Unacceptable Reasons for Disenrollment Requests by Contractor. 4.2.4.1 The Contractor shall not request Disenrollment of a Member for discriminating reasons, including: · Adverse changes in a Member’s health status; · Missed appointments; · Utilization of medical services; · Diminished mental capacity; · Pre-existing medical condition; · Uncooperative or disruptive behavior resulting from his or her special needs; or · Lack of compliance with the treating physician’s plan of care.
Appears in 2 contracts
Samples: Business Associate Agreement (Centene Corp), Business Associate Agreement (Wellcare Health Plans, Inc.)
Unacceptable Reasons for Disenrollment Requests by Contractor. 4.2.4.1 The Contractor shall not request Disenrollment of a Member or P4HB Participant for discriminating reasons, including: · • Adverse changes in a Member’s or P4HB Participants health status; · • Missed appointments; · • Utilization of medical services; · • Diminished mental capacity; · • Pre-existing medical condition; · • Uncooperative or disruptive behavior resulting from his or her special needs; or · • Lack of compliance with the treating physician’s plan of care.
Appears in 2 contracts
Samples: Business Associate Agreement, Business Associate Agreement (Wellcare Health Plans, Inc.)
Unacceptable Reasons for Disenrollment Requests by Contractor. 4.2.4.1 The Contractor shall not request Disenrollment of a Member or P4HB Participant for discriminating reasons, including: · Adverse changes in a Member’s or P4HB Participants health status; · Missed appointments; · Utilization of medical services; · Diminished mental capacity; · Pre-existing medical condition; · Uncooperative or disruptive behavior resulting from his or her special needs; or · Lack of compliance with the treating physician’s plan of care.
Appears in 2 contracts
Samples: Business Associate Agreement (Wellcare Health Plans, Inc.), Business Associate Agreement (Centene Corp)
