When a contract with a provider or facility is terminated (including expiry or nonrenewal, but not termination for quality failure or fraud), benefits for that provider end because of changed participation terms, or the plan's contract with its issuer ends, the plan or issuer must notify each enrollee who is a continuing care patient of the provider (undergoing treatment for a serious and complex condition, institutional or inpatient care, scheduled nonelective surgery with postoperative care, pregnancy care, or terminal illness treatment) on a timely basis of the termination and of the right to elect transitional care; must give an opportunity to notify the plan of the need for transitional care; and must allow the patient to continue benefits under the same terms for the course of treatment from that provider for 90 days from the notice or until the patient is no longer a continuing care patient, whichever is earlier.
The graph holds this control, the 0 it maps to, and the evidence behind each claim, over MCP and REST.