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Non-Discrimination by Contracted Practitioners

Corporate Procedure

Policy Name

Non-Discrimination by Contracted Practitioners

Policy Number

PNM21pr

Policy Manual Section

 

Related Policies

 

Issuing Department

Provider Network Management

Approving Authority

Provider Network Management

Original Policy Date

03/13/08

Revision Date(s)

03/09

Review Date(s)
(No revisions)

 

Replaces Policy Number

 

I.    POLICY PURPOSE AND STATEMENT OF INTENT

  • “HealthPlus” shall refer to HealthPlus of Michigan, Inc. and its affiliated entities, HealthPlus Partners, Inc., HealthPlus Options, Inc., and HealthPlus Insurance Company, unless otherwise stated.
  • To define the process of ensuring that contracted practitioners are informed of the nondiscrimination policy applicable in the care and treatment of HealthPlus members.
  • To ensure that practitioners have in place non-discrimination policies and procedures.
  • To ensure that practitioners do not discriminate in the care and treatment of HealthPlus members.

II.   Procedure Statement

  • HealthPlus establishes non-discrimination standards for contracted practitioners who treat and/or serve HealthPlus members.
  • HealthPlus informs practitioners of the non-discrimination standards by including specific language in its contracts, by publishing articles in the practitioner and office manager newsletters, and by including the procedure in the Provider Manual.
  • Compliance with the standards is monitored by identification and investigation of member complaints regarding discrimination.

III.  Practitioner Responsibility Standards

All contracted practitioners who provide services to HealthPlus members will establish and maintain Non-Discrimination Policies or Procedures that address the following:

  • Practitioner will furnish Covered Services to any Enrollee at the same level, scope and quality of care provided to all other patients and will not discriminate against any Enrollee based upon the frequency or extent of Covered Services needed. Practitioners will not discriminate because of age, sex, health status/medical history, race, religion, ethnicity, marital status, national origin, height, weight, mental or physical disability, sexual orientation, genetic information, claims experience, Medicaid status, insurance, or evidence of insurance eligibility.

IV. Implementation

  • The Non-discrimination Procedure is included in the Provider Manual.
  • The Non-discrimination Procedure is mailed to all Practitioners as an update to the currently existing Provider Manual.
  • The Non-discrimination language is incorporated into all new and existing contracts upon renewal.
  • Reminder articles regarding discrimination are periodically published in the practitioner and office manager newsletters.
  • On an annual basis HealthPlus evaluates member complaints about discrimination to identify and investigate any significant issues.
  • Administrative staff is responsible for establishing, publishing, and maintaining procedures and work rules to implement this procedure.

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