Influencing or Attempting to Influence the Beneficiary Clause Samples
Influencing or Attempting to Influence the Beneficiary. 1. The ACO shall not, and shall require its Participant Providers, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities or Marketing Activities to not, directly or indirectly, commit any act or omission, nor adopt any policy, that coerces or otherwise influences a Beneficiary’s decision to complete or not complete a Voluntary Alignment Form or a ▇▇▇▇▇▇▇▇▇▇.▇▇▇, ▇▇▇▇▇▇▇▇.▇▇▇, or any successor site designation, including but not limited to the following:
a. Completing a Voluntary Alignment Form on behalf of the Beneficiary;
b. Designating a primary clinician on ▇▇▇▇▇▇▇▇▇▇.▇▇▇, ▇▇▇▇▇▇▇▇.▇▇▇, or any successor site on behalf of the Beneficiary;
c. Including the Voluntary Alignment Form and instructions with any other materials or forms, including but not limited to materials requiring the signature of the Beneficiary; and
d. Withholding or threatening to withhold medical services or limiting or threatening to limit access to care.
2. The ACO may instruct its Participant Providers and Preferred Providers to answer questions from Beneficiaries regarding Voluntary Alignment, but must prohibit Participant Providers and Preferred Providers from completing a Voluntary Alignment Form or designating a clinician on ▇▇▇▇▇▇▇▇▇▇.▇▇▇, ▇▇▇▇▇▇▇▇.▇▇▇, or any successor site on behalf of the Beneficiary.
3. The ACO shall require its Participant Providers and Preferred Providers to instruct Beneficiaries to call the ACO for questions about how to make changes to a Voluntary Alignment Form or how to designate a primary clinician on ▇▇▇▇▇▇▇▇▇▇.▇▇▇, ▇▇▇▇▇▇▇▇.▇▇▇, or any successor site.
Influencing or Attempting to Influence the Beneficiary.
(a) The ACO, Next Generation Participants, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities are prohibited from providing gifts or other remuneration to Beneficiaries as inducements for influencing a Beneficiary’s decision to complete or not complete a Voluntary Alignment Form.
(b) The ACO, Next Generation Participants, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities shall not, directly or indirectly, commit any act or omission, nor adopt any policy, that coerces or otherwise influences a Beneficiary’s decision to complete or not complete a Voluntary Alignment Form, including but not limited to the following:
i. Offering of anything of value to the Beneficiary;
ii. Including the Voluntary Alignment Form and instructions with any other materials or forms, including but not limited to materials requiring the signature of the Beneficiary; and
iii. Withholding or threatening to withhold medical services or limiting or threatening to limit access to care.
(c) For purposes of Section V.H.2, any items or services provided in violation of this Section V.C.2 will not be considered to have a reasonable connection to the medical care of the Beneficiary.