Beneficiary Rights and Responsibilities
Beneficiary Rights and Responsibilities OneCare and its network fully supports and complies with all applicable state and federal laws regarding member rights, including the following:
Applicable Statute References:
The right to receive information in accordance with 42 CFR 438.10, which relates to informational materials;
The right to be treated with respect and with due consideration for his or her dignity and privacy;
The right to receive information on available treatment options and alternatives, presented in a manner appropriate to the member’s condition and ability to understand;
The right to participate in decisions regarding his or her health care, including the right to refuse treatment;
The right to be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other federal regulations on the use of restraints and seclusion;
The right to request and receive a copy of his or her medical records, and request that they
The right to be furnished health care services in accordance with 42 CFR 438.206 through 438.210, which relate to service availability, assurances of adequate capacity and services, coordination and continuity of care, and coverage and authorization of services.
Per Rule 5.000: Oversight of Accountable Care Organizations, the Green Mountain Care Board requires the ACO to provide enrollees with a written, plain language notice that they are attributed to the ACO. Letters are sent either by OneCare or by the payer to enrollees. The letters contain information to contact OneCare, their Insurance provider and Health Care Advocate.