Common use of Prohibited Punitive Action Against the Provider Clause in Contracts

Prohibited Punitive Action Against the Provider. Contractor must ensure that punitive action is not taken against the provider who either requests an expedited resolution or supports a Member’s appeal. Further, Contractor may not prohibit, or otherwise restrict, a health care professional acting within the lawful scope of practice, from advising or advocating on behalf of a Member who is his or her patient: for the Member’s health status, medical care, or treatment options, including any alternative treatment that may be self- administered, for any information the Member needs in order to decide among all relevant treatment options, for the risks, benefits, and consequences of treatment or non-treatment, for the Member’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions.

Prohibited Punitive Action Against the Provider. Contractor must ensure that punitive action is not taken against the provider who either requests an expedited resolution or supports a Member’s appealAppeal. Further, Contractor may not prohibit, or otherwise restrict, a health care professional acting within the lawful scope of practice, from advising or advocating on behalf of a Member who is his or her patient: for the Member’s health status, medical care, or treatment options, including any alternative treatment that may be self- administered, for any information the Member needs in order to decide among all relevant treatment options, for the risks, benefits, and consequences of treatment or non-treatment, for the Member’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions.

Prohibited Punitive Action Against the Provider. Contractor must ensure that punitive action is not taken against the provider Provider who either requests an expedited resolution or supports a Member’s appealAppeal. Further, Contractor may not prohibit, or otherwise restrict, a health care professional acting within the lawful scope of practice, from advising or advocating on behalf of a Member who is his or her patient: patient for the Member’s health status, medical care, or treatment options, including any alternative treatment that may be self- administered, for any information the Member needs in order to decide among all relevant treatment options, for the risks, benefits, and consequences of treatment or non-treatment, for the Member’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions.

Prohibited Punitive Action Against the Provider. Contractor must ensure that punitive action is not taken against the provider who either requests an expedited resolution or supports a Member’s appeal. Further, Contractor may not prohibit, or otherwise restrict, a health care professional acting within the lawful scope of practice, from advising or advocating on behalf of a Member who is his or her patient: patient for the Member’s health status, medical care, or treatment options, including any alternative treatment that may be self- administered, for any information the Member needs in order to decide among all relevant treatment options, for the risks, benefits, and consequences of treatment or non-treatment, for the Member’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions.

Prohibited Punitive Action Against the Provider. Contractor must ensure that punitive action is not taken against the provider Provider who either requests an expedited resolution or supports a Member’s appealAppeal. Further, Contractor may not prohibit, or otherwise restrict, a health care professional acting within the lawful scope of practice, from advising or advocating on behalf of a Member who is his or her patient: for the Member’s health status, medical care, or treatment options, including any alternative treatment that may be self- administered, for any information the Member needs in order to decide among all relevant treatment options, for the risks, benefits, and consequences of treatment or non-treatment, for the Member’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions.