Provider Discrimination. The Contractor may not discriminate with respect to the participation, reimbursement, or indemnification of any provider who is acting within the scope of his or her license or certification under applicable State law, solely on the basis of that license or certification. If the Contractor declines to include an individual or groups of providers in its provider network, it will provide the affected providers with written notice of the reason for its decision.
Appears in 19 contracts
Sources: Contract for Medicaid Managed Care Services, Medicaid Managed Care Services Agreement, Contract for Medicaid Managed Care Services
Provider Discrimination. The Contractor may not discriminate with respect to the participation, reimbursement, or indemnification of any provider who is acting within the scope of his or her license or certification under applicable State law, solely on the basis of that license or certification. If Contractor must comply with the Contractor declines to include an individual or groups of providers requirements as specified in its provider network, it will provide the affected providers with written notice of the reason for its decision42 C.F.R. § 438.214.
Appears in 4 contracts
Sources: Medicaid Rite Smiles Program Agreement, Agreement for the Medicaid Rite Smiles Program, Agreement for the Medicaid Rite Smiles Program
Provider Discrimination. The Contractor may not discriminate with respect to the participation, reimbursement, or indemnification of any provider who is acting within the scope of his or her license or certification under applicable State law, solely on the basis of that license or certification. If the Contractor declines to include an individual or groups of providers in its provider network, it will provide the affected providers with written notice of the reason for its decision.
Appears in 2 contracts
Sources: Contract for Medicaid Rite Smiles Program, Medicaid Managed Integrated Adult Care Services Agreement
Provider Discrimination. The Contractor may not discriminate with respect to the participation, reimbursement, or indemnification of any provider who is acting within the scope of his or her license or certification under applicable State law, solely on the basis of that license or certification. If Contractor must comply with the Contractor declines to include an individual or groups of providers requirements as specified in its provider network, it will provide the affected providers with written notice of the reason for its decision42 CFR § 438.214.
Appears in 2 contracts
Sources: Medicaid Rite Smiles Program Agreement, Medicaid Program Agreement
Provider Discrimination. The Contractor may shall not discriminate with respect to the against any Provider (limiting their participation, reimbursement, reimbursement or indemnification of any provider indemnification) who is acting within the scope of his or her license or certification under applicable State law, solely on the basis of that license or certification. If the Contractor declines to include an individual or groups of providers in its provider network, it will provide the affected providers with written notice of the reason for its decisionSee: 42 C.F.R. § 438.12(a)(1); 42 C.F.R. § 457.1208. {From CMSC E.2.01}.
Appears in 1 contract
Sources: Iowa Health Link Contract
Provider Discrimination. The Contractor may not discriminate with respect to the participation, reimbursement, or indemnification of any provider who is acting within the scope of his or her license or certification under applicable State law, solely on the basis of that license or certification. If Contractor must comply with the Contractor declines to include an individual or groups of providers requirements as specified in its provider network, it will provide the affected providers with written notice of the reason for its decision42 CFR 438.214.
Appears in 1 contract
Sources: Medicaid Agreement