Common use of Network Disruption Clause in Contracts

Network Disruption. (i) Contractor shall implement policies and practices designed (i) to reduce the potential for disruptions in Contractor’s provider networks, and (ii) to minimize the amount of uncertainty, disruption, and inconvenience of Enrollees in the execution of the transition of care as required under State laws, rules and regulations in connection with any such disruption. Contractor agrees to maintain adequate records, reasonably satisfactory to the Exchange, documenting its policies and its compliance with these requirements by Contractor and Participating Providers. (ii) If Contractor experiences provider network disruptions that require a block transfer of Enrollees from a terminated Participating Physician or Participating Hospital to a new Participating Physician or Participating Hospital, Contractor shall provide the Exchange with copies of the written notices the Contractor proposes to send to affected Enrollees, as required under Health and Safety Code 1373.65 prior to mailing to Enrollees. (iii) If Contractor experiences provider network disruptions or other similar circumstances that make it necessary for Enrollees to change QHPs or Participating Providers, Contractor agrees to provide prior notice to the Exchange and Health Insurance Regulator, in accordance with advance notice, meeting, and other requirements set forth in applicable laws, rules and regulations, including, Insurance Code 10199.1 and Health and Safety Code 1367.23 and 1366.1. (iv) In the event of a change in Participating Providers or QHPs under paragraphs (ii) or (iii) above, Contractor shall, and shall require Participating Providers to, cooperate with the Exchange in planning for the orderly transfer of Enrollees as necessary and as required under applicable laws, rules, and regulations including, those relating to continuation of care, including, those set forth at Health and Safety Code Section 1373.95 and Insurance Code 10133.55.

Network Disruption. (i) Contractor shall implement policies and practices designed (i) to reduce the potential for disruptions in Contractor’s provider networks, and (ii) to minimize the amount of uncertainty, disruption, and inconvenience of Enrollees in the execution of the transition of care as required under State laws, rules and regulations in connection with any such disruption. Contractor agrees to maintain adequate records, reasonably satisfactory to the Exchange, documenting its policies and its compliance with these requirements by Contractor and Participating Providers. (ii) If Contractor experiences provider network disruptions that require a block transfer of Enrollees from a terminated Participating Physician or Participating Hospital to a new Participating Physician or Participating Hospital, Contractor shall provide the Exchange with copies of the written notices the Contractor proposes to send to affected Enrollees, as required under Health and Safety Code 1373.65 prior to mailing to Enrollees. (iii) If Contractor experiences provider network disruptions or other similar circumstances that make it necessary for Enrollees to change QHPs or Participating Providers, Contractor agrees to provide prior notice to the Exchange and Health Insurance Regulator, in accordance with advance notice, meeting, and other requirements set forth in applicable laws, rules and regulations, including, Insurance Code 10199.1 and Health and Safety Code 1367.23 and 1366.1. (iv) In the event of a change in Participating Providers or QHPs under paragraphs (ii) or (iii) above, Contractor shall, and shall require cause Participating Providers to, cooperate with the Exchange in planning for the orderly transfer of Enrollees as necessary and as required under applicable laws, rules, and regulations including, those relating to continuation of care, including, those set forth at Health and Safety Code Section 1373.95 and Insurance Code 10133.55.

Network Disruption. (i) Contractor shall implement policies and practices designed (i) to reduce the potential for disruptions in Contractor’s provider networks, and (ii) to minimize the amount of uncertainty, disruption, and inconvenience of Enrollees in the execution of the transition of care as required under State laws, rules and regulations in connection with any such disruption. Contractor agrees to maintain adequate records, reasonably satisfactory to the Exchange, documenting its policies and its compliance with these requirements by Contractor and Participating Providers. (ii) If Contractor experiences provider network disruptions that require a block transfer of Enrollees from a terminated Participating Physician or Participating Hospital to a new Participating Physician or Participating Hospital, Contractor shall provide the Exchange with copies of the written notices the Contractor proposes to send to affected Enrollees, as required under Health and Safety Code 1373.65 prior to mailing to Enrollees. (iii) If Contractor experiences provider network disruptions or other similar circumstances that make it necessary for Enrollees to change QHPs or Participating Providers, Contractor agrees to provide prior notice to the Exchange and Health Insurance Regulator, in accordance with advance notice, meeting, and other requirements set forth in applicable laws, rules and regulations, including, Insurance Code 10199.1 and Health and Safety Code 1367.23 and 1366.1. (iv) In the event of a change in Participating Providers or QHPs under paragraphs (ii) or (iii) above, Contractor shall, and shall require requirecause Participating Providers to, cooperate with the Exchange in planning for the orderly transfer of Enrollees as necessary and as required under applicable laws, rules, and regulations including, those relating to continuation of care, including, those set forth at Health and Safety Code Section 1373.95 and Insurance Code 10133.55.