialing Process d. Application Procedure 21.3 SDOH Exclusion or Termination of Providers 21.4 Evaluation Information 21.5 Payment In Full 21.6 Choice/Assignment of PCPs 21.7 PCP Changes 21.8 Provider Status Changes 21.9 PCP Responsibilities 21.10 Member to Provider Ratios 21.11 Minimum Office Hours a. General Requirements b. Medical Residents 21.12 Primary Care Practitioners a. General Limitations b. Specialists and Sub-specialists as PCPs c. OB/GYN Providers as PCPs d. Certified Nurse Practitioners as PCPs e. Registered Physician's Assistants as Physician Extenders 21.13 PCP Teams a. General Requirements b. Medical Residents 21.14 Hospitals a. Tertiary Services b. Emergency Services 21.15 Dental Networks 21.16 Presumptive Eligibility Providers 21.17 Mental Health and Chemical Dependence Services Providers 21.18 Laboratory Procedures 21.19 Federally Qualified Health Centers (FQHCs) 21.20 Provider Services Function Section 22 Subcontracts and Provider Agreements 22.1 Written Subcontracts 22.2 Permissible Subcontracts 22.3 Provision of Services Through Provider Agreements 22.4 Approvals TABLE OF CONTENTS October OCTOBER 1, 2004 6 TABLE OF CONTENTS FOR MODEL CONTRACT 22.5 Required Components 22.6 Timely Payment 22.7 Restrictions on Disclosure 22.8 Transfer Table of Liability 22.9 Termination of Health Care Professional Agreements 22.10 Health Care Professional Hearings 22.11 Non-Renewal of Provide Agreements 22.12 Physician Incentive Plan Contents for Model Contract Section 23 Fraud and Abuse Prevention Plan Section 24 Americans With Disabilities Act Compliance Plan Section 25 Fair Hearings 25.1 Enrollee Access to Fair Hearing Process 25.2 Enrollee Rights to a Fair Hearing 25.3 Contractor Notice to Enrollees 25.4 Aid Continuing 25.5 Responsibilities of SDOH 25.6 Contractor's Obligations

Length of Confidentiality Requirements. TABLE OF CONTENTS October 1, 2004 5 TABLE OF CONTENTS FOR MODEL CONTRACT Section 21 Participating Providers 21.1 Network Requirements a. Sufficient Number b. Absence of Appropriate Network Provider c. Suspension of Enrollee Assignments to Providers d. Notice of Provider Termination 21.2 Credentialing a. Licensure b. Minimum Standards c. Credentialing/Recredentialling Recredentialing Process d. Application Procedure 21.3 SDOH Exclusion or Termination of Providers 21.4 Evaluation Information 21.5 Payment In Full 21.6 Choice/Assignment of PCPs 21.7 PCP Changes 21.8 Provider Status Changes 21.9 PCP Responsibilities 21.10 Member to Provider Ratios 21.11 Minimum Office Hours a. General Requirements b. Medical Residents 21.12 Primary Care Practitioners a. General Limitations b. Specialists and Sub-specialists as PCPs c. OB/GYN Providers as PCPs d. Certified Nurse Practitioners as PCPs e. Registered Physician's Assistants as Physician Extenders 21.13 PCP Teams a. General Requirements b. Medical Residents 21.14 Hospitals a. Tertiary Services b. Emergency Services 21.15 Dental Networks 21.16 Presumptive Eligibility Providers 21.17 Mental Health and Chemical Dependence Services Providers 21.18 Laboratory Procedures 21.19 Federally Qualified Health Centers (FQHCs) 21.20 Provider Services Function Section 22 Subcontracts and Provider Agreements 22.1 Written Subcontracts 22.2 Permissible Subcontracts 22.3 Provision of Services Through Provider Agreements 22.4 Approvals TABLE OF CONTENTS October 1, 2004 6 TABLE OF CONTENTS FOR MODEL CONTRACT 22.5 Required Components 22.6 Timely Payment 22.7 Restrictions on Disclosure 22.8 Transfer of Liability 22.9 Termination of Health Care Professional Agreements 22.10 Health Care Professional Hearings 22.11 Non-Renewal of Provide Provider Agreements 22.12 Physician Incentive Plan Section 23 Fraud and Abuse Prevention Plan Section 24 Americans With Disabilities Act Compliance Plan Section 25 Fair Hearings 25.1 Enrollee Access to Fair Hearing Process 25.2 Enrollee Rights to a Fair Hearing 25.3 Contractor Notice to Enrollees 25.4 Aid Continuing 25.5 Responsibilities of SDOH 25.6 Contractor's Obligations