Common use of Prohibition on Disenrollment for Adverse Change in Enrollee Health Clause in Contracts

Prohibition on Disenrollment for Adverse Change in Enrollee Health. The Contractor may not disenroll an Enrollee because of:

Prohibition on Disenrollment for Adverse Change in Enrollee Health. The Contractor may not disenroll an Enrollee because of:of an adverse change in the Enrollee’s health status, or because of the Enrollee’s utilization of medical services, diminished mental capacity, or uncooperative or disruptive behavior resulting from his or her special needs (except when his or her continued enrollment in the Health Plan seriously impairs the Contractor’s ability to furnish services to either this particular Enrollee or other Enrollees).

Prohibition on Disenrollment for Adverse Change in Enrollee Health. The Contractor may not disenroll an Enrollee because of:of an adverse change in the Enrollee’s health status, or because of the Enrollee’s utilization of medical services, diminished mental capacity, or uncooperative or disruptive behavior resulting from their special needs (except when the Enrollee’s continued enrollment in the Health Plan seriously impairs the Contractor’s ability to furnish services to the Enrollee or other Enrollees).

Prohibition on Disenrollment for Adverse Change in Enrollee Health. The Contractor may not disenroll an Enrollee because of:of an adverse change in the Enrollee’s health status, or because of the Enrollee’s utilization of medical services, diminished mental capacity, or uncooperative or disruptive behavior resulting from the Enrollee’s special needs (except when the Enrollee’s continued enrollment in the Health Plan seriously impairs the Contractor’s ability to furnish services to either this particular Enrollee or other Enrollees).