Common use of NON-RENEWAL/TERMINATION OF PROVIDER CONTRACT/ Clause in Contracts

NON-RENEWAL/TERMINATION OF PROVIDER CONTRACT/. SUBCONTRACT The provider/subcontractor understands that the Contractor shall notify DMAHS at least 30 days prior to the effective date of the suspension, termination, or voluntary withdrawal of the provider/subcontractor from participation in the Contractor’s network. If the termination was “for cause,” as related to fraud, waste, and abuse, the Contractor's notice to DMAHS shall include the reasons for the termination. Provider resource consumption patterns shall not constitute “cause” unless the Contractor can demonstrate it has in place a risk adjustment system that takes into account enrollee health-related differences when comparing across providers.

NON-RENEWAL/TERMINATION OF PROVIDER CONTRACT/. SUBCONTRACT The provider/subcontractor understands that the Contractor contractor shall notify DMAHS at least 30 days prior to the effective date of the suspension, termination, or voluntary withdrawal of the provider/subcontractor from participation in the Contractorcontractor’s network. If the termination was “for cause,” as related to fraud, waste, and abuse, the Contractorcontractor's notice to DMAHS shall include the reasons for the termination. Provider resource consumption patterns shall not constitute “cause” unless the Contractor contractor can demonstrate it has in place a risk adjustment system that takes into account enrollee health-related differences when comparing across providers.

NON-RENEWAL/TERMINATION OF PROVIDER CONTRACT/. SUBCONTRACT The provider/subcontractor understands that the Contractor contractor shall notify DMAHS at least 30 days prior to the effective date of the suspension, termination, or voluntary withdrawal of the provider/subcontractor from participation in the Contractorcontractor’s network. If the termination was “for cause,” as related to fraud, waste, and abuse, the Contractor's contractor’s notice to DMAHS shall include the reasons for the termination. Provider resource consumption patterns shall not constitute “cause” unless the Contractor contractor can demonstrate it has in place a risk adjustment system that takes into account enrollee health-related differences when comparing across providers.