PROVIDER PROTECTIONS. 1. The M+C Organization agrees to comply with all applicable provider requirements in subpart E of part 422, including provider certification requirements, anti-discrimination requirements, provider participation and consultation requirements, the prohibition on interference with provider advice, limits on provider indemnification, rules governing payments to providers, and limits on physician incentive plans. [422.502(A)(6)]
PROVIDER PROTECTIONS. 3.1 This guarantee is and shall at all times be a continuing security and shall cover the ultimate balance from time to time owing to the Provider by the Resident in respect of the Guaranteed Obligations.
PROVIDER PROTECTIONS. (a) ACDE shall not exclude or terminate Provider or a Group Physician from ACDE’s provider network because the Provider or Group Physician advocated on behalf of a Member including in the context of a utilization management appeal or another dispute with ACDE over appropriate medical care, provided that such advocacy is consistent with the degree of learning and skill ordinarily possessed by a health care provider practicing in accordance with the applicable standard of care.
PROVIDER PROTECTIONS. (a) ACOH shall not exclude or terminate Provider from ACOH’s provider network because the Provider advocated on behalf of a Member including in the context of a utilization management appeal or another dispute with ACOH over appropriate medical care, provided that such advocacy is consistent with the degree of learning and skill ordinarily possessed by a health care provider practicing in accordance with the applicable standard of care.
PROVIDER PROTECTIONS. 1. The MA Organization agrees to comply with all applicable provider requirements in 42 CFR Part 422 Subpart E, including provider certification requirements, anti-discrimination requirements, provider participation and consultation requirements, the prohibition on interference with provider advice, limits on provider indemnification, rules governing payments to providers, and limits on physician incentive plans. [422.504(a)(6)]
PROVIDER PROTECTIONS. 2.7.1. Provider shall not be penalized or the Agreement or this Appendix terminated by Horizon because Provider acts as an advocate for a Member in seeking appropriate, medically necessary health care services.
PROVIDER PROTECTIONS. ACIA shall not exclude or terminate Provider or a Group Physician from ACIA’s provider network because the Provider or Group Physician advocated on behalf of a Member including in the context of a utilization management appeal or another dispute with ACIA over appropriate medical care, provided that such advocacy is consistent with the degree of learning and skill ordinarily possessed by a health care provider practicing in accordance with the applicable standard of care. Provider shall note be excluded or terminated from participation with ACIA due to the fact that the Provider may have a practice that includes a substantial number of patients with expensive medical conditions.
