Provider Discrimination Sample Clauses

Provider Discrimination. Contractor may not discriminate with respect to the participation, reimbursement, or indemnification of any provider who is acting within the scope of his or her license or certification under applicable State law, solely on the basis of that license or certification.
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Provider Discrimination. Neither Health Plan nor Subcontractor shall discriminate with respect to participation, reimbursement, or indemnification of a provider who is acting within the scope of the provider’s license or certification under applicable State law, solely on the basis of such license or certification. This provision shall not be construed as prohibiting Health Plan and Subcontractor from limiting a provider’s participation to the extent necessary to meet the needs of Covered Persons. This provision also is not intended and shall not interfere with measures established by Health Plan that are designed to maintain quality of care practice standards and control costs consistent with Health Plan’s responsibilities under the applicable State Contract.
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Provider Discrimination. Neither Health Plan nor Subcontractor shall discriminate with respect to participation, reimbursement, or indemnification of a provider who is acting within the scope of the provider’s license or certification under applicable State law, solely on the basis of such license or certification. This provision shall not be construed as prohibiting Health Plan and Subcontractor from limiting a provider’s participation to the extent necessary to meet the needs of Covered Persons. This provision also is not intended and shall not interfere with measures established by Health Plan that are designed to maintain quality of care practice standards and control costs consistent with Health Plan’s responsibilities under the applicable State Contract. UHC/PRO.ST.PROG..XXXXXX.00.00.XX UnitedHealthcare Confidential and Proprietary 5.3 Provider / Covered Person Communications. Neither Health Plan nor Subcontractor shall prohibit or otherwise restrict Provider, when acting within the lawful scope of Provider’s licensure and practice, from advising or advocating on behalf of a Covered Person who is Provider’s patient for the following:
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Provider Discrimination. ‌ Neither Contractor, Subcontractor, nor representatives of Contractor shall provide false or misleading information to providers in an attempt to recruit providers for Contractor’s network. The Contractor shall not discriminate against providers with respect to participation, reimbursement, or indemnification for any provider acting within the scope of that provider’s license or certification under applicable State law or regulation solely on the basis of the provider’s license or certification. Contractor shall not discriminate for the participation, reimbursement, or indemnification of any provider who is acting within the scope of his or her license or certification under applicable State law, solely based on the license or certification. Contractor shall not discriminate against particular providers that serve high-risk populations or specialize in conditions that require costly treatment. If Contractor declines to include individual or groups of providers in its network, it must provide the affected providers written notice of the reason for its decision. Denials of provider enrollment due to excess network capacity must receive DOM approval prior to provider notification. Nothing in this provision, however, shall preclude Contractor from using a fee schedule for different specialties or for different practitioners in the same specialty, or preclude Contractor from establishing measures that are designed to maintain quality of services and control costs and are consistent with its responsibilities to Members. Contractor shall not employ or contract with providers excluded from participation in Federal health care programs under either Section 1128 or Section 1128A of the Social Security Act. Contractor is prohibited from employing or contracting a provider that has been excluded by DOM, other state Medicaid agencies, or other state CHIP.
Sample 1
Provider Discrimination. The Contractor may not discriminate for the participation, reimbursement, or indemnification of any provider who is acting within the scope of his or her license or certification under applicable State law, solely on the basis of that license or certification. Declining providers. If Contractor declines to include individual or groups of providers in its network, it must give the affected providers written notice of the reason for its decision. 42CFR 438.12 (a)of this section may not be construed to: • Require the MAO to contract with providers beyond the number necessary to meet the needs of its enrollee. • Preclude the MAO from using different reimbursement amounts for different specialties or for different practitioners in the same specialty; or • Preclude the MAO from establishing measures that are designed to maintain quality of services and control costs and is consistent with its responsibilities to enrollee.
Sample 1

Related to Provider Discrimination

  • D3 Discrimination D3.1 The Contractor shall not unlawfully discriminate either directly or indirectly on such grounds as race, colour, ethnic or national origin, disability, sex or sexual orientation, religion or belief, or age and without prejudice to the generality of the foregoing the Contractor shall not unlawfully discriminate within the meaning and scope of the Sex Discrimination Xxx 0000, the Race Relations Xxx 0000, the Equal Pay Xxx 0000, the Disability Discrimination Xxx 0000, the Employment Equality (Sexual Orientation) Regulations 2003, the Employment Equality (Religion or Belief) Regulations 2003, the Employment Equality (Age) Regulations 2006, the Equality Xxx 0000, all as amended or replaced by the Equality Xxx 0000 (when in force) and the Human Rights Xxx 0000 or other relevant or equivalent legislation, or any statutory modification or re- enactment thereof.

