Material Change to Operations. A material change to operations is any change in overall business operations, such as policy, process or protocol which affects, or can reasonably be expected to affect the Contractor’s membership or provider network. Prior to implementing a material change in operation, the Contractor shall submit a request to FSSA for review and approval at least thirty (30) calendar days in advance of the effective date of the change. The request must contain, at minimum, information regarding the nature of the change, the rationale for the change, and the proposed effective date. All material changes must be communicated to members or providers at least thirty (30) days prior to the effective date of the change.
Material Change to Operations. A material change to operations is any change in overall business operations, such as policy, process or protocol which affects, or can reasonably be expected to affect, more than five percent (5%) of the Contractor’s membership or provider network. Prior to implementing a material change in operation, the Contractor shall submit a request to FSSA for review and approval at least thirty (30) calendar days in advance of member and provider notification. The request must contain, at minimum, information regarding the nature of the change, the rationale for the change, the proposed effective date and sample member and provider notification materials. All material changes must be communicated to members or providers at least thirty (30) days prior to the effective date of the change.
Material Change to Operations. A material change to operations is defined as any change in overall business operations (i.e., policy, process, protocol, such as prior authorization or retrospective review) which affects, or can reasonably be foreseen to affect, the Contractor's ability to meet the performance standards as described in this contract. It also includes any change that would impact more than 5% of total membership and/or provider network in a specific GSA. The Contractor must submit the request for approval of a material change to operations, including draft notification to affected members and providers, as specified in Attachment F3, Contractor Chart of Deliverables. The request should contain, at a minimum, information regarding the nature of the operational change; the reason for the change; methods of communication to be used; and the anticipated effective date. AHCCCS will respond to the Contractor within 30 days. A material change in Contractor operations requires 30 days advance written notice to affected providers and members. The requirements regarding material changes to operations do not extend to contract negotiations between the Contractor and a provider. The Contractor may be required to conduct meetings with providers to address issues (or to provide general information, technical assistance, etc.) related to Federal and State requirements, changes in policy, reimbursement matters, prior authorization and other matters as identified or requested by the AHCCCS.
Material Change to Operations. A material change to operations is any change in overall business operations, such as policy, process or protocol which affects, or can reasonably be expected to affect, more than five percent (5%) of the Contractor’s membership or Provider Network and that a reasonable person would find to be a significant change. Prior to implementing a material change in operation, the Contractor shall notify the Agency. The notification shall contain, at minimum: (i) information regarding the nature of the change; (ii) the rationale for the change; (iii) the proposed effective date; and (iv) sample Member and Provider notification materials. All material changes shall be communicated to Enrolled Members or Providers at least thirty (30) Days prior to the effective date of the change. The Agency reserves the right to deny or require modification to proposed material changes if it is determined, at the sole discretion of the Agency, that such change will adversely impact Quality or Access.
