PROVISION OF COVERED SERVICES THROUGH THE ISOC Sample Clauses

PROVISION OF COVERED SERVICES THROUGH THE ISOC. (R). ------------------------------------------------- (A) Subject to the Transition Plan described in Section 3A.1, PHE, through the PHE Providers, shall have the exclusive right and obligation to arrange for the delivery of Covered Services to Covered Persons. PHE agrees that it will (i) arrange for the provision of Covered Services (x) at all Centers pursuant to its contractual relationship with Medical Group, as set forth in the Medical Services Agreement, and (y) through other PHE Providers pursuant to the Provider Agreements entered into by PHE with each such PHE Provider; and (ii) manage the rendering of all Covered Services to Covered Persons, it being explicitly understood that the Plan's obligation with respect to Covered Services rendered to Network Covered Persons is to be financially responsible for the cost thereof only during the Financial Risk Period. (B) PHE shall be responsible for confirming whether Covered Persons are eligible for Covered Services by using the eligibility information and system provided by the Plan in accordance with Section 4.3. (C) PHE shall cause PHE Providers to provide health care services of a quality that, at a minimum, is consistent with accepted medical and surgical practices in the State. (D) PHE shall cause PHE Providers to provide health care services that are generally recognized as being within their medical and specialty training. (E) PHE may on its own behalf or on behalf of Medical Group transfer the care of a Covered Person from one Primary Care Physician to another Primary Care Physician upon demonstrating to the satisfaction of Plan's Medical Director that the original Primary Care Physician is unable to maintain a satisfactory Physician-patient relationship with the Covered Person. If the Plan's Medical Director grants such request, the transfer shall be accomplished at an appropriate time and in such a manner so as to not constitute the abandonment of the Covered Person. (F) PHE shall cause Medical Group and PHE Providers to provide sufficient support staff to enable Covered Persons to receive the health care services that are generally recognized and accepted as being within the Physician's medical practice and specialty. All such support staff must be duly licensed as may be required by State law, rules and regulations. (G) If the panel of a Primary Care Physician at a Health Care Center exceeds the access standards for the ratio of Covered Persons and other patients per Primary Care Physician, a...