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Docusign Envelope lD: 7 4E827C5-FAB8-8084-827C-41 4AD59920A6
<br />2.3
<br />limitations. Provider is fiee to communicate any and all treatment options to Members regardless of
<br />benefit coverage limitations.
<br />Promotlonnl and Marheting Activities. At the request of Health Plan, Provider shall (l) display Health
<br />Plan promotional materials in its offices and facilities as practical, and (2) shall cooperate with and
<br />participate in all reasonablo Health Plan's marketing efforts. Provider shall not use Health Plan's name in
<br />any advertising or promotional materials without the prior written permission of Health Plan.
<br />As applicable, Provider shall not directly or indirectly conduct door-to-door telephonic, or other cold-call
<br />marketing of enrollment (42 CFR 438,104@)(l)(v)),
<br />Nondiscrimination.
<br />&. Enrollment. Provider shall not diffetentiate or discriminate in providing Covered Services to
<br />Membem because of race, color, religion, national origirl ancestry, &Ea, sex, marital status, sexual
<br />orientation, physical, sensory, or merrtal handicap, socioeconornic status, ol participation in publicly
<br />financed programs of health care seruices. Provider shall render Covered Services to Members in the
<br />same location, in the same rnanner, in accordance with the same standards, and within the sarne time
<br />availability regardless of payor.
<br />b, Employment. Provider shall not differentiate or discriminate against any employee or applicant for
<br />employment, with respect to their hire, tenure, terms, conditions or privileges of employment, or any
<br />matter direotly or indirectly related to employmento because of race, color, religion, national origin,
<br />ancestry, age, sex, height, weight, marital status, physical, sensory, or mental disability unrelated to
<br />the individuat's ability to perform the duties of the particular job or position.
<br />Recordkeeping.
<br />a, Maintainlng Member Medlcal Record. Provider shall rnaintain a medical record for each Member
<br />to whom Provider tenders health care services. Provider shall open each Member's medical record
<br />upon the Member's first encounter with Provider. The Member's medical record shall contain all
<br />informaXion required by Laws, generally accepted and prevailing professional pmctice, applicable
<br />govemment sponsored health programs, and all Health Plan policies and procedures. Plovider shall
<br />retain all such recorcls for at least ten (10) years.
<br />b. Confidentinlity of Member Ilealth Informatlon. Provider shall comply with all Laws, Health
<br />Plan's policies and procedures, and governntent sponsored progmm requirements regarding privacy
<br />and confidentiality of Members' health information and medical records, inoluding mental health
<br />records. Provider shall not disclose or use Member names, addresses, social security numbers,
<br />identities, other personal information, treatment modalities, or medical records without obtaining
<br />appropriate authorization to do so. This provision shall not affect or limit Provider's obligation to
<br />malce available medical records, encounter data and information concerning Member care to Health
<br />Plan, any authorized state or federal agency, or other Providers ofhealth care upon authorized
<br />referral.
<br />c. HIPAA. To the extent Provider is considered a covered entity under the Health Insurance Portability
<br />and Accountability Act of 1996 ("HIPAA"), Provider shall comply with all provisions of HIPAA
<br />including, but not limiXed to, provisions addressing privacy, security, and confidentiality.
<br />d. Delivery of Patient Care fnformation. Provider shall promptly deliver to Health Plan, upon request
<br />and/or as may be required by Laws, Health Plan's policies and procedures, applicable government
<br />sponsored health programs, Health Plan's contracts with the government agencies or third party
<br />payers, any information, statistical data, encounter dat4 or patient treatment information pertaining to
<br />Members served by Provider, including but not limited to, any and all information requested by
<br />Health Plan in conjunction with utilization review and management, grievances, peer review, HEDIS
<br />Studies, Heatth Plan's Quality Improvement Program, Consumer Assessment of Health Plans
<br />("CAHPS"), or Claims payment. Health Plan will not pay copying fees when records are requested
<br />for any ofthe above listed programs. Provider shall fuither provide direct access to said patient care
<br />2,4
<br />2.5
<br />MrtwPRov22.3 MI'IWPS A./Rev is e d J an 2024 Page 6 of25
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