Common use of Provider Discrimination Clause in Contracts

Provider Discrimination. Neither Health Plan nor Subcontractor shall discriminate with respect to participation, reimbursement, or indemnification of a provider who is acting within the scope of the provider’s license or certification under applicable State law, solely on the basis of such license or certification. This provision shall not be construed as prohibiting Health Plan and Subcontractor from limiting a provider’s participation to the extent necessary to meet the needs of Covered Persons. This provision also is not intended and shall not interfere with measures established by Health Plan that are designed to maintain quality of care practice standards and control costs consistent with Health Plan’s responsibilities under the applicable State Contract.