Common use of Prohibited Punitive Action Against the Provider Clause in Contracts

Prohibited Punitive Action Against the Provider. Contractor must ensure that punitive action is not taken against the provider who either requests an expedited resolution or supports an Enrollee’s appeal. Further, Contractor may not prohibit, or otherwise restrict, a health care professional acting within the lawful scope of practice, from advising or advocating on behalf of an Enrollee who is his or her patient: for the Enrollee’s health status, medical care, or treatment options, including any alternative treatment that may be self-administered, for any information the Enrollee needs in order to decide among all relevant treatment options, for the risks, benefits, and consequences of treatment or non-treatment, for the Enrollee’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions.

Prohibited Punitive Action Against the Provider. Contractor must ensure that punitive action is not taken against the provider Provider who either requests an expedited resolution or supports an Enrolleea Member’s appealAppeal. Further, Contractor may not prohibit, or otherwise restrict, a health care professional acting within the lawful scope of practice, from advising or advocating on behalf of an Enrollee a Member who is his or her patient: for the EnrolleeMember’s health status, medical care, or treatment options, including any alternative treatment that may be self-self- administered, for any information the Enrollee Member needs in order to decide among all relevant treatment options, for the risks, benefits, and consequences of treatment or non-treatment, for the EnrolleeMember’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions.

Prohibited Punitive Action Against the Provider. Contractor must ensure that punitive action is not taken against the provider who either requests an expedited resolution or supports an Enrolleea Member’s appeal. Further, Contractor may not prohibit, or otherwise restrict, a health care professional acting within the lawful scope of practice, from advising or advocating on behalf of an Enrollee a Member who is his or her patient: for the EnrolleeMember’s health status, medical care, or treatment options, including any alternative treatment that may be self-self- administered, for any information the Enrollee Member needs in order to decide among all relevant treatment options, for the risks, benefits, and consequences of treatment or non-treatment, for the EnrolleeMember’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions.

Prohibited Punitive Action Against the Provider. Contractor must ensure that punitive action is not taken against the provider who either requests an expedited resolution or supports an Enrolleea Member’s appealAppeal. Further, Contractor may not prohibit, or otherwise restrict, a health care professional acting within the lawful scope of practice, from advising or advocating on behalf of an Enrollee a Member who is his or her patient: for the EnrolleeMember’s health status, medical care, or treatment options, including any alternative treatment that may be self-self- administered, for any information the Enrollee Member needs in order to decide among all relevant treatment options, for the risks, benefits, and consequences of treatment or non-treatment, for the EnrolleeMember’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions.

Prohibited Punitive Action Against the Provider. Contractor must ensure that punitive action is not taken against the provider Provider who either requests an expedited resolution or supports an Enrolleea Member’s appealAppeal. Further, Contractor may not prohibit, or otherwise restrict, a health care professional acting within the lawful scope of practice, from advising or advocating on behalf of an Enrollee a Member who is his or her patient: patient for the EnrolleeMember’s health status, medical care, or treatment options, including any alternative treatment that may be self-self- administered, for any information the Enrollee Member needs in order to decide among all relevant treatment options, for the risks, benefits, and consequences of treatment or non-treatment, for the EnrolleeMember’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions.

Prohibited Punitive Action Against the Provider. Contractor must ensure that punitive action is not taken against the provider who either requests an expedited resolution or supports an Enrolleea Member’s appeal. Further, Contractor may not prohibit, or otherwise restrict, a health care professional acting within the lawful scope of practice, from advising or advocating on behalf of an Enrollee a Member who is his or her patient: patient for the EnrolleeMember’s health status, medical care, or treatment options, including any alternative treatment that may be self-self- administered, for any information the Enrollee Member needs in order to decide among all relevant treatment options, for the risks, benefits, and consequences of treatment or non-treatment, for the EnrolleeMember’s right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions.

Prohibited Punitive Action Against the Provider. Contractor must ensure that punitive action is not taken against the provider Provider who either requests an expedited resolution or supports an Enrolleea Member’s appeal. Further, Contractor may not prohibit, or otherwise restrict, a health care professional acting within the lawful scope of practice, from advising or advocating on behalf of an Enrollee enrollee who is his or her patient: for the Enrollee’s enrollee's health status, medical care, or treatment options, including any alternative treatment that may be self-administered, for any information the Enrollee enrollee needs in order to decide among all relevant treatment options, for the risks, benefits, and consequences of treatment or non-treatment, for the Enrollee’s enrollee's right to participate in decisions regarding his or her health care, including the right to refuse treatment, and to express preferences about future treatment decisions.