Provider Termination. 1. The Health Plan shall comply with all state and federal laws regarding provider termination. 2. The Health Plan shall notify enrollees in accordance with the provisions of this Contract regarding provider termination. 3. In a case in which a patient's health is subject to imminent danger or a physician's ability to practice medicine is effectively impaired by an action by the Board of Medicine or other governmental agency, notice to both the provider and BMHC shall be immediate. The Health Plan shall submit a list of terminated providers to BMHC once a month, in accordance with requirements in Attachment II, Section XII, Reporting Requirements. 4. The Health Plan shall notify the provider, BMHC and enrollees in active care at least sixty (60) calendar days before the effective date of the suspension or termination of a provider from the network. If the termination was for "cause," the Health Plan shall provide to BMHC the reasons for termination.
Appears in 2 contracts
Sources: Standard Contract (Wellcare Health Plans, Inc.), Standard Contract (Wellcare Health Plans, Inc.)
Provider Termination. 1. The Health Plan shall comply with all state and federal laws regarding provider termination.
2. The Health Plan shall notify enrollees in accordance with the provisions of this Contract regarding provider termination.
3. In a case in which a patient's ’s health is subject to imminent danger or a physician's ’s ability to practice medicine is effectively impaired by an action by the Board of Medicine or other governmental agency, notice to both the provider and BMHC shall be immediate. The Health Plan shall submit a list of terminated providers to BMHC once a month, in accordance with requirements in Attachment II, Section XII, Reporting Requirements.
4. The Health Plan shall notify the provider, BMHC and enrollees in active care at least sixty (60) calendar days before the effective date of the suspension or termination of a provider from the network. If the termination was for "“cause," ” the Health Plan shall provide to BMHC the reasons for termination.
Appears in 1 contract
Sources: Standard Contract (Amerigroup Corp)