Pennsylvania Government Programs Regulatory Requirements Appendix Sample Contracts
DOWNSTREAM PROVIDERPennsylvania Government Programs Regulatory Requirements Appendix • April 7th, 2021
This Appendix applies with respect to the provision of health care services that Provider provides directly to Covered Persons through Health Plan’s (as defined herein) products or benefit plans under the State of Pennsylvania Medical Assistance managed care program (the “Medical Assistance Program”) and the Children’s Health Insurance Program (“CHIP”) (each a “State Program” and collectively, the “State Programs”) as governed by the State’s designated regulatory agencies. Provider has agreed to provide Covered Services to Covered Persons who receive their coverage pursuant to contracts between the State and Health Plan (the “State Contracts” as defined herein). The State contracts and applicable State and federal law require that the provisions contained in this Appendix be part of the Agreement. In the event of a conflict between this Appendix and other appendices or any provision of the Agreement, the provisions of this Appendix shall control except with regard to benefit contracts
DOWNSTREAM PROVIDERPennsylvania Government Programs Regulatory Requirements Appendix • February 11th, 2025
The requirements of this Appendix apply to benefit plans sponsored, issued or administered by UnitedHealthcare of Pennsylvania, Inc. (referred to herein as “United”), an Affiliate of UnitedHealthcare Insurance Company, for Customer who are eligible to receive health care benefits under the State of Pennsylvania Medical Assistance managed care program (the “Medical Assistance Program”) and the Children’s Health Insurance Program (“CHIP”) Program (each a “State Program” and collectively, the “State Programs”) as governed by the State’s designated regulatory agencies. In the event of a conflict between this Appendix and other appendices or any provision of the Agreement, the provisions of this Appendix shall control except with regard to benefit plans outside the scope of this Appendix or unless otherwise required by law. In the event United is required to amend or supplement this Appendix as required or requested by the State, Provider agrees that United shall be permitted unilaterally t