Subsequent Change in PCP Initiated by the CONTRACTOR. The CONTRACTOR may initiate a PCP change for a Member under the following circumstances: The Member and the CONTRACTOR agree that assignment to a different PCP in the CONTRACTOR’s provider network is in the Member’s best interest, based on the Member’s medical condition; A Member’s PCP ceases to be a Contract Provider; A Member’s behavior toward the PCP is such that it is not feasible to safely or prudently provide medical care and the PCP has made reasonable efforts to accommodate the Member; A Member has initiated legal actions against the PCP; or The PCP is suspended or terminated. The CONTRACTOR shall make a good faith effort to give written notice of termination of a Contract Provider, by the later of thirty (30) Calendar Days prior to the effective date of the termination or fifteen (15) Calendar Days after receipt or issuance of the termination notice, to each Member who received their Primary Care from, or was seen on a regular basis by, the terminated Provider. In such instances, the CONTRACTOR shall allow affected Members to select a PCP or shall make an assignment within fifteen (15) Calendar Days of the termination effective date.
Subsequent Change in PCP Initiated by the CONTRACTOR. The CONTRACTOR may initiate a PCP change for a Member under the following circumstances:
