Member Rights and Responsibilities. The CONTRACTOR shall provide each Member with written information in the Member handbook that encompasses all the provisions in this Section 4.15.3. The CONTRACTOR must ensure that each Member is free to exercise their rights and that the exercise of these rights does not adversely affect the way the CONTRACTOR and its Contract Providers or the State treats the Member. The CONTRACTOR must have written policies regarding the Member’s and/or Representatives’ rights, including but not limited to, the guaranteed right to: Be treated with respect and with due consideration for their dignity and privacy; Receive information on available treatment options and alternatives, presented in a manner appropriate to their condition and ability to understand; Make and have honored an Advance Directive consistent with State and federal laws; Receive Covered Services in a nondiscriminatory fashion; Participate in decisions regarding their health care, including the right to refuse treatment; Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience, or retaliation, as specified in federal regulations on the use of restraints and seclusion; Request and receive a copy of their medical records and to request that they be amended or corrected as specified in 45 C.F.R. § 164.524 and part 526; Choose a Representative to be involved as appropriate in making care decisions; Provide informed consent; Voice Grievances about the care provided by the CONTRACTOR and to make use of the Grievance, Appeal and Fair Hearing processes without fear of retaliation; Choose from among Contract Providers in accordance with the CONTRACTOR’s prior authorization requirements; Receive information about Covered Services and how to access Covered Services, and Contract Providers; Be free from harassment by the CONTRACTOR or its Contract Providers in regard to contractual disputes between the CONTRACTOR and Providers; and Participate in understanding Physical Health and Behavioral Health problems and developing mutually agreed-upon treatment goals. The CONTRACTOR shall ensure that each Member (and/or as appropriate, Representative) is free to exercise their rights and that the exercise of those rights does not adversely affect the way the CONTRACTOR or its Contract Providers treat the Member (and/or Representative). Members and/or Representatives, to the extent possible, have a responsibility to: Provide information that the CONTRACTOR and its Contract Providers need in order to care for the Member; Follow the plans and instructions for care that they have agreed upon with their Providers; and Keep, reschedule, or cancel a scheduled appointment rather than to simply fail to keep it.
Appears in 4 contracts
Samples: Managed Care Services Agreement, Services Agreement, Managed Care Services Agreement
