Common use of Restrictions on Disclosure Clause in Contracts

Restrictions on Disclosure. The Contractor shall not by contract or written policy or written procedure prohibit or restrict any health care provider from the following: a) disclosing to any subscriber, Enrollee, patient, designated representative or, where appropriate, prospective Enrollee any information that such provider deems appropriate regarding: i) a condition or a course of treatment with such subscriber, Enrollee, patient, designated representative or prospective Enrollee, including the availability of other therapies, consultations, or tests; or ii) The provisions, terms, or requirements of the Contractor's products as they relate to the Enrollee, where applicable. b) filing a complaint, making a report or comment to an appropriate governmental body regarding the policies or practices of the Contractor when they believe that the policies or practices negatively impact upon the quality of, or access to, patient care. c) advocating to the Contractor on behalf of the Enrollee for approval or coverage of a particular treatment or for the provision of health care services.

Appears in 4 contracts

Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)

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Restrictions on Disclosure. The Contractor shall not by contract or written policy or written procedure prohibit or restrict any health care provider from the following: a) disclosing to any subscriber, subscriber Enrollee, patient, designated representative or, where appropriate, prospective Enrollee any information that such provider deems appropriate regarding: i) a condition or a course of treatment with such subscriber, Enrollee, patient, designated representative or prospective Enrollee, including the availability of other therapies, consultations, or tests; or ii) The provisions, terms, terms or requirements of the Contractor's products as they relate to the Enrollee, where applicable. b) filing a complaint, making a report or comment to an appropriate governmental body regarding the policies or practices of the Contractor when they believe that the policies or practices negatively impact upon the quality of, or access to, patient care. c) advocating to the Contractor on behalf of the Enrollee for approval or coverage of a particular treatment or for the provision of health care services.

Appears in 2 contracts

Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)

Restrictions on Disclosure. The Contractor shall not by contract or written policy or written procedure prohibit or restrict any health care provider from the following: a) disclosing to any subscriber, Enrollee, patient, designated representative or, where appropriate, prospective Enrollee any information that such provider deems appropriate regarding: i) a condition or a course of treatment with such subscriber, Enrollee, patient, designated representative or prospective Enrollee, including the availability of other therapies, consultations, or tests; or ii) The provisions, terms, or requirements of the Contractor's products as they relate to the Enrollee, where applicable. a) Disclosing to any subscriber, Enrollee, patient, designated representative or, where appropriate, prospective Enrollee any information that such provider deems appropriate regarding: b) filing a complaint, making a report or comment to an appropriate governmental body regarding the policies or practices of the Contractor when they believe that the policies or practices POLICIES OR PRACTICES negatively impact upon the quality ofQUALITY OF, or access to, patient care. c) advocating to the Contractor on behalf of the Enrollee for approval or coverage of a particular treatment or for the provision of health care services.

Appears in 1 contract

Samples: Medicaid Managed Care Model Contract (Amerigroup Corp)

Restrictions on Disclosure. The Contractor shall not by contract or written policy or o r written procedure prohibit or restrict any health care provider from the following: a) disclosing to any subscriber, Enrollee, patient, designated representative or, where appropriate, prospective Enrollee any information that such provider deems appropriate regarding: : i) a condition or a course of treatment with such subscriber, Enrollee, patient, designated representative or prospective Enrollee, including the availability of other therapies, consultations, or tests; or or ii) The provisions, terms, or requirements of the Contractor's products as they relate to the Enrollee, where applicable. b) filing a complaint, making a report or comment to an appropriate governmental body regarding the policies or practices of the Contractor when they believe that the policies or practices negatively impact upon the quality of, or access to, patient care. c) advocating to the Contractor on behalf of the Enrollee for approval or coverage of a particular treatment or for the provision of health care services.

Appears in 1 contract

Samples: Contractor Agreement (Americhoice Corp)

Restrictions on Disclosure. The Contractor shall not by contract or written policy or written procedure prohibit or restrict any health care provider from the following: a) disclosing to any subscriber, Enrollee, patient, designated representative or, where appropriate, prospective Enrollee any information that such provider deems appropriate regarding: i) a condition or a course of treatment with such subscriber, Enrollee, patient, designated representative or prospective Enrollee, including the availability of other therapies, consultations, or tests; or ii) The provisions, terms, or requirements of the Contractor's products as they relate to the Enrollee, where applicable. b) filing a complaint, making a report or comment to an appropriate governmental body regarding the policies or practices of the Contractor when they believe that the policies or practices negatively impact upon the quality of, or access to, patient care. c) advocating to the Contractor on behalf of the Enrollee for approval or coverage of a particular treatment or for the provision of health care services.

Appears in 1 contract

Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)

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Restrictions on Disclosure. The Contractor shall not by contract or by written policy or written procedure prohibit or restrict any health care provider from the following: a) disclosing Disclosing to any subscriber, Enrollee, patient, designated representative or, where appropriate, prospective Enrollee any information that such provider deems appropriate regarding: i) a condition or a course of treatment with such subscriber, Enrollee, patient, patient designated representative or prospective Enrollee, including the availability of other therapies, consultations, or tests; or ii) The provisions, terms, or requirements of the Contractor's products as they relate to the Enrollee, where applicable. b) filing Filing a complaint, making a report or comment to an appropriate governmental body regarding the policies or practices of the Contractor when they believe that the policies or practices negatively impact upon the quality of, or access to, patient care. c) advocating Advocating to the Contractor on behalf of the Enrollee for approval or coverage of a particular treatment or for the provision of health care services.

Appears in 1 contract

Samples: Consultant Services Agreement (Wellcare Health Plans, Inc.)

Restrictions on Disclosure. The Contractor shall not by contract or written policy or written procedure prohibit or restrict any health care provider from the following: a) disclosing to any subscribersubscribe, Enrollee, patient, designated representative or, where appropriate, prospective Enrollee any information that such provider deems appropriate regarding: i) a condition or a course of treatment with such subscriber, Enrollee, patient, designated representative or prospective Enrollee, including the availability of other therapies, consultations, or tests; or ii) The provisions, terms, or requirements of the Contractor's products as they relate to the Enrollee, where applicable. b) filing a complaint, making a report or comment to an appropriate governmental body regarding the policies or practices of the Contractor when they believe that the policies or practices negatively impact upon the quality of, or access to, patient care. c) advocating to the Contractor on behalf of the Enrollee for approval or coverage of a particular treatment or for the provision of health care services.

Appears in 1 contract

Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)

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