Unacceptable Practices. a) Unacceptable practices for which the Contractor may be sanctioned include, but are not limited to: i) Failing to provide medically necessary services that the Contractor is required to provide under its contract with the State. ii) Imposing premiums or charges on Enrollees that are in excess of the premiums or charges permitted under the Medicaid Advantage Program;
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Sources: Medicaid Advantage Contract Attestation (Wellcare Health Plans, Inc.)
Unacceptable Practices. a) Unacceptable practices for which the Contractor may be sanctioned include, include but are not limited to:
i) Failing to provide medically necessary services that the Contractor is required to provide under its contract with the State. .
ii) Imposing premiums or charges on Enrollees that are in excess of the premiums or charges permitted under the Medicaid Advantage MMC Program or FHPlus Program;.
iii) Discriminating among Enrollees on the basis of their health status or need for health care services.
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