Common use of Termination of Physician/Patient Relationship Clause in Contracts

Termination of Physician/Patient Relationship. (a) Group or a Group Provider may terminate the professional relationship with a Member only with Blue Shield’s consent and in accordance with the procedures set forth in the Provider Manual. In the event a Group Provider terminates his/her relationship with a Member, Group shall assist the Member in selecting another Group Provider for the provision of Capitated Professional Services. (b) In no event may either Group or a Group Provider terminate the professional relationship with a Member because of such Member’s medical condition, or the amount, variety, or cost of Covered Services that are required by the Member. (c) Group acknowledges that a Member may request transfer between PCPs, and between Blue Shield medical groups, in accordance with the Member’s applicable Health Services Contract and Evidence of Coverage. As appropriate, Group agrees to accept the transfer of a Blue Shield member to Group at the request of Blue Shield. (d) Notwithstanding the foregoing, when the consent of CMS or any other governmental agency to the termination of a physician-patient relationship is required pursuant to the rules and regulations governing the Medicare Program or any other governmental program, neither Group nor a Group Provider may terminate the physician-patient relationship with a Blue Shield 65 Plus Member or such other Member without first obtaining the consent of Blue Shield, CMS, or as applicable, the other governmental agency.