Refusal to Accept Treatment. Plan Physicians use their best efforts to recommend Medically Necessary and appropriate services in a manner compatible with a Member's wishes, insofar as this can be done consistently with the Plan Physician's judgment regarding proper medical practice in accordance with prevailing medical standards. Certain Members may, for personal reasons, refuse to accept procedures or treatments recommended by Plan Physicians. Plan Physicians may regard such refusal as incompatible with the continuance of a satisfactory physician-patient relationship and as obstructing the providing of proper medical care. If a Member refuses to follow a recommended treatment(s) or procedure(s), and the Plan Physician believes that no professionally acceptable alternative exists, the Member will be so advised. The Member may then contact Plan to obtain assistance in either: (a) choosing a new Primary Care Physician; or (b) seeking a referral to a specialty Plan Physician, as appropriate. If, after consulting with such other Plan Physician, the Member still refuses to follow a recommended treatment(s) or procedure(s), then the Member may contact Plan for a determination as to whether any Medically Necessary, medically superior (as determined by Plan), covered alternative procedure(s) or treatment(s) is available to the Member. If Plan advises the Member to the contrary, or if the Member refuses to undergo any such other Medically Necessary, medically superior covered alternative procedure(s) or treatment(s), the Member may appeal Plan's decision through Plan's grievance procedure.
Refusal to Accept Treatment. Certain Members may, for personal reasons, refuse to accept procedures or treatment recommended by Physicians. Physicians may regard such refusal as incompatible with the continuance of a satisfactory physician-patient relationship and as obstructing the provision of proper medical care. Physicians use their best efforts to render all necessary and appropriate professional services in a manner compatible with a Member's wishes, insofar as this can be done consistently with the Physician's judgment regarding proper medical practice. If a Member refuses to follow a recommended treatment or procedure for a condition, and the Physician believes that no professionally acceptable alternative exists, the Member will be so advised. If the Member still refuses to follow the recommended treatment or procedure, then neither Medical Group, Hospitals, Health Plan nor any Physician has any further responsibility to provide any alternative treatment or procedure sought by Member for that condition.
Refusal to Accept Treatment. A Member may refuse, for personal or religious reasons, to accept procedures or treatment recommended as necessary by Plan Physicians. Although such refusal is the Member’s right, in some situations it may be regarded as a barrier to the continuance of the physician-patient relationship or to the rendering of the appropriate standard of care. When a Member refuses a recommended, necessary treatment or procedure and the Plan Physician believes that no professionally acceptable alternative exists, the Member shall be so advised. If the Member still refuses the treatment or procedures which the Plan Physician does not believe medically or professionally appropriate, the Physician and Health Plan are relieved of further professional and financial responsibility to provide further care for the condition under treatment.
