Non-Inclusion of Providers. (A) The Contractor shall report to the Department when a Provider is denied Participating Provider status. Such denial can include when a Provider is denied admission to the Contractor’s provider panel, is removed from the Contractor’s panel, or voluntarily withdraws from the panel when the denial, removal, or withdrawal is due to a substantive issue. Substantive issues include violations of the Department of Occupational and Professional Licensing’s regulations, and allegations of Fraud, Waste or Abuse.
Appears in 19 contracts
Samples: Health Contract, medicaid.utah.gov, medicaid.utah.gov
Non-Inclusion of Providers. (A) The Contractor shall report to the Department when a Provider is denied Participating Network Provider status. Such denial can include when a Provider is denied admission to the Contractor’s provider panel, is removed from the Contractor’s panel, or voluntarily withdraws from the panel when the denial, removal, or withdrawal is due to a substantive issue. Substantive issues include violations of the Department of Occupational and Professional Licensing’s DOPL regulations, and allegations of Fraud, Waste or Abuse.
Appears in 16 contracts
Samples: medicaid.utah.gov, medicaid.utah.gov, medicaid.utah.gov
Non-Inclusion of Providers. (A) The Contractor shall report to the Department when a Provider is denied Participating Network Provider status. Such denial can include when a Provider is denied admission to the Contractor’s provider panel, is removed from the Contractor’s panel, or voluntarily withdraws from the panel when the denial, removal, or withdrawal is due to a substantive issue. Substantive issues include violations of the Department of Occupational and Professional LicensingDOPL’s regulations, and allegations of Fraud, Waste or Abuse.
Appears in 7 contracts
Samples: medicaid.utah.gov, medicaid.utah.gov, medicaid.utah.gov
Non-Inclusion of Providers. (A) The Contractor shall report to the Department when a Provider is denied Participating Network Provider status. Such denial can include when a Provider is denied admission to the Contractor’s provider panel, is removed from the Contractor’s panel, or voluntarily withdraws from the panel when the denial, removal, or withdrawal is due to a substantive issue. Substantive issues include violations of the Department of Occupational and Professional Licensing’s regulations, and allegations of Fraud, Waste or Abuse.
Appears in 5 contracts
Samples: Health Contract, medicaid.utah.gov, Health Contract
Non-Inclusion of Providers. (A) The Contractor shall report to the Department when a Provider is denied Participating Network Provider status. Such denial can include when a Provider is denied admission to the Contractor’s provider panel, is removed from the Contractor’s panel, or voluntarily withdraws from the panel when the denial, removal, or withdrawal is due to a substantive issue. Substantive issues include violations of the Department of Occupational and Professional LicensingDOPL’s regulations, and allegations of Fraud, Waste or Abuse.
Appears in 2 contracts
Samples: medicaid.utah.gov, medicaid.utah.gov