Provider Discrimination Prohibition. United will not discriminate in the participation, reimbursement, or indemnification of any provider who is acting within the scope of his or her license or certification under applicable State law, solely on the basis of that license or certification. In addition, United will not discriminate against providers that serve high-risk populations or specialize in conditions that require costly treatment. This provision shall not be construed as prohibiting United from limiting a provider’s participation to the extent necessary to meet the needs of Customers. This provision also is not intended and shall not interfere with measures established by United that are designed to maintain quality of care practice standards and control costs.
Appears in 3 contracts
Samples: Medicaid and Chip Regulatory Requirements Appendix, Colorado Medicaid and Chip Regulatory Requirements Appendix, Provider Agreement
Provider Discrimination Prohibition. United will not discriminate in the participation, reimbursement, or indemnification of any provider who is acting within the scope of his or her license or certification under applicable State law, solely on the basis of that license or certification. In addition, United will not discriminate against providers that serve high-risk populations or specialize in conditions that require costly treatment. This provision shall not be construed as prohibiting United from limiting a provider’s participation to the extent necessary to meet the needs of CustomersMembers. This provision also is not intended and shall not interfere with measures established by United that are designed to maintain quality of care practice standards and control costs.
Appears in 2 contracts
Samples: Medicaid and Chip Regulatory Requirements Appendix, Medicaid and Chip Regulatory Requirements Appendix
