CONTRACT TERMINATION

In the event that the Centers for Medicare and Medicaid Services (CMS) decides to terminate or not renew its contract with Partnership Health Plan, Inc. (PHP) we will notify you of the termination by mail at least 30 days before the effective date of the termination. We will also notify the general public of the termination at least 30 days before the effective date of the termination by publishing a notice in one or more newspapers that are in general circulation in each of the counties that we serve. If CMS terminates the contract with PHP due to violations of such a nature that the contract is terminated immediately, CMS will notify you in writing of its decision to terminate PHP’s contract. CMS will also notify you of alternative options for obtaining qualified prescription drug coverage, including alternative free standing Prescription Drug Programs and Medicare Advantage Prescription Drug programs in your geographic area. CMS will notify the general public by publishing the notice of termination in local newspapers no later than 30 days prior to the termination.

In the event that PHP decides to terminate the contract with CMS because CMS fails to carry out the terms of the contract, PHP will notify you at least 60 days before the termination effective date. We will send you a written notice that describes alternatives available for obtaining qualified prescription coverage within the service area, including alternative free standing Prescription Drug Programs, Medicare Advantage-Prescription Drug programs, and original Medicare. PHP will also publish a notice in local newspapers in the service area, at least 60 days prior to contract termination.

In either instance, PHP will ensure that there is timely transfer of data and files.

In the event the contract with the Wisconsin Department of Health and Family Services (DHFS) is terminated, DHFS will notify all members of the date of termination and process by which the members will continue to receive contract services. In addition, Partnership Health Plan, Inc. will assist members in their transition to fee for service (FFS).