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Supplier agreements should establish as a general principle the need to comply with federal, regional, local or other laws by the supplier, as well as the health plan`s own guidelines and procedures. Specific laws can be prosculated, for example. B the Health Insurance Portability and Accountability Act (HIPAA), as the amended Health Insurance Act. 5.03 Full Agreement and Séverability: This agreement, along with all the annexes and exhibits that will be included in this Agreement and with all the duly amended amendments to that agreement, constitutes the entire agreement of the parties and replaces all previous agreements and agreements reached by the parties with respect to the purpose of this agreement. The provisions of this agreement are independent and separate. If a provision is found to be invalid or unenforceable, it will not render another provision invalid or unenforceable, unless that provision substantially alters the responsibilities of the parties under this agreement. Under state health insurance laws, health plans must maintain an appropriate number of primary and specialized health care providers in defined geographic areas to ensure that insured members have access to the necessary care. Health plans spend enormous resources to manage the adequacy of their networks of health care providers in order to remain in compliance with state rules. Finally, the offer agreement should make it clear when the claimant should inform the health plan – preferably immediately or without delay – of some significant changes in the claimant`s personal or professional life that, by their nature, raise concerns about the health or safety of plan members. This allows the health plan to quickly make a decision on whether the provider will continue to participate in the health plan provider network. Major changes may include: 6.02. Protection of confidential information: As a health care provider with access to confidential information, the provider undertakes to behave in strict compliance with applicable legislation, including, but not exclusively, laws that protect and preserve the confidentiality of confidential information. The provider is required to read and comply with these requirements and to read and respect all staff who work with the supplier and have access to confidential information.
Violation of any of these requirements is disciplinary for the supplier, which may include, among other things, loss of participation in managed care plans, loss of privileges for access to confidential information, losses or privileges in Intermountain Healthcare institutions and legal liability. 2.04 Occupational Relations: The provider understands that neither SelectHealth nor Affiliated Managed Care Plans practice medicine and that they are not allowed to direct the treatment of patients. As SelectHealth and Affiliated Managed Care Plans establish practical protocols, usage management policies or quality improvement standards, these elements are not a substitute for the vendor`s professional judgment. The provider has a professional responsibility to establish an appropriate and independent provider – patient relationships with members to whom the provider provides covered services. The provider is responsible for providing appropriate medical care to members under its responsibility, regardless of the requirements of this agreement, a health care program, payment agreement or use management provision by SelectHealth or a related care management plan.