Mainstreaming. The Contractor must ensure that network Providers do not intentionally segregate their Members in any way from other persons receiving services. The Contractor must investigate Complaints regarding Providers and take affirmative action so that Members are provided covered services without regard to race, color, creed, sex, religion, age, national origin, ancestry, marital status, sexual orientation, language, health status, disease or pre-existing condition (including genetic information), anticipated need for health care or physical or mental handicap, except where medically indicated. Examples of prohibited practices include, but are not limited to, the following: 1. Denying or not providing a Member any Medicaid covered service or availability of a facility within the Contractor’s network. Health care and treatment necessary to preserve life must be provided to all Members who are not terminally ill or permanently unconscious, except where a competent Member objects to such care on his/her own behalf. 2. Subjecting a Member to segregated, separate, or different treatment, including a different place or time from that provided to other Members, public or private patients, in any manner related to the receipt of any Medicaid covered service, except where medically necessary. 3. The assignment of times or places for the provision of services on the basis of the race, color, creed, religion, age, sex, national origin, ancestry, marital status, sexual orientation, income status, program membership, language, health status, disease or pre-existing condition, anticipated need for health care or physical or mental disability of the Members to be served. If the Contractor knowingly executes an agreement with a Provider with the intent of allowing or permitting the Provider to implement barriers to care (e.g., the terms of the Provider agreement are more restrictive than this Contract), the Contractor shall be in breach of this Contract.
Appears in 3 contracts
Samples: Contract Between the State of Mississippi Division of Medicaid and a Coordinated Care Organization (Cco), Contract Between the State of Mississippi Division of Medicaid and a Coordinated Care Organization (Cco), Contract Between the State of Mississippi Division of Medicaid and a Care Coordination Organization
Mainstreaming. The Contractor must shall make all reasonable efforts to ensure that network Providers providers do not intentionally segregate their Members in any way from other persons receiving services. The Contractor must investigate Complaints regarding Providers providers and take affirmative action so that Members are provided covered services without regard to race, color, creed, sex, religion, age, national origin, ancestry, marital status, sexual orientation, language, health status, disease or pre-existing condition (including genetic information), anticipated need for health care or physical or mental handicap, except where medically indicated. Examples of prohibited practices include, but are not limited to, the following:
1. Denying or not providing a Member any Medicaid CHIP covered service or availability of a facility within the Contractor’s network. Health care and treatment necessary to preserve life must be provided to all Members who are not terminally ill or permanently unconscious, except where a competent Member objects to such care on his/her own behalf.
2. Subjecting a Member to segregated, separate, or different treatment, including a different place or time from that provided to other Members, public or private patientsMembers, in any manner related to the receipt of any Medicaid CHIP covered service, except where medically necessary.
3. The assignment of times or places for the provision of services on the basis of the race, color, creed, religion, age, sex, national origin, ancestry, marital status, sexual orientation, income status, program membershipMembership, language, health status, disease or pre-existing condition, anticipated need for health care or physical or mental disability of the Members to be served. If the Contractor knowingly executes an agreement with a Provider provider with the intent of allowing or permitting the Provider provider to implement barriers to care (e.g., the terms of the Provider provider agreement are more restrictive than this Contract), the Contractor shall be in breach of this Contract.
Appears in 2 contracts
Samples: Contract for Administration of the Children’s Health Insurance Program, Contract for Administration of the Children’s Health Insurance Program
