Common use of NETWORK CHANGES Clause in Contracts

NETWORK CHANGES. In addition to reporting quarterly on the size and composition of its provider networks, the MCO must notify BMS and the enrollment broker of any changes to the composition of its provider network that materially affect the MCO’s ability to deliver all capitated services within 14 days of such change identified. The MCO must provide BMS and the enrollment broker with advanced written notice of any PCP network deletions within 14 days. The MCO must report any disenrollment of hospitals from the MCO’s network to BMS immediately. In cases of PCP withdrawals, the MCO must also provide enrollees with at least 30 days’ notice whenever possible and allow them the opportunity to select a new PCP before being assigned one. In cases of MCO–initiated provider termination, the MCO must provide written notice to enrollees when a contracted provider has been terminated, within 15 days of issuance of the termination notice. The MCO must have procedures to address changes in its network that constrain the ability of clients to access services. Material changes in network composition that negatively affect client access to services and which are not corrected may be grounds for contract termination.

NETWORK CHANGES. In addition to reporting quarterly on the size and composition of its provider networks, the MCO must notify BMS and the enrollment broker of any changes to the composition of its provider network that materially affect the MCO’s ability to deliver all capitated services within 14 fourteen (14) days of such change identified. The MCO must provide BMS and the enrollment broker with advanced written notice of any PCP network deletions within 14 fourteen (14) days. The MCO must report any disenrollment of hospitals from the MCO’s network to BMS immediately. In cases of PCP withdrawals, the MCO must also provide enrollees with at least 30 thirty (30) days’ notice whenever possible and allow them the opportunity to select a new PCP before being assigned one. In cases of MCO–initiated provider termination, the MCO must provide written notice to enrollees when a contracted provider has been terminated, within 15 fifteen (15) days of issuance of the termination notice. The MCO must have procedures to address changes in its network that constrain the ability of clients to access services. Material changes in network composition that negatively affect client access to services and which are not corrected may be grounds for contract Contract termination.

NETWORK CHANGES. In addition to reporting quarterly on the size and composition of its provider networks, the MCO must notify BMS and the enrollment broker promptly of any changes to the composition of its provider network that materially affect the MCO’s ability to deliver all capitated services within 14 days of such change identifiedin a timely manner. The MCO must provide BMS and the enrollment broker with advanced written notice of any PCP network deletions within 14 daysthat will affect more than 100 members. The MCO must shall report any disenrollment of hospitals from the MCO’s network to BMS immediately. In cases of PCP withdrawals, the MCO must also provide enrollees with at least 30 days’ days notice whenever possible and allow them the opportunity to select a new PCP before being assigned one. In cases of MCO–initiated provider termination, the MCO must shall make a good faith effort, as appropriate, to provide written notice to enrollees when a contracted provider has been terminated, within 15 days of issuance of the termination notice. The MCO must have procedures to address changes in its network that constrain the ability of clients to access services. Material changes in network composition that negatively affect client access to services and which are not corrected may be grounds for contract termination.