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.
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:
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 Act. Contractor is prohibited from employing or contracting a provider that has been excluded by DOM, other state Medicaid agencies, or other state CHIP.
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.

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 Act 1996 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.

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

  • 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 The Employer and the Union agree that there shall be no discrimination, interference, restriction, or coercion exercised or practiced with respect to any employee by reason of age, sex, race, creed, colour, nationality, religion, ancestry, ethnic origin, place of origin, marital status, gender identity, sexual orientation, family status, family affiliation, political belief, political association, social condition, disability, a conviction for which a pardon has been granted, nor by reason of union membership or activity.

  • 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 7.13 All members of the Appointments Committee shall be given access to information about the content and application of relevant federal and provincial legislation, ad about University policies, relating to employment equity and federal immigration requirements. In accord with the provisions of the Article Employment Equity, Members shall familiarize themselves with such information as a condition of serving on the Appointments Committee. Furthermore, the Employer shall ensure that the Committee is aware of the relevant legislation and University policies, and the Chief Librarian or Xxxx and the Members participating in the work of the Committee shall share responsibility for ensuring that the relevant legislation and University policies are followed throughout the deliberations of the Committee. The Committee may call upon the Human Rights Office for assistance.

  • 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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