ENROLLEE-PROVIDER COMMUNICATIONS. Subject to this Section and in accordance with the Managed Care Reform and Patient Rights Act, Contractor shall not prohibit or otherwise restrict a Provider from advising an Enrollee about the health status of the Enrollee or medical care or treatment for the Enrollee’s condition or disease regardless of whether benefits for such care or treatment are provided under this Contract, if the Provider is acting within the lawful scope of practice, and Contractor shall not retaliate against a Provider for so advising Enrollee.
ENROLLEE-PROVIDER COMMUNICATIONS. 1. The Contractor shall not prohibit or restrict the provider/subcontractor from engaging in medical communications with the provider’s/subcontractor’s patient, either explicit or implied, nor shall any provider manual, newsletters, directives, letters, verbal instructions, or any other form of communication prohibit medical communication between the provider/subcontractor and the provider’s/subcontractor’s patient. Providers/subcontractors shall be free to communicate freely with their patients about the health status of their patients, medical care or treatment options regardless of whether benefits for that care or treatment are provided under the provider contract/subcontract, if the professional is acting within the lawful scope of practice. Providers/subcontractors shall be free to practice their respective professions in providing the most appropriate treatment required by their patients and shall provide informed consent within the guidelines of the law including possible positive and negative outcomes of the various treatment modalities.
ENROLLEE-PROVIDER COMMUNICATIONS. Subject to this Article V, Section 5.1(g), and in accordance with the Managed Care Reform and Patient Rights Act, the Contractor shall not prohibit or otherwise restrict a Provider from advising an Enrollee about the health status of the Enrollee or medical care or treatment for the Enrollee's condition or disease regardless of whether benefits for such care or treatment are provided under this Contract, if the Provider is acting within the lawful scope of practice, and shall not retaliate against a Provider for so advising an Enrollee.
ENROLLEE-PROVIDER COMMUNICATIONS. 1. The contractor shall not prohibit or restrict the provider/subcontractor from engaging in medical communications with the provider’s/subcontractor’s patient, either explicit or implied, nor shall any provider manual, newsletters, directives, letters, verbal instructions, or any other form of communication prohibit medical communication between the provider/subcontractor and the provider’s/subcontractor’s patient. Providers/subcontractors shall be free to communicate freely with their patients about the health status of their patients, medical care or treatment options regardless of whether benefits for that care or treatment are provided under the provider contract/subcontract, if the professional is acting within the lawful scope of practice. Providers/subcontractors shall be free to practice their respective professions in providing the most appropriate treatment required by their patients and shall provide informed consent within the guidelines of the law including possible positive and negative outcomes of the various treatment modalities. Company, in making utilization review determinations agrees to define "medical necessity" in confirmance with New Jersey Medicaid and Department of Health licensing standards defining eligibility for admisison to or coverage of the applicable level of care.
ENROLLEE-PROVIDER COMMUNICATIONS. 1. The Contractor shall not prohibit or restrict the Subcontractor from engaging in medical communications with the Subcontractor’s patient, either explicit or implied, nor shall any manual, newsletters, directives, letters, verbal instructions, or any other form of communication prohibit medical communication between the Subcontractor and the Subcontractor’s patient. Subcontractor shall be free to communicate freely with their patients about the health status of their patients, medical care or treatment options regardless of whether benefits for that care or treatment are provided under the Subcontractor Contract/Subcontract, if the professional is acting within the lawful scope of practice. Subcontractor shall be free to practice their respective professions in providing the most appropriate treatment required by their patients and shall provide informed consent within the guidelines of the law including possible positive and negative outcomes of the various treatment modalities.