  • ANTI-DISCRIMINATION i) It is the intention of the parties to seek to achieve the object in section 3 (f) of the Industrial Relations Xxx 0000 to prevent and eliminate discrimination in the workplace. This includes discrimination on the grounds of race, sex, material status, disability, homosexuality, transgender identity and age or responsibilities as a carer.

  • Harassment & Discrimination The local parties will determine the appropriate means of promoting an effective and meaningful way of addressing discrimination and harassment issues, which may include, but is not limited to the following: • Reviewing the hospital’s harassment policy and making joint recommendations to the Chief Nursing Officer; • Promoting a harassment free workplace where there is ‘zero tolerance’; • Ensuring that all employees are familiar with the employer’s harassment policy by identifying educational opportunities, including the orientation period for new employees; • Identifying supports and solutions to assist employees to deal with harassment and discrimination issues (i.e. Employee assistance Programs, staff supports); • Development of processes to address the accommodations/ modified work needs for nurses; • Development of assertiveness training programs.

  • DISCRIMINATION / HARASSMENT 22.01 The parties agree to comply with their obligations under the Ontario Human Rights Code.

  • NON-DISCRIMINATION/HARASSMENT 3.01 Both the Company and the Union are committed to providing a workplace free of discrimination and harassment. Employees must not engage in discrimination or harassment because of prohibited ground contrary to the Ontario Human Rights Code (the “Code”). Prohibited grounds are race, ancestry, place of origin, colour, ethnic origin, citizenship, creed, sex, sexual orientation, age, record of offenses, marital status, family status or handicap, as defined in the Code. This provision shall be interpreted in accordance with and subject to the provisions of the Code. Employees shall not be discriminated against on the basis of union affiliation.

  • NO DISCRIMINATION/HARASSMENT 6.01 The Company and the Union agree that there shall be no discrimination, interference, restriction or coercion exercised or practised with respect to any employee by reason of age, marital status, sex, race, creed, colour, national origin, political or religious affiliation, handicap, sexual orientation nor by reason of Union membership or position in the Union. Prohibited grounds shall be interpreted in accordance with and subject to the provisions of the Human Rights Code.

  • Freedom from Discrimination 9.01 The Union, the Employer, and the employees agree that there shall be no discrimination, interference, restriction, or coercion exercised or practiced with respect to any employee by reason of race, ethnic origin, colour, ancestry, citizenship, place of origin, creed, religion, age, sex, sexual orientation, marital status, family status, pregnancy, disability, lawful source of income, conviction for an offence for which a pardon has been granted, or union membership or activity or for exercising their rights under the Agreement.

  • NON-DISCRIMINATION 1. Nationals of a Contracting State shall not be subjected in the other Contracting State to any taxation or any requirement connected therewith, which is other or more burdensome than the taxation and connected requirements to which nationals of that other State in the same circumstances, in particular with respect to residence, are or may be subjected. This provision shall, notwithstanding the provisions of Article 1, also apply to persons who are not residents of one or both of the Contracting States.

  • Discrimination and Harassment 3.01 The Company shall not discriminate against an employee because of membership in the Union or because of activities authorized herein on behalf of the Union.

  • ANTI DISCRIMINATION AND ANTI HARASSMENT Contractor and/or any subcontractor shall not unlawfully discriminate against or harass any individual including, but not limited to, any employee or volunteer of the County of Marin based on race, color, religion, nationality, sex, sexual orientation, age or condition of disability. Contractor and/or any subcontractor understands and agrees that Contractor and/or any subcontractor is bound by and will comply with the anti discrimination and anti harassment mandates of all Federal, State and local statutes, regulations and ordinances including, but not limited to, County of Marin Personnel Management Regulation (PMR) 21.

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