Common use of RECOMMENDED PLAN OF TREATMENT Clause in Contracts

RECOMMENDED PLAN OF TREATMENT. Members agree, when joining the HMO, to receive care according to the recommendations of the Member’s Primary Care Physician. Members have the right to give their informed consent before the start of any procedure or treatment. Members also have the right to refuse any drugs, treatment or other procedure offered to them by the HMO Providers, and to be informed by their Physician of the medical consequences of their refusal of any drugs, treatment, or procedure. The HMO and their Primary Care Physician will make every effort to arrange a professionally acceptable alternative treatment. The HMO will not be responsible for the costs of any alternative treatment that is not a Covered Service or determined to be not Medically Necessary for that condition. Members may use the Grievance Procedure to have any denial of benefits reviewed, if they so desire. Special Circumstances, as recognized in the community and by the HMO and appropriate regulatory authority, are extraordinary circumstances not within the control of the HMO, including but not limited to:  a major disaster;  an epidemic;  a pandemic;  the complete or partial destruction of facilities;  riot;  civil insurrection; or  similar causes.

RECOMMENDED PLAN OF TREATMENT. Members agree, when joining the HMO, to receive care according to the recommendations of the Member’s Primary Care Physician. Members have the right to give their informed consent before the start of any procedure or treatment. Members also have the right to refuse any drugs, treatment or other procedure offered to them by the HMO Providers, and to be informed by their Physician of the medical consequences of their refusal of any drugs, treatment, or procedure. The HMO and their Primary Care Physician will make every effort to arrange a professionally acceptable alternative treatment. The HMO will not be responsible for the costs of any alternative treatment that is not a Covered Service or determined to be not Medically Necessary for that condition. Members may use the Grievance Appeal Procedure to have any denial of benefits reviewed, if they so desire. Special Circumstancescircumstances, as recognized in the community and by the HMO and appropriate regulatory authority, are extraordinary circumstances not within the control of the HMO, including but not limited to:  a major disaster;  an epidemic;  a pandemic; pandemic;‌‌  the complete or partial destruction of facilities;  riot;  civil insurrection; or  similar causes.