Common use of Managed Care Clause in Contracts

Managed Care. The County may offer the services of a managed care program to unit members. The parties agree to prepare a brochure comparing and describing the benefits of managed care and jointly encourage its use by unit members. Participation in a selection from the Managed Care preferred provider physicians’ list shall be voluntary. The County and the Union will encourage employees incurring job related injuries to work cooperatively with nurse advisors who operate under the Managed Care case management system. To this end, the parties acknowledge the goal of the case management system is to assist the employee in obtaining maximum medical improvement in order to return to work at the earliest possible opportunity. The managed care program will have the following components: 1. Employees may at their option select a doctor for treatment from a network of physicians. 2. Employees will receive initial care from a network physician at no cost, even if the claim is ultimately denied. 3. The managed care provider will coordinate benefits with group health provider to avoid confusion and duplication of filings. 4. The managed care provider will perform utilization review of treatment.