Provider Terminations. If a Member’s PCP, specialist, or other Provider is no longer available to the Member through the Contractor’s network, the Contractor shall have a plan to ensure continuity and coordination of care and to assist the Member in selecting a network Provider.
Provider Terminations. In the event that a Participating Provider is terminated or leaves County, County shall ensure that there is no disruption in services provided to Members who are receiving treatment for a chronic or ongoing medical condition or LTSS, County shall ensure that there is no disruption in services provided to the CalOptima Member.
Provider Terminations. If a provider is no longer available to the Member through Contractor’s network, Contractor shall have a plan to ensure continuity and coordination of care and to assist the Member in selecting a network provider.
Provider Terminations. In the event that a subcontract with a Group Provider is denied, suspended or terminated, Group shall provide the provider with written notice of the reason for the action as required by state and federal law, including any standards and profiling data Group used to evaluate the provider, the number and mix of similar health care providers that Group needs (if applicable), and notice of the provider’s right to appeal the action, including notice of the process and timing to request a hearing. In the event Group terminates a contract with a Group Provider for deficiencies in the quality of care provider, Group shall give notice of the action to the appropriate licensing and disciplinary bodies.
Provider Terminations. If Blue Shield terminates a Group Provider without cause, Blue Shield must provide Group at least sixty (60) days notice. If Group terminates a Group Provider without cause, Group must provide Blue Shield at least sixty (60) days notice.
Provider Terminations. In the event a provider is terminated for cause by County, County shall provide the provider with written notice of the reason or reasons for the action and as required by applicable Federal and State laws. In the event County terminates a provider for deficiencies in the quality of care provided, County shall give notice of the action to the appropriate licensing and disciplinary agencies.
Provider Terminations. CN shall provide Payor notification of changes to Participating Provider roster twice per year at Payor’s discretion as to the date of delivery.
Provider Terminations. The CHIP-MCO must comply with the Department’s requirements for provider terminations as outlined in Exhibit B, CHIP-MCO Requirements for Provider Terminations.
Provider Terminations. The PH-MCO must comply with the Department’s requirements for provider terminations as outlined in Exhibit C, PH-MCO Requirements for Provider Terminations.
