Provider / Covered Person Communications Sample Clauses

Provider / Covered Person Communications. Neither Health Plan nor Subcontractor shall prohibit or otherwise restrict Provider, when acting within the lawful scope of Provider’s licensure and practice, from advising or advocating on behalf of a Covered Person who is Provider’s patient for the following: (a) The Covered Person’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered; (b) Any information the Covered Person needs in order to decide among all relevant treatment options; (c) The risks, benefits, and consequences of treatment or non-treatment; (d) The Covered Person’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; or (e) Providing information to such Covered Person pertaining to the provisions, terms or requirements of the State Program or the method by which Provider is compensated by Subcontractor or Health Plan for Covered Services. (f) Notwithstanding the foregoing, neither Health Plan nor Subcontractor is required to provide, reimburse for, or provide coverage of a counseling or referral service if Health Plan or Subcontractor objects to the service on moral or religious grounds; provided, however, that Health Plan or Subcontractor furnishes information about such services to the Department, Covered Persons and potential Covered Persons in accordance with the requirements of the applicable State Contract.

Provider / Covered Person Communications. United shall not prohibit or otherwise restrict Provider, when acting within the lawful scope of Provider’s licensure and practice, from advising or advocating on behalf of a Covered Person who is Provider’s patient about the Covered Person’s medical conditions, treatment options, United’s referral policies, and other United policies, including financial incentives or arrangements and all managed care plans with whom Provider contracts. Provider must inform United of any reports of abuse, neglect, or exploitation made regarding a Covered Person. This includes Provider self-reports and reports made by others that Provider becomes aware of.

Provider / Covered Person Communications. Neither Health Plan nor Subcontractor shall prohibit or otherwise restrict Provider, when acting within the lawful scope of Provider’s licensure and practice, from advising or advocating on behalf of a Covered Person who is Provider’s patient about the Covered Person’s medical conditions, treatment options, Subcontractor’s or Health Plan’s referral policies, and other Subcontractor or Health Plan policies, including financial incentives or arrangements and all managed care plans with whom Provider contracts. Provider must inform Subcontractor and/or Health Plan of any reports of abuse, neglect, or exploitation made regarding a Covered Person. This includes Provider self- reports and reports made by others that Provider becomes aware of.