Continuity of Treatment Sample Clauses

Continuity of Treatment. Provider shall cooperate with Health Plan and Subcontractor and provide Covered Persons with continuity of treatment, including coordination of care to the extent required under law and according to the terms of the Agreement, in the event Provider’s participation with Subcontractor terminates during the course of a Covered Person’s treatment by Provider, except in the case of adverse reasons on the part of Provider.
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Continuity of Treatment. Texas HealthSpring will notify the Member within thirty (30) days of any impending termination of a Primary Care Physician from Texas HealthSpring's network who is currently treating the Member. Texas HealthSpring will notify the Member within thirty (30) days of any impending termination of a specialist provider from Texas HealthSpring's network, who is currently treating the Member or has treated the Member within the past six (6) months. If the RPO Provider's contract is terminated for any reason other than medical competence or professional behavior, RPO and RPO Provider shall continue the course of treatment of a Member that began prior to such termination or expiration until the Member can, without medically injurious consequences, be transferred to the care of another Participating Provider. RPO Provider shall be compensated for the aforementioned continued provision of ongoing treatment to a Member who is then receiving Medically Necessary treatment in accordance with the dictates of medical prudence for a special circumstance, such as treatment for a Member who has a disability, acute condition, or life-threatening illness, or is past the 24th week of pregnancy in exchange for continuity of ongoing treatment of a Member then receiving medically necessary treatment in accordance with the dictates of medical prudence. "Special circumstances" means a condition such that the treating physician reasonably believes that discontinuing care by the treating physician or provider could cause harm to the Member. The special circumstance shall be identified by the treating physician, who must request that the Member be permitted to continue treatment under the physician's care. In such cases, RPO will continue to reimburse the physician at no less than at the contract rate for the continued provision of ongoing treatment to a Member and neither RPO nor RPO Provider may seek payment from the Member of any amount for which the Member would not be responsible if the physician were still in Texas HealthSpring's Participating Provider network. RPO Provider shall abide by the determination of the applicable Payor's Member Grievance Procedure, including but not limited to grievance procedures for resolving disputes regarding the necessity for continued treatment, as described in the Texas HealthSpring Member Grievance Procedures.
Sample 1
Continuity of Treatment. If the Provider leaves the Network, upon the Provider’s request, the insurance carrier or Network is obligated to continue to reimburse the Provider for a period not to exceed ninety (90) days at the contracted rate for care of Covered Individual with a life-threatening condition or an acute condition for which disruption of care would harm the employee; and Disputes concerning continuity of care shall be resolved through the complaint resolution process under §§1305.401-1305.405, TIC, and Subchapter G, Ch. 10, TAC.
Sample 1
Continuity of Treatment. 3.1.1 Unless this Agreement terminates for reasons of clinical competence or professional behavior, termination will not release the MCO of its obligation to compensate Provider for the continued care and treatment of any Member who is under Special Circumstances (as defined below).
Sample 1

Related to Continuity of Treatment

  • Equality of Treatment Unless otherwise provided in this Agreement, the persons specified in Article 3, who ordinarily reside in the territory of a Contracting State, shall receive equal treatment with nationals of that Contracting State in the application of the legislation of that Contracting State.

  • Continuity of Supply A Service Order will continue until terminated in accordance with this Agreement. A change to a Service Order will not initiate a new Service Order, or cause the existing Service Order to terminate, unless expressly agreed in writing. In particular, a change to a Service Order that is implemented by the LFC electronically and does not require a physical visit to a site or Interconnection Point will not cause the Service Order to terminate.

  • Continuity of Services A. The Contractor recognizes that the service(s) to be performed under this Contract are vital to the State and must be continued without interruption and that, upon Contract expiration, a successor, either the State or another contractor, may continue them. The Contractor agrees to:

  • Fair Treatment The College and the Union agree that there shall be no discrimination, restriction, or coercion exercised or practised with respect to any employee for reason of membership or activity in the Union.

  • Continuity of Care OMPP is committed to providing continuity of care for members as they transition between various IHCP programs and the Contractor’s enrollment. The Contractor shall have mechanisms in place to ensure the continuity of care and coordination of medically necessary health care services for its Hoosier Healthwise members. The State emphasizes several critically important areas where the Contractor shall address continuity of care. Critical continuity of care areas include, but are not limited to:  Transitions for members receiving HIV, Hepatitis C and/or behavioral health services, especially for those members who have received prior authorization from their previous MCE or through fee-for-service;  Transitions for members who are pregnant;  A member’s transition into the Hoosier Healthwise program from traditional fee- for-service or HIP;  A member’s transition between MCEs, particularly during an inpatient stay;  A member’s transition between IHCP programs, Members exiting the Hoosier Healthwise program to receive excluded services;  A member’s exiting the Hoosier Healthwise program to receive excluded services;  A member’s transition to a new PMP;  A member’s transition to private insurance or Marketplace coverage; and  A member’s transition to no coverage. In situations such as a member or PMP disenrollment, the Contractor shall facilitate care coordination with other MCEs or other PMPs. When receiving members from another MCE or fee-for-service, the Contractor shall honor the previous care authorizations for a minimum of thirty (30) calendar days from the member’s date of enrollment with the Contractor. Contractor shall establish policies and procedures for identifying outstanding prior authorization decisions at the time of the member’s enrollment in their plan. For purposes of clarification, the date of member enrollment for purposes of the prior authorization time frames set forth in this section begin on the date the Contractor receives the member’s fully eligible file from the State. Additionally, when a member transitions to another source of coverage, the Contractor shall be responsible for providing the receiving entity with information on any current service authorizations, utilization data and other applicable clinical information such as disease management, case management or care management notes. This process shall be overseen by the Transition Coordination Manager. The Contractor will be responsible for care coordination after the member has disenrolled from the Contractor whenever the member disenrollment occurs during an inpatient stay. In these cases, the Contractor will remain financially responsible for the hospital DRG payment and any outlier payments (without a capitation payment) until the member is discharged from the hospital or the member’s eligibility in Medicaid terminates. The Contractor shall coordinate discharge plans with the member’s new MCE. See Section 3.7.5 for additional requirements regarding continuity of care for behavioral health services. The Hoosier Healthwise MCE Policies and Procedures Manual describes the Contractor’s continuity and coordination of care responsibilities in more detail.

  • Protection of Private Information If this Agreement requires City to disclose “Private Information” to Contractor within the meaning of San Francisco Administrative Code Chapter 12M, Contractor and subcontractor shall use such information only in accordance with the restrictions stated in Chapter 12M and in this Agreement and only as necessary in performing the Services. Contractor is subject to the enforcement and penalty provisions in Chapter 12M.

  • Joint Funded Project with the Ohio Department of Transportation In the event that the Recipient does not have contracting authority over project engineering, construction, or right-of- way, the Recipient and the OPWC hereby assign certain responsibilities to the Ohio Department of Transportation, an authorized representative of the State of Ohio. Notwithstanding Sections IV, VI.A., VI.B., VI.C., and VII of the Project Agreement, Recipient hereby acknowledges that upon notification by the Ohio Department of Transportation, all payments for eligible project costs will be disbursed by the Grantor directly to the Ohio Department of Transportation. A Memorandum of Funds issued by the Ohio Department of Transportation shall be used to certify the estimated project costs. Upon receipt of a Memorandum of Funds from the Ohio Department of Transportation, the OPWC shall transfer funds directly to the Ohio Department of Transportation via an Intra-State Transfer Voucher. The amount or amounts transferred shall be determined by applying the Participation Percentages defined in Appendix D to those eligible project costs within the Memorandum of Funds. In the event that the Project Scope is for right-of-way only, notwithstanding Appendix D, the OPWC shall pay for 100% of the right-of-way costs not to exceed the total financial assistance provided in Appendix C. APPENDIX D LOCAL SUBDIVISION CONTRIBUTION, PROJECT FINANCING AND EXPENSES SCHEME AND DISBURSEMENT RATIO

  • Continuity of Service Except where there exists an emergency situation necessitating a more expeditious procedure, the Licensee shall use reasonable efforts to interrupt service for the purpose of Cable Communications System construction, routine repairing or testing the Cable System only during periods of minimum use. When necessary service interruptions can be anticipated, the Licensee shall notify Subscribers in advance via message on the community channel community bulletin board.

  • Xxx Treatment We have not promised you any particular tax outcome from buying or holding the Note.

  • Substance Abuse Treatment Information Substance abuse treatment information shall be maintained in compliance with 42 C.F.R. Part 2 if the Party or subcontractor(s) are Part 2 covered programs, or if substance abuse treatment information is received from a Part 2 covered program by the Party or subcontractor(s).

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