Enrollment Discrimination Clause Samples

Enrollment Discrimination. Per 42 CFR 438.3(d)(1)-(4), the Contractor must accept individuals eligible for enrollment in the order in which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll in Hoosier Care Connect. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability. Further, the Contractor will not use any policy or practice that has the effect of discriminating in any such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1.

Enrollment Discrimination. Per 42 CFR 438.3(d)(1)-(4), the Contractor shall accept individuals eligible for enrollment in the order in which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1.

Enrollment Discrimination. The Contractor shall accept individuals eligible for enrollment in the order in which they apply without restriction (unless authorized by CMS), up to the limits set under the Contract. The Contractor shall not discriminate against individuals eligible to enroll on the basis of health status or need for health care services. The Contractor shall not discriminate against individuals eligible to enroll or on the basis of race, color, religion, national origin, sex, sexual orientation, gender, gender identity or disability, limited English proficiency, marital status, political affiliation, or level of income and shall not use any policy or practice that has the effect of discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender, gender identity or disability, limited English proficiency, marital status, political affiliation, or level of income. The Contractor shall not discriminate against individuals eligible to enroll because of an adverse change in the Member’s health status, or because of the Member’s utilization of medical services, diminished mental capacity, or uncooperative or disruptive behavior resulting from Member’s special needs (except when Member’s continued Enrollment in the Contractor seriously impairs the Contractor’s ability to furnish services to either this particular Member or other Members). The Division may impose liquidated damages in accordance with Section 15, Non- Compliance and Termination, of this Contract if the Contractor is in violation of this section.

Enrollment Discrimination. ‌ Contractor shall not discriminate against individuals eligible to enroll on the basis of health status or need for health care services or on the basis of race, color, age, religion, sex, national origin, limited English proficiency, marital status, political affiliation, or level of income and shall not use any policy or practice that has the effect of discrimination on the basis of race, color, national origin, limited English proficiency, marital status, political affiliation, or level of income. Contractor shall not disenroll a Member because of an adverse change in the Member’s health status, or because of the Member’s utilization of medical services, diminished mental capacity, or uncooperative or disruptive behavior resulting from Member’s special needs (except when Member’s continued Enrollment in Contractor seriously impairs Contractor’s ability to furnish services to either this particular Member or other Members). DOM may impose penalties in accordance with Section 15, Non-Compliance and Termination, of this Contract if Contractor is in violation of this section.

Enrollment Discrimination. ‌ The Contractor must accept individuals eligible for enrollment in the order in which they apply without restriction (unless authorized by CMS), up to the limits set under the Contract. Contractor must not discriminate against individuals eligible to enroll on the basis of health status or need for health care services. The Contractor must not discriminate against individuals eligible to enroll on the basis of race, color, religion, sex, sexual orientation, gender identity, disability, national origin, limited English proficiency, marital status, political affiliation, or level of income, and must not use any policy or practice that has the effect of discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, disability, limited English proficiency, marital status, political affiliation, or level of income. The Contractor must not disenroll a Member because of an adverse change in the Member’s health status, or because of the Member’s utilization of medical services, diminished mental capacity, or uncooperative or disruptive behavior resulting from Member’s special needs (except when Member’s continued Enrollment in the Contractor seriously impairs the Contractor’s ability to furnish services to either this particular Member or other Members). 3.3 Disenrollment‌ 3.3.1 Disenrollment from MississippiCAN‌ A Member must be disenrolled from the Contractor if the Member: 1. No longer resides in the State of Mississippi; 2. Is deceased; 3. No longer qualifies for medical assistance under one of the Medicaid eligibility categories in the eligible population; 4. Becomes a nursing home resident. For the purposes of determining eligibility for MississippiCAN, PRTFs shall not be considered a long-term care facility; 5. ▇▇▇▇▇▇▇ enrolled in a waiver program; 6. Becomes eligible for Medicare coverage; or 7. Is diagnosed with hemophilia and receives clotting factor products and other treatments.

Enrollment Discrimination. ‌ The Contractor must accept individuals eligible for enrollment in the order in which they apply without restriction (unless authorized by CMS), up to the limits set under the Contract. Contractor must not discriminate against individuals eligible to enroll on the basis of health status or need for health care services. The Contractor must not discriminate against individuals eligible to enroll on the basis of race, color, religion, sex, sexual orientation, gender identity, disability, national origin, limited English proficiency, marital status, political affiliation, or level of income, and must not use any policy or practice that has the effect of discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, disability, limited English proficiency, marital status, political affiliation, or level of income. The Contractor must not disenroll a Member because of an adverse change in the Member’s health status, or because of the Member’s utilization of medical services, diminished mental capacity, or uncooperative or disruptive behavior resulting from Member’s special needs (except when Member’s continued Enrollment in the Contractor seriously impairs the Contractor’s ability to furnish services to either this particular Member or other Members).

Enrollment Discrimination. ‌ Contractor shall not discriminate against individuals eligible to enroll on the basis of health status or need for health care services or on the basis of race, color, age, religion, sex, national origin, limited English proficiency, marital status, political affiliation, or level of income and shall not use any policy or practice that has the effect of discrimination on the basis of race, color, national origin, limited English proficiency, marital status, political affiliation, or level of income. The Contractor shall not Disenroll a Member because of an adverse change in the Member’s health status, or because of the Member’s utilization of medical services, diminished mental capacity, or uncooperative or disruptive behavior resulting from Member’s special needs (except when Member’s continued Enrollment in the Contractor seriously impairs the Contractor’s ability to furnish services to either this particular Member or other Members). The Division may impose liquidated damages in accordance with Section 15, Default and Termination, of this Contract if the Contractor is in violation of this section.