Common use of Policies and Procedures for Core Functions Clause in Contracts

Policies and Procedures for Core Functions. 2.3.2.8.1. The Contractor shall develop, maintain, and provide to EOHHS upon request, policies and procedures for all core functions necessary to manage the One Care eligible and enrolled population effectively and efficiently and meet the requirements outlined in this Contract. All policies and procedures requiring EOHHS approval shall be documented and shall include the dates of approval by EOHHS. 2.3.2.8.2. These policies and procedures shall include, but are not limited to, the following topics: 2.3.2.8.2.1. Response to violations of Enrollees' privacy rights by staff, Providers, or Material Subcontractors; 2.3.2.8.2.2. Non-discrimination of Enrollees; 2.3.2.8.2.3. Non-restriction of Providers advising or advocating on an Enrollee's behalf; 2.3.2.8.2.4. Enrollee cooperation with those providing health care services; 2.3.2.8.2.5. Marketing activities that apply to the Contractor, Providers, and Material Subcontractors, including both Medicare and Medicaid activities, as well as the Contractor's procedures for monitoring these activities; 2.3.2.8.2.6. Cost-sharing by Enrollees; 2.3.2.8.2.7. Advance directives;

Policies and Procedures for Core Functions. 2.3.2.8.1. The Contractor shall develop, maintain, and provide to EOHHS upon request, policies and procedures for all core functions necessary to manage the One Care SCO eligible and enrolled population effectively and efficiently and meet the requirements outlined in this Contract. All policies and procedures requiring EOHHS approval shall be documented and shall include the dates of approval by EOHHS. 2.3.2.8.2. These policies and procedures shall include, but are not limited to, the following topics: 2.3.2.8.2.1. Response to violations of Enrollees' privacy rights by staff, Providers, Providers or Material Subcontractors; 2.3.2.8.2.2. Non-discrimination of Enrollees; 2.3.2.8.2.3. Non-restriction of Providers advising or advocating on an Enrollee's behalf; 2.3.2.8.2.4. Enrollee cooperation with those providing health care services; 2.3.2.8.2.5. Marketing activities that apply to the Contractor, Providers, and Material Subcontractors, including both Medicare and Medicaid activities, as well as the Contractor's procedures for monitoring these activities; 2.3.2.8.2.6. Cost-sharing by Enrollees; 2.3.2.8.2.7. Advance directives;