Assignment of Members Clause Samples
Assignment of Members. 2.1. Except as provided in Section 2.2, any Indian, as defined by 42 C.F.R. § 438.14(a), enrolled with AHCCCS to receive Medicaid-funded services through the Fee-For-Service American Indian Health Program may enroll with the Contractor to receive primary care case management services.
2.2. The following individuals are not eligible for enrollment in the Contractor’s AIMH:
2.2.1. Persons enrolled in another managed care program;
2.2.2. Persons enrolled in the Tribal ALTCS program;
2.2.3. Persons enrolled through hospital presumptive eligibility;
2.2.4. Persons enrolled in Fee-For-Service Temporary, Fee-For-Service Regular, or Federal Emergency Services Only;
2.2.5. Persons residing in Nursing Facilities or Intermediate Care Facilities for the Mentally Retarded (also known as Intermediate Care Facilities for the Intellectually Disabled); and
2.2.6. Persons enrolled in prior quarter coverage or any other retroactive eligibility category (during the period of retroactive eligibility).
2.3. A Member’s enrollment and disenrollment with the Contractor is completely voluntarily and at the will of the Member. At any time and without cause, a Member may opt into or out of the AIMH program, or move to another AIMH that is not operated by the Contractor by notifying AHCCCS or the Contractor. [42 C.F.R. § 438.3(d) (2) & (q) (5); 42 C.F.R. § 438.54(c); 42 C.F.R. 438.56(c) & (d)]
2.4. Upon enrollment in the Fee-For-Service American Indian Health Program, AHCCCS will provide the Member with the opportunity to enroll in an AIMH and will provide the information required by 42 C.F.R. § 438.10(e)(2). At any time after enrollment in the Fee-For-Service American Indian Health Program, a Member may contact AHCCCS and request placement into an AIMH. If the Member contacts AHCCCS to request assignment to a Contractor as his or her AIMH, AHCCCS will notify the Contractor.
2.5. The Contractor will maintain forms, in both electronic and paper formats, that an individual may complete to enroll or disenroll with the Contractor, or select a new AIMH. The Contractor must use the forms approved by AHCCCS that are available on AHCCCS’ website.
2.5.1. AHCCCS will ensure that the template enrollment and disenrollment forms comply with 42 C.F.R. § 438.10(e) (2) by including the following: information about enrolling and disenrolling at will; the basic features of managed care; the populations included and excluded from the AIMH program; the benefits of the AIMH program including the Contracto...
Assignment of Members. Practitioner agrees to accept new Members, including existing patients who wish to join Health Plan, so long as his/her practice is open to other patients. Notwithstanding the foregoing, Practitioner may close his/her practice to new Members at any time after assigned Health Plan Membership reaches 300 Members. Practitioner shall provide sixty (60) days notice to Health plan prior to closing his or her practice to new Members. Such notice shall be provided (a) by certified mail, return receipt requested or (b) by overnight courier and shall be deemed given upon documented receipt. Practitioner shall ensure that his/her total patient population conforms to reasonable quality-of-care capacity limitations.
Assignment of Members. The Chief of each Agency shall assign at least one Officer to participate as a member of the Task Force for all scheduled operations. Assignments may be ongoing or may be made on a single operation basis at the discretion of the assigning Chief. All members assigned to the Task Force shall be non-probationary Officers in good standing within the assigning Agency.
Assignment of Members. During the term of this Agreement, PacifiCare shall include Medical Group's name in all materials provided to Members, potential Members or purchasers of group coverage that list Participating Providers in the Service Area. Until this Agreement is terminated, Members shall be permitted to select Medical Group as their Primary Care Physician and such selections shall be honored by PacifiCare, subject to Section 12.2; provided, however, that PacifiCare shall not be required to permit new Members to select Medical Group if Medical Group has failed to comply with a Conformance Request based on capacity, poor access, poor administrative operations or quality of care concerns within a reasonable period of time after receipt of such Conformance Request. PacifiCare shall notify Medical Group before suspending or limiting selection of Medical Group or any Medical Group Physician by new Members.
Assignment of Members. If a Member does not select a Primary Care Physician at the time of application or enrollment, BCBSTX may assign Member to a Primary Care Physician. If BCBSTX elects to assign Member, the assignment shall be made in a manner that results in a fair and equal distribution of Members among Primary Care Physicians. If applicable, BCBSTX shall notify Medical Group of Designated Member’s assignment within thirty (30) working days of the assignment.
Assignment of Members. If Provider is a Primary Medical Provider and if Provider’s practice is open to any patients, Provider agrees to accept Plan Members in the amounts specified in Section 2.16 of this Agreement. Provider must provide at least ninety (90) days written notice to Plan before closing Provider’s practice to all new Members.
Assignment of Members. Nothing in this Agreement shall be construed to acquire the HMO to assign any minimum or maximum number of Members to the PROVIDER-MANAGER or the PROVIDER-MANAGER's PCPS.