Common use of Alternative Delivery Systems Clause in Contracts

Alternative Delivery Systems. The State Health Plan shall also provide 33 hospice care and birthing center care benefits to employees and enrolled 34 family members. To be eligible for the hospice care benefit, the covered 35 individual must be diagnosed as terminally ill by the attending physician 36 and/or hospice medical director with a medical prognosis of six months or 37 less life expectancy. Covered hospice benefits include physical, 38 occupational, and speech language therapy; home health aid services; 39 medical supplies; and nursing care. Covered hospice benefits are not 40 subject to the individual deductible or any co-payment and will be paid 41 only for services rendered by federally certified or state licensed hospices. 42 Hospice services covered under the SHP will be continued. Details of the 43 covered service will be provided in the SHP booklet. Both hospice care 44 and birthing center care shall be available to employees at their option in 1 lieu of hospital confinement. Birthing center care is covered under the 2 delivery and nursery care benefit set forth in Appendix K.

Alternative Delivery Systems. The State Health Plan shall also provide 33 15 hospice care and birthing center care benefits to employees and enrolled 34 16 family members. To be eligible for the hospice care benefit, the covered 35 17 individual must be diagnosed as terminally ill by the attending physician 36 18 and/or hospice medical director with a medical prognosis of six months or 37 19 less life expectancy. Covered hospice benefits include physical, 38 20 occupational, and speech language therapy; home health aid services; 39 21 medical supplies; and nursing care. Covered hospice benefits are not 40 subject 22 to the individual deductible or any co-payment and will be paid 41 only for 23 services rendered by federally certified or state licensed hospices. 42 Hospice 24 services covered under the SHP will be continued. Details of the 43 covered 25 service will be provided in the SHP booklet. Both hospice care 44 and birthing 26 center care shall be available to employees at their option in 1 lieu of hospital 27 confinement. Birthing center care is covered under the 2 delivery and nursery 28 care benefit set forth in Appendix K.K. 29