Orange County NC Website
Browse       Search
<br /> <br /> Page 45 of 48 <br />include an effective date for the proposed Amendment. Health Care Provider receiving a proposed Amendment shall <br />be given at least sixty (60) days from the date of receipt to object to the proposed Amendment. The proposed <br />Amendment shall be effective upon Health Care Provider failing to object in writing within sixty (60) days. If Health <br />Care Provider objects to a proposed Amendment, then the proposed Amendment is not effective and the initiating <br />Insurer shall be entitled to terminate the Contract upon sixty (60) days written notice to Health Care Provider. Nothing <br />in this Part prohibits Health Care Provider and Insurer from negotiating Contr act terms that provide for mutual <br />consent to an Amendment, a process for reaching mutual consent, or alternative notice contacts. (Attachment G- <br />1.x.iii) <br /> <br />34. Exemption from Notification of Emergent or Observation Admissions. For all contracts with a hospital who <br />attests live in production status with North Carolina HealthConnex, the contract shall indicate the provider is <br />exempted from reporting any emergent or observation admissions to the PHP, and that the PHP shall utilize <br />NC*Notify for such admission information. Except the exemption from notification shall not apply when the hospital <br />has technical or data quality issues, in which case the hospital shall notify the PHP directly. <br /> <br />35. Incident Reporting Procedures and Peer Review Process. Providers rendering Covered Services to Members <br />or Covered Persons shall report critical incidents to Health Plan and to the Department in accordance with all <br />applicable Laws and Governmental Authority’s mandated requirements and procedures for reporting such incidents, <br />and Providers shall cooperate with Health Plan in its investigation of critical incidents. Notwithstanding the foregoing, <br />nothing in this Agreement shall require Providers who participate in Health Plan’s peer review, medical review, or <br />quality review committees to take any actions that are contrary to the confidentiality and liability protections afforded <br />such Providers under N.C. Gen. Stat. §§90-21.22A, 131E-76, or 131E-95, as applicable. <br /> <br />36. Patient Choice Counseling Limitations. Nothing in this Agreement shall be construed to limit the ability of <br />Provider to inform its patients of Provider or its Contracted Provider’s participation or non-participation in specific <br />Medicaid Managed Care health plans. Provider may also inform its patients of the categories of Medicaid participants <br />remaining in North Carolina Medicaid Direct. <br />DocuSign Envelope ID: 2EC1F0FD-FAF9-4B42-B52E-D419F55A6210