Common use of PCP Changes Clause in Contracts

PCP Changes. The Contractor agrees to notify its Enrollees of any of the following PCP changes: a) Enrollees will be notified within fifteen (15) days from the date on which the Contractor becomes aware that such Enrollee's PCP has changed his or her office address or telephone number. b) If a PCP ceases participation in the Contractor's network, the Contractor shall provide written notice within fifteen (15) days from the date that the Contractor becomes aware of such change in status to each Enrollee who has chosen the provider as their PCP. In such cases, the notice shall describe the procedures for choosing an alternative PCP and, in the event that the Enrollee is in an ongoing course of treatment, the procedures for continuing care consistent with subdivision 6 (e) of PHL Section 4403. c) Where an Enrollee's PCP ceases participation with the Contractor, the Contractor must ensure that a new PCP is assigned within thirty (30) days of the date of the notice to the Enrollee.

Appears in 6 contracts

Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)

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PCP Changes. i) The Contractor agrees to notify its Enrollees of any of the following PCP changes: aA) Enrollees will be notified within fifteen (15) days from the date on which the Contractor becomes aware that such Enrollee's PCP has changed his or her office address or telephone number. bB) If a PCP ceases participation in the Contractor's network, the Contractor shall provide written notice within fifteen (15) days from the date that the Contractor becomes aware of such change in status to each Enrollee who has chosen the provider as their his or her PCP. In such cases, the notice shall describe the procedures for choosing an alternative PCP and, in the event that the Enrollee is in an ongoing course of treatment, the procedures for continuing care consistent with subdivision 6 (e6(e) of PHL Section 4403. cC) Where an Enrollee's PCP ceases participation with the Contractor, the Contractor must ensure that the Enrollee selects or is assigned to a new PCP is assigned within thirty (30) days of the date of the notice to the Enrollee.

Appears in 1 contract

Samples: Medicaid Managed Care Agreement (Amerigroup Corp)

PCP Changes. The Contractor agrees to notify its Enrollees of any of the following PCP changes: a) Enrollees will be notified within fifteen (15) days from the date on which the Contractor becomes aware that such Enrollee's PCP has changed his or her office address or telephone number. b) If a PCP ceases participation in the Contractor's network, the Contractor shall provide written notice within fifteen (15) days from the date that the Contractor becomes aware of such change in status to each Enrollee who has chosen the provider as their PCP. In such cases, the notice shall describe the procedures for choosing an alternative PCP and, in the event that the Enrollee is in an ongoing course of treatment, the procedures for continuing care consistent with subdivision 6 (e) of PHL Section 4403. c) Where an Enrollee's PCP ceases participation with the Contractor, the Contractor CONTRACTOR must ensure that a new PCP is assigned within thirty WITHIN THIRTY (30) days of the date of the notice to the Enrollee.

Appears in 1 contract

Samples: Medicaid Managed Care Model Contract (Amerigroup Corp)

PCP Changes. The Contractor agrees to notify its Enrollees of any of the following PCP changes: a) Enrollees will be notified within fifteen (15) days from the date on which the Contractor becomes aware that such Enrollee's PCP has changed his or her office address or telephone number. b) If a PCP ceases participation in the Contractor's network, the Contractor shall provide written notice within fifteen (15) days from the date that the Contractor becomes aware of such change in status to each Enrollee who has chosen the provider as their PCP. In such cases, the notice shall describe the procedures for choosing an alternative PCP and, in the event that the Enrollee is in an ongoing course of treatment, the procedures for continuing care consistent with subdivision 6 (e6(e) of PHL Section 4403. c) Where an Enrollee's PCP ceases participation with the Contractor, the Contractor must ensure that a new PCP is assigned within thirty (30) days of the date of the notice to the Enrollee.

Appears in 1 contract

Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)

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PCP Changes. The Contractor agrees to notify its Enrollees of any of the following PCP changes: a) Enrollees will be notified within fifteen (15) days from the date on which the Contractor becomes aware that such Enrollee's PCP has changed his or her office address or telephone Telephone number. b) If a PCP ceases participation in the Contractor's network, the Contractor shall provide written notice within fifteen (15) days from the date that the Contractor becomes aware of such change in status to each Enrollee who has chosen the provider as their PCP. In such cases, the notice shall describe the procedures for choosing an alternative PCP and, in the event that the Enrollee is in an ongoing course of treatment, the procedures for continuing care consistent with subdivision 6 (e) of PHL Section 4403. c) Where an Enrollee's PCP ceases participation with the Contractor, the Contractor must ensure that a new PCP is assigned within thirty (30) days of the date of the notice to the Enrollee.

Appears in 1 contract

Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)

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