Primary Care and Coordination of Services. Contractor shall implement procedures to deliver primary care to and coordinate health care services for Enrollees. These procedures must:
Primary Care and Coordination of Services. INSURER shall implement procedures to ensure enrollees have access to an adequate, ongoing source of primary care and that the PCP responsible for ongoing primary care coordinates the referral to other health care services that the enrollee is entitled to receive. INSURER shall implement procedures to share the identity of the enrollee, the results of its identification and assessment of that enrollees special health care needs and any special health care needs that enrollee may have with other Insurers serving the enrollee so that those activities may not be duplicated. INSURER shall implement procedures to ensure that in the process of coordinating care, each enrollee’s privacy is protected consistent with the confidentiality requirements in 45 CFR parts 160 and 164.
