Common use of Member Rights Clause in Contracts

Member Rights. Per 42 CFR 438.100, the Contractor shall guarantee the following rights to members : ▪ The right to receive information on the managed care program and plan into which he/she is enrolled per 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(i). ▪ The right to receive information in accordance with 42 CFR 438.10; ▪ The right to be treated with respect and with due consideration for his or her dignity and privacy in accordance with 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(ii); ▪ The right to receive information on available treatment options and alternatives, presented in a manner appropriate to the member's condition and ability to understand in accordance with 42 CFR 438.3(j)(2), 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(iii); ▪ The right to participate in decisions regarding his or her health care, including the right to refuse treatment in accordance with 42 CFR 438.100(a)(1); 42 CFR 438.100(b)(2)(iv); ▪ The right to be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other federal regulations on the use of restraints and seclusion in accordance with 42 CFR 438.100(a)(1); 42 CFR 438.100(b)(2)(v); ▪ The right to request and receive a copy of his or her medical records, and request that they be amended or corrected, as specified in 42 CFR 438.100(a)(1), 42 CFR 438.100(b)(2)(vi) and the HIPAA Privacy Rule set forth in 45 CFR parts 160 and 164, subparts A and E, which address security and privacy of individually identifiable health information; and ▪ The right to be furnished health care services in accordance with 42 CFR 438.206 through 438.210, which relate to service availability, assurances of adequate capacity and services, coordination and continuity of care, and coverage and authorization of services . The Contractor shall also comply with other applicable state and federal laws regarding member rights, as set forth in 42 CFR 438.100(d) and 42 CFR 438.100(a)(2). The Contractor must have written policies in place regarding the protected member rights listed above. The Contractor shall have a plan in place to ensure that its staff and network providers take member rights into account when furnishing services to the Contractor’s members. Members shall be free to exercise protected member rights, and the Contractor must not discriminate against or treat adversely, a member that chooses to exercise his or her rights in accordance with 42 CFR 438.100(a)(1) and 42 CFR 438.100(c).

Member Rights. Per 42 CFR 438.100, the Contractor shall guarantee the following rights to members : ▪ • The right to receive information on the managed care program and plan into which he/she is enrolled per 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(i). ▪ • The right to receive information in accordance with 42 CFR 438.10; ▪ • The right to be treated with respect and with due consideration for his or her dignity and privacy in accordance with 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(ii); ▪ • The right to receive information on available treatment options and alternatives, presented in a manner appropriate to the member's condition and ability to understand in accordance with 42 CFR 438.3(j)(2), 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(iii); ▪ • The right to participate in decisions regarding his or her health care, including the right to refuse treatment in accordance with 42 CFR 438.100(a)(1); 42 CFR 438.100(b)(2)(iv); ▪ • The right to be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other federal regulations on the use of restraints and seclusion in accordance with 42 CFR 438.100(a)(1); 42 CFR 438.100(b)(2)(v); ▪ • The right to request and receive a copy of his or her medical records, and request that they be amended or corrected, as specified in 42 CFR 438.100(a)(1), 42 CFR 438.100(b)(2)(vi) and the HIPAA Privacy Rule set forth in 45 CFR parts 160 and 164, subparts A and E, which address security and privacy of individually identifiable health information; and ▪ • The right to be furnished health care services in accordance with 42 CFR 438.206 through 438.210, which relate to service availability, assurances of adequate capacity and services, coordination and continuity of care, and coverage and authorization of services services. The Contractor shall also comply with other applicable state and federal laws regarding member rights, as set forth in 42 CFR 438.100(d) and 42 CFR 438.100(a)(2). The Contractor must have written policies in place regarding the protected member rights listed above. The Contractor shall have a plan in place to ensure that its staff and network providers take member rights into account when furnishing services to the Contractor’s members. Members shall be free to exercise protected member rights, and the Contractor must not discriminate against or treat adversely, a member that chooses to exercise his or her rights in accordance with 42 CFR 438.100(a)(1) and 42 CFR 438.100(c).

Member Rights. Per 42 CFR 438.100, the Contractor shall guarantee the following rights to members members: ▪ The right to receive information on the managed care program and plan into which he/she is enrolled per 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(i). ▪ The right to receive information in accordance with 42 CFR 438.10; ▪ The right to be treated with respect and with due consideration for his or her dignity and privacy in accordance with 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(ii438. 100(b)(2)(ii); ▪ The right to receive information on available treatment options and alternatives, presented in a manner appropriate to the member's condition and ability to understand in accordance with 42 CFR 438.3(j)(2), 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(iii); ▪ The right to participate in decisions regarding his or her health care, including the right to refuse treatment in accordance with 42 CFR 438.100(a)(1); 42 CFR 438.100(b)(2)(iv); ▪ The right to be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other federal regulations on the use of restraints and seclusion in accordance with 42 CFR 438.100(a)(1); 42 CFR 438.100(b)(2)(v); ▪ The right to request and receive a copy of his or her medical records, and request that they be amended or corrected, as specified in 42 CFR 438.100(a)(1), 42 CFR 438.100(b)(2)(vi) and the HIPAA Privacy Rule set forth in 45 CFR parts 160 and 164, subparts A and E, which address security and privacy of individually identifiable health information; and ▪ The right to be furnished health care services in accordance with 42 CFR 438.206 through 438.210, which relate to service availability, assurances of adequate capacity and services, coordination and continuity of care, and coverage and authorization of services services. The Contractor shall also comply with other applicable state and federal laws regarding member rights, as set forth in 42 CFR 438.100(d) and 42 CFR 438.100(a)(2). The Contractor must have written policies in place regarding the protected member rights listed above. The Contractor shall have a plan in place to ensure that its staff and network providers take member rights into account when furnishing services to the Contractor’s members. Members shall be free to exercise protected member rights, and the Contractor must not discriminate against or treat adversely, a member that chooses to exercise his or her rights in accordance with 42 CFR 438.100(a)(1) and 42 CFR 438.100(c).

Member Rights. Per 42 CFR 438.100, the Contractor shall guarantee the following rights to members members: ▪ • The right to receive information on the managed care program and plan into which he/she is enrolled per 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(i). ▪ • The right to receive information in accordance with 42 CFR 438.10; ▪ • The right to be treated with respect and with due consideration for his or her dignity and privacy in accordance with 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(ii); ▪ • The right to receive information on available treatment options and alternatives, presented in a manner appropriate to the member's condition and ability to understand in accordance with 42 CFR 438.3(j)(2), 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(iii); ▪ • The right to participate in decisions regarding his or her health care, including the right to refuse treatment in accordance with 42 CFR 438.100(a)(1); 42 CFR 438.100(b)(2)(iv); ▪ • The right to be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other federal regulations on the use of restraints and seclusion in accordance with 42 CFR 438.100(a)(1); 42 CFR 438.100(b)(2)(v); ▪ • The right to request and receive a copy of his or her medical records, and request that they be amended or corrected, as specified in 42 CFR 438.100(a)(1), 42 CFR 438.100(b)(2)(vi) and the HIPAA Privacy Rule set forth in 45 CFR parts 160 and 164, subparts A and E, which address security and privacy of individually identifiable health information; and ▪ • The right to be furnished health care services in accordance with 42 CFR 438.206 through 438.210, which relate to service availability, assurances of adequate capacity and services, coordination and continuity of care, and coverage and authorization of services . The Contractor shall also comply with other applicable state and federal laws regarding member rights, as set forth in 42 CFR 438.100(d) and 42 CFR 438.100(a)(2). The Contractor must have written policies in place regarding the protected member rights listed above. The Contractor shall have a plan in place to ensure that its staff and network providers take member rights into account when furnishing services to the Contractor’s members. Members shall be free to exercise protected member rights, and the Contractor must not discriminate against or treat adversely, a member that chooses to exercise his or her rights in accordance with 42 CFR 438.100(a)(1) and 42 CFR 438.100(c)services.

Member Rights. Per 42 CFR 438.100, the Contractor shall guarantee the following rights to members members: ▪ The right to receive information on the managed care program and plan into which he/she is enrolled per 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(i). ▪ The right to receive information in accordance with 42 CFR 438.10; ▪ The right to be treated with respect and with due consideration for his or her dignity and privacy in accordance with 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(ii438. 100(b)(2)(ii); ▪ The right to receive information on available treatment options and alternatives, presented in a manner appropriate to the member's condition and ability to understand in accordance with 42 CFR 438.3(j)(2), 42 CFR 438.100(a)(1) and 42 CFR 438.100(b)(2)(iii); ▪ The right to participate in decisions regarding his or her health care, including the right to refuse treatment in accordance with 42 CFR 438.100(a)(1); 42 CFR 438.100(b)(2)(iv); ▪ The right to be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other federal regulations on the use of restraints and seclusion in accordance with 42 CFR 438.100(a)(1); 42 CFR 438.100(b)(2)(v); ▪ The right to request and receive a copy of his or her medical records, and request reques t that they be amended or corrected, as specified in 42 CFR 438.100(a)(1), 42 CFR 438.100(b)(2)(vi) and the HIPAA Privacy Rule set forth in 45 CFR parts 160 and 164, subparts A and E, which address security and privacy of individually identifiable health information; and ▪ The right to be furnished health care services in accordance with 42 CFR 438.206 through 438.210, which relate to service availability, assurances of adequate capacity and services, coordination and continuity of care, and coverage and authorization of services services. The Contractor shall also comply with other applicable state and federal laws regarding member rights, as set forth in 42 CFR 438.100(d) and 42 CFR 438.100(a)(2). The Contractor must have written policies in place regarding the protected member rights listed above. The Contractor shall have a plan in place to ensure that its staff and network providers take member rights into account when furnishing services to the Contractor’s members. Members shall be free to exercise protected member rights, and the Contractor must not discriminate against or treat adversely, a member that chooses to exercise his or her rights in accordance with 42 CFR 438.100(a)(1) and 42 CFR 438.100(c).