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5 11/2005
Responsibilities of the Hospital
A hospital must promptly notify BCBSGa/BCBSHP of:
♦ Any change or notification of possible change in its state licensure,
accreditation status by JCAHO or Medicare certification;
♦ Any change in its ownership or business address;
♦ Any legal or governmental action or any other problem or situation which might
impair the ability of HOSPITAL to carry out its duties and obligations under this
Agreement including, but not limited to, employee strikes or walkouts, financial
insolvency, or damage to the physical plant resulting in any interruption in
medical services;
♦ Any written complaint, claim or suit or threat of legal action by a member
against the hospital or a member of the hospital’s medical staff;
♦ Any action taken by hospital or its medical staff against a physician;
♦ Any change or notification of possible change in professional licensure of staff
member or a physician; and
♦ Any change or notification of possible change in hospital’s comprehensive
general or professional liability insurance limits. If hospital reserves funds to
meet the insurance requirements, hospital shall notify BCBSGa/BCBSHP of any
change in the reserves.
A hospital must provide at least ninety (90) days prior written notice of the intention
to add, limit or delete any facility or service. This would include the addition of any
freestanding facilities.
Hospital Based Physicians
Hospital based physicians include emergency room physicians, radiologists,
pathologists and anesthesiologists. These physicians have a contractual relationship
with the hospital.
The hospital shall take any action necessary to ensure that its contracted hospital-
based physicians cooperate with, participate in and are bound by the BCBSGa/BCBSHP
utilization and quality management programs and coordinate as appropriate with the
admitting physician and PCP.